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Circle Y ("Yes") or N ("No") as appropriate for all the items below. Circle Y if you've
experienced stress related to the item in the last month.
Stressors at home
Argument with parent(s) or other adult at home Y N
Conflicts with brother(s) or sister(s) Y N
Significant change in family, such as
- separation or divorce of parents Y N
- blending of two families (moving in with step-siblings) Y N
- remarriage of a parent Y N
- parent changing jobs Y N
- at-home parent gets a full-time job outside of the home Y N
Move to a new house or apartment Y N
Home remodeling; invasion of your "space" Y N
Alcohol or drug abuse by family member Y N
Physical or sexual abuse by a family member of a sibling or other Y N
Physical or sexual abuse by a family member of yourself Y N
Parent or family member becomes seriously ill Y N
Parent or family member dies Y N
A pet dies Y N
Stressors at school
Did less well in school (academically) than expected or desired Y N
Underwent educational or psychological testing Y N
Placed in special class (gifted, remedial, other) Y N
Had confrontation with teacher, coach or administrative staff Y N
Was tardy for three or more classes Y N
Was expelled from a class Y N
Received a detention Y N
Received probation for academic or behavioural problem Y N
Felt frustrated with learning Y N
Was singled out for an award or special recognition Y N
Was elected to an honoured position (captain, editor) Y N
Was accepted to or promoted on an athletic team Y N
Was eliminated from or demoted on an athletic team Y N
Incident of school vandalism occurred at your school Y N
Incident of youth violence occurred at school or neighbourhood Y N
Other disruptions in school (e.g., teacher's strike,
Y N
resignation of principal, change in class size, school closing)
Take a close look at the number of questions that you have answered YES to. Are there
some that are beyond your control? Which ones do you have some influence over? Take
some time to evaluate what you can do to handle the stress in your life. Seek out a caring
and supportive adult in your life if you need to speak with someone about your stressors.
From Fighting Invisible Tigers: A Stress Management Guide for Teens by Earl Hipp, copyright 1995. Used with
permission from Free Spirit Publishing, Minneapolis, MN; 1-800-735-7323; http://www.freespirit.com/; ALL RIGHTS
RESERVED.