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Addiction Screening Test

When addressing an addiction, all holistic techniques begin with the same basic philosophy: people develop addictions to correct an "imbalance" within them. Addicts become stuck, unaware, and unable to deal with thoughts, feelings, and actions. Somewtimes we drink, take drugs, or eat to excess to disassociate. Holistic therapies work to restore balance by connecting mind and body.

To receive a free addiction screening, please enter your information and complete the questionnaire below.

Rate your answers as follows:

  (1) Sometimes
(2) Often
(3) Never - or I don't know

1. Has your addiction stopped being fun?
1 2 3
2. Do you ever do it alone?
1 2 3
3. Is it hard for you to imagine a life without it?
1 2 3
4. Do you find that your friends are allienated by your addiction?
1 2 3
5.  Do you partake in your addiction to avoid dealing with your problems?
1 2 3
6. Do you use your addiction to cope with your feelings?
1 2 3
7. Does your addiction let you live in a privately defined world?
1 2 3
8. Have you ever failed to keep promises you made about cutting down or controlling your addiction?
1 2 3
9. Has your addiction caused problems with memory, concentration, or motivation?
1 2 3
10. When you can't partake in your addiction, do you feel anxious or worried about how to get more?.
1 2 3
11. Do you plan your life around your addiction?
1 2 3
12.  Have friends or relatives ever complained that your addiction is damaging your relationship with them?
1 2 3
13. Does your addiction make you careless of your family's welfare?
1 2 3
14.  Does your addiction help you because you are shy with other people?
1 2 3
15. Is your addiction affecting your reputation?
1 2 3
16. Does your addiction cause you to have difficulty in sleeping?
1 2 3
17. Is your addiction jeopardizing your job or business?
1 2 3
18. Have you ever had a complete loss of memory as a result of your addiction?
1 2 3
19. Has your physician ever treated you for your addiction?
1 2 3
20. Have you ever been to a hospital or institution on account of your addiction?
1 2 3

Please enter your contact information below if you would like to be contacted about your results and possble counseling.

Name:

Telephone:

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Randi Fredricks   :::   1723 Hamilton Ave Suite D, San Jose, California, 95125   :::   408-315-0645

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This site does not provide medical advice, diagnosis, or treatment and is intended for informational purposes only. No therapeutic relationship is established by the use of this site. Randi Fredricks is a Marriage Family Therapist Intern IMF 56610 supervised by Mary Crocker Cook MFC 24835. Randi Fredricks is not licensed with the
California Bureau of Naturopathic Medicine. © 2001-2008 Randi Fredricks All rights reserved.