Parent Survey

 "Brittany began sneaking out...seeking inappropriate relationships...experimenting with alcohol and drugs..
..running away...we turned to Project PATCH. We will be eternally grateful to Project PATCH for their
devoted work and guidance bringing back home
a new and delightful daughter!"
Bonnie Crawford, Mom

Please use this tool to help determine whether your child can be helped by the Project PATCH Residential Treatment Program. 

Choose from the following: 0=Never, 1=Sometimes, 2=Frequently, 3=Always.


When you have rated all 40 statements, add up the numbers to determine a score for your child (for scoring see below)-there are no right or wrong answers.

Academics

  • My child doesn't enjoy school
  • My child's academic performance has declined
  • My child fails classes
  • My child has excessive absences, suspensions, or expulsions
  • My child has authority problems with school staff
  • My child destroys school property
  • My child acts out physically at school

Home Life

  • My child doesn't respect parental authority
  • My child doesn't communicate or have a good relationship with parents
  • My child doesn't communicate or have a good relationship with siblings
  • My child doesn't willingly participate in family activities
  • My child doesn't accept and perform family obligations
  • My child steals from family members
  • My child destroys family property
  • My child acts out physically towards parents
  • My child acts out physically towards siblings
  • My child runs away

Spiritual Life

  • My child doesn't believe in God
  • My child believes in God but doesn't have a relationship with God
  • My child doesn't participate in spiritual activities such as youth group or church services
  • My child is angry with God
  • My child is involved with cult activities

Social

  • My child doesn't have friends
  • My child doesn't have positive friendships
  • My child cycles through friendships
  • My child doesn't act appropriately in social settings
  • My child steals from friends or peers
  • My child is involved with the juvenile justice system

Activities

  • My child gives up personal interests
  • My child doesn't have hobbies
  • My child doesn't use time constructively
  • My child seeks inappropriate social activities such as drug use
  • My child is sexually active

Behavior

  • My child is easily angered, or is argumentative
  • My child is impulsive
  • My child doesn't tell the truth, or is sneaky
  • My child makes excuses or rationalizes
  • My child blames everyone or everything else, doesn't take responsibility for choices or behavior
  • My child acts as if the world or everyone else owes them, sense of entitlement
  • My child has either threatened or attempted suicide

Scoring:

  0-30: You are experiencing typical but not abnormal teenage years.
31-73: Local community resources would be most appropriate for you and your child.  

 74 +:
 

 Please call Project PATCH for a personalized interview to determine whether Project PATCH would be an appropriate match.

We encourage your questions regarding Project PATCH. You are welcome to speak with NancyAnne Ward, Project PATCH Admissions Director,
at 360.690.8495 or send an email to patch@projectpatch.org.