PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| - | waic_noprovider | N | checkbox | 0, If you DO NOT have a treatment provider, please indicate so by checking the box. | - | Instructions: The following statements describe some of the different ways a person might think or feel about his or her treatment provider. Next to each statement is a seven point scale. If the statement describes the way you always feel (or think) circle the number 7; if it never applies to you circle the number 1. Use the numbers in between to describe the variations between these extremes. | |
| 1. My treatment provider and I agree about the things I will need to do to help improve my situation | waic_1 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 2. What I am doing in treatment gives me new ways of looking at my problem. | waic_2 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 3. I believe my treatment provider likes me. | waic_3 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 4. My treatment provider does not understand what I am trying to accomplish in treatment. | waic_4 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 5. I am confident in my treatment provider's ability to help me. | waic_5 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 6. My treatment provider and I are working towards mutually agreed upon goals. | waic_6 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 7. I feel that my treatment provider appreciates me. | waic_7 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 8. We agree on what is important for me to work on. | waic_8 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 9. My treatment provider and I trust one another. | waic_9 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 10. My treatment provider and I have different ideas on what my problems are. | waic_10 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 11. We have established a good understanding of the kind of changes that would be good for me. | waic_11 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| 12. I believe the way that we are working with my problem is correct. | waic_12 | N | radio | 1, 1 Never | 2, 2 Rarely | 3, 3 Occasionally | 4, 4 Sometimes | 5, 5 Often | 6, 6 Very Often | 7, 7 Always | - | - | |
| Notes | wai_notes | Y | notes | - | - | - |