Self Assessment
At Pine Grove we specialize in triaging patients into the most appropriate program suited for your needs. The self assessment allows a potential patient to review potential signs and symptoms of chemical addiction, sex addiction and/or eating disorders. If you answer “yes” to any of these questions, we encourage you to contact our Admissions office for a further assessment with a trained clinical staff member. Our number is 1-888-574-HOPE (4673). The Admissions office is open from 8 am to 8 pm CST Monday-Friday and 8 am – 5 pm CST on weekends.
Eating Disorder
- Have you ever been on a severely restrictive diet such as a liquid diet or a fast?
- Do you have episodes of eating large amounts of food in a discrete period of time, i.e. binge eating?
- Have you ever self-induced vomiting to control your weight or get rid of the food you have eaten?
- Have you ever used diet pills?
- Have you ever used laxatives to control your weight or “get rid” of food?
- Have you ever used diuretics to control your weight?
- Have you ever used exercise to control your weight?
- Have you ever used other methods to purge/control your weight (i.e. thyroid hormone, insulin, enemas, surgery, jaw wiring)?
- Are you preoccupied or obsessed about your body weight and size?
- Have you ever been hospitalized or treated in the emergency room for physical complications from your eating disorder (i.e. electrolyte imbalance, dehydration)?
Sexual Addiction Screening
- Have you experienced difficulty resisting impulses to engage in sexual behaviors?
- Have you tried to stop, control, or reduce these behaviors?
- Have you thought of killing yourself because of your sexual behaviors?
- Have you experienced legal consequences due to your sexual behaviors?
- Do you spend large amounts of time trying to get sex or recover from being sexual?
- Do you ever feel anxious or irritable if you are unable to engage in sexual behaviors?
- Do you worry that others will find out about your sexual activities?
- Do you often find yourself preoccupied with sexual thoughts?
- Do you feel that your sexual behavior is not normal?
- Are you experiencing family problems as a result of your behaviors?
Chemical Dependency Questions
- Do you feel that you have a problem with Alcohol or Drugs?
- Are you ever preoccupied with thoughts of drinking or using?
- Do you drink or use alone?
- Do you drink or use regardless of the consequences?
- If you drink, can you stop after one glass? Could you stop drinking if you chose to?
- Have you risked loosing your job or family because of your use?
- Do you avoid social situations where you cannot drink or use?
- Do you hide your use or lie about the extent of your use?
- Are you uncomfortable in social situations without using?
- Do you use drinking or using as a coping mechanism?
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