ADLERIAN TRAINING INSTITUTE LIFESTYLE ASSESSMENT FORM NAME DATE Family Constellation Parents (mother) (father)

Siblings (from oldest to youngest, left to right, give name, gender, and age of the children) Name Name Name Name Name

[include any miscarriages, stillbirths, early deaths, serious illness, surgeries, or major accidents; who was most like, most different, plus personal description of childhood; to whom were mom and dad closest; who played with whom, fought with whom, cared for whom]

Birth Story

Sibling Traits (see guide for trait combinations) Smart Helpful Neat Risk taker Goodness Pampered/over protected Rebel Critical Easy going Pleasing Excitement seeker Complainer Sensitive Masculine Feminine Athletic Idealistic/materialistic

Family Atmosphere Family of origins name, culture, socio-economic level, religion?

Father Current age Occupation Three adjectives to describe each

Mother

Relationship to children

How each showed affection How each disciplined How each set limits Ambitions for children Child most like each parent: In what way? How was client like each parent How was client different from each parent

Family Atmosphere (Continued) How would you describe your parents relationship?

On what did mom and dad both agree? On what and in what way did they disagree?

Who made the decisions in the family? Announced?

How were they made?

How did mom and dad fight? How did you feel when they fought? What did you do?

Which other people had influence or impact on you and your family? In what way?

Personal Development: Life Tasks Childhood Ambitions/Unusual Talents Or Achievements

Sicknesses, Surgeries, Or Accidents In Family

Friendship

School And Work Experience

Gender And Intimacy (include physical and sexual development)

Early Recollections (one time events) 1. Age

What Part Stands Out? What Were You Feeling? Your Reaction? 2. Age

What Part Stands Out? What Were You Feeling? Your Reaction?

Early Recollections (Continued) 3. Age

What Part Stands Out? What Were You Feeling? Your Reaction? 4. Age

What Part Stands Out? What Were You Feeling? Your Reaction?

Early Recollections (Continued) 5. Age

What Part Stands Out? What Were You Feeling? Your Reaction? 6. Age

What Part Stands Out? What Were You Feeling? Your Reaction?

Early Recollections (Continued) 7. Age

What Part Stands Out? What Were You Feeling? Your Reaction? 8. Age

What Part Stands Out? What Were You Feeling? Your Reaction?

Early Recollections (Continued) 9. Age

What Part Stands Out? What Were You Feeling? Your Reaction? 10. Age

What Part Stands Out? What Were You Feeling? Your Reaction?

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Early Recollections (Continued) 11. Age

What Part Stands Out? What Were You Feeling? Your Reaction? 12. Age

What Part Stands Out? What Were You Feeling? Your Reaction?

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Narrative Summary (Family Constellation, Sibling Traits, Family Atmosphere, & Personal Development/Life Tasks)

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Narrative Summary (Early Recollections)

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Narrative Summary (Assets And Strengths)

Narrative Summary (Areas For Further Growth)

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A GUIDE TO LIFESTYLE ASSESSMENT adapted from the work of Oscar Christensen by James Bitter and Clair Hawes Introduction When Alfred Adler first coined the term lifestyle to describe the dynamic movement of personality, he also created some interventions to assess an individuals lifestyle. It was Rudolf Dreikurs, however, who systematized the process of lifestyle assessment, using family constellation, family atmosphere, personal development, and early recollections to co-create a client profile. While there are many different forms for assessing lifestyle available today, all of them, properly administered, will yield approximately the same information. This form is adapted from a form used by Oscar C. Christensen, Ed.D., at the University of Arizona. Family Constellation

When you were growing up, who were your sister(s) and brother(s)? [First name(s); age(s); gender, if it is not obvious from the name] Up until you reached puberty, which of your siblings was most different from you? In what way? Up until you reached puberty, which of your siblings was most like you? In what way? If there were other siblings, what were they like? What were you like as a child? Were there any miscarriages, stillbirths, early deaths, serious illness, surgeries, or major accidents? Who played with whom? Who fought with whom? Who took care of whom? To whom did mom feel closest or who was her favorite? Why? To whom did dad feel closest or who was his favorite? Why?

Sibling Traits: Using some or all of the traits below and thinking about your sisters and brothers until all of you were out of elementary school, list the siblings in order of most to least for each trait. Smart, good grades in school? Helpful, hardest worker, achiever, highest standard of achievement? Neat, paid close attention to detail, methodical? Risk taker, confident, courageous, self-assured? Good, responsible, dependable, obedient, considerate? pampered, over-protected, spoiled, temper-tantrums? Rebel (overt and covert), punished, wanted their own way, got their own way? Critical of others, critical of self, bossy? Easy-going, sense of humor, most friends? Tried to please, actually pleased others? Excitement-seeker, daring? Complainer, fighter, revenge-seeker? Sensitive to others, easily hurt? Masculine? Feminine? Athletic? Idealistic? Materialistic?

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Family Atmosphere What is/was the family of origins name? Culture? Socio-Economic Level? Religion? What is/was your mothers name? Current Age? Occupation? What is/was your fathers name? Current Age? Occupation? What are three adjectives that would have described your mother when you were little? Now? What are three adjectives that would have described your father when you were little? Now? How would you describe your parents relationship? On what did mom and dad both agree? On what and in what way did they disagree? Who made the decisions in your family? How were they made? Announced? How did mom and dad fight? How did you feel when they fought? What did you do? What was moms relationship to the kids? How did she discipline the children? Expectations for the children? What was dads relationship to the kids? How did he discipline the children? Expectations for the children? Which child was most like mom? In what way? Which child was most like dad? In what way? How were grandparents part of the family? Aunts and uncles? Cousins? Were there any other parental figures or adults in the family?

Personal Development: Life Tasks Friendship: what was the familys attitude toward friends? How were children taught to share, to be friendly, to engage with others? What was your role with friends, peer group, other adults? School and Work: what type of school did you attend? What were your best and worst subjects? Which subjects did you like and dislike the most? What was your classroom behavior? What was your relationship to teachers and other students? What grades did you get? What chores did you have as a child? How and what did you learn about the world of work? When did you have your first paying job? What was it? How did you do? Gender and Intimacy: what was it like to be a little girl or little boy? When did gender become important to you? How did your body develop from childhood to adulthood? How did you feel about your body? How old were you when you reached puberty? How did it go for you? How did you learn about sex? What did you think about what you learned? What were your initial feelings about sexual activity? What are they now? Have you even been sexually or physically abused? By whom? When? What was done about it? What does it mean to you to be masculine? What does it mean to you to be feminine? How would you compare yourself to your descriptions of masculine and feminine? What are your feelings about love and marriage? How do you see yourself getting along with the other sex? How is or how do you imagine partnership working out for you?

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Early Recollections Thinking back as early as you can, what is something that happened to you one time (say, before the age of nine)? How old were you? What part stands out? What was the most vivid part? If you played the whole memory through your head like a movie and stopped it at one frame, what would be happening in that frame? In the middle of the part that stands out or is most vivid, what are you feeling? What is your reaction? Repeat the above questions until three to twelve early recollections are generated.

Summaries Family Constellation, Sibling Traits, Family Atmosphere, and Personal Development/Life Tasks: using the information gathered in the first four sections, write a narrative summary in the third person that describes the individuals perception of self, family position, family life, and growth and development. Early Recollections: using the information generated in the early memories, write a narrative summary in the first person that describes the individuals current perception of self, others, life, the world, and her or his ethical convictions. Assets And Strengths: using all the information collected so far, list the individuals strong points, resources, assets, capabilities, and achievements. Area(s) For Further Growth: using all the information collected so far, list the individuals ideas, attitudes, beliefs, and convictions which interfere with personal growth and development. List problem behaviors and situational difficulties that the person needs to address in order to live and happy and productive life.

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