In this questionnaire, which you have prepared together with your care provider, the aim is to reflect on the problems you are currently experiencing and that have made you take the step towards therapy.

These problems may be related to complaints you have, your mood, your functioning, your relationships, your sense of self-worth, etc. But perhaps you also experience other problems? We ask you to indicate for each of these problems how much it bothered you during the last 7 days, including today.