Appendix A

Outcome Measures for Assessment

This appendix includes six outcome measures you may want to use to assess your clients’ treatment progress.

Directions: Think of times that you feel distressed or upset. Select the item from the menu that best describes your beliefs about feeling distressed or upset.

1. Strongly agree
2. Mildly agree
3. Agree and disagree equally
4. Mildly disagree
5. Strongly disagree

1.	Feeling distressed or upset is unbearable to me.	1	2	3	4	5
2.	When I feel distressed or upset, all I can think about is how bad I feel.	1	2	3	4	5
3.	I can’t handle feeling distressed or upset.	1	2	3	4	5
4.	My feelings of distress are so intense that they completely take over.	1	2	3	4	5
5.	There’s nothing worse than feeling distressed or upset.	1	2	3	4	5
6.	I can tolerate being distressed or upset as well as most people.	1	2	3	4	5
7.	My feelings of distress or being upset are not acceptable.	1	2	3	4	5
8.	I’ll do anything to avoid feeling distressed or upset.	1	2	3	4	5
9.	Other people seem to be able to tolerate feeling distressed or upset better that I can.	1	2	3	4	5
10.	Being distressed or upset is always a major ordeal for me.	1	2	3	4	5
11.	I am ashamed of myself when I feel distressed or upset.	1	2	3	4	5
12.	My feelings of distress or being upset scare me.	1	2	3	4	5
13.	I’ll do anything to stop feeling distressed or upset.	1	2	3	4	5
14.	When I feel distressed or upset, I must do something about it immediately.	1	2	3	4	5
15.	When I feel distressed or upset, I cannot help but concentrate on how bad the distress actually feels.	1	2	3	4	5

Difficulties in Emotion Regulation Scale (DERS)

Please indicate how often the following statements apply to you by writing the appropriate number from the scale below on the line beside each item.

1 Almost never (0–10%)
2 Sometimes (11–35%)
3 About half the time (36–65%)
4 Most of the time (66–90%)
5 Almost always (91–100%)

1.	I am clear about my feelings.	1	2	3	4	5
2.	I pay attention to how I feel.	1	2	3	4	5
3.	I experience my emotions as overwhelming and out of control.	1	2	3	4	5
4.	I have no idea how I’m feeling.	1	2	3	4	5
5.	I have difficulty making sense out of my feelings.	1	2	3	4	5
6.	I am attentive to my feelings.	1	2	3	4	5
7.	I know exactly how I am feeling.	1	2	3	4	5
8.	I care about what I am feeling.	1	2	3	4	5
9.	I am confused about how I feel.	1	2	3	4	5
10.	When I’m upset, I acknowledge my emotions.	1	2	3	4	5
11.	When I’m upset, I become angry at myself for feeling that way.	1	2	3	4	5
12.	When I’m upset, I become embarrassed for feeling that way.	1	2	3	4	5
13.	When I’m upset, I have difficulty getting work done.	1	2	3	4	5
14.	When I’m upset, I become out of control.	1	2	3	4	5
15.	When I’m upset, I believe I will remain that way for a long time.	1	2	3	4	5
16.	When I’m upset, I believe that I will end up feeling very depressed.	1	2	3	4	5
17.	When I’m upset, I believe that my feelings are valid and important.	1	2	3	4	5
18.	When I’m upset, I have difficulty focusing on other things.	1	2	3	4	5
19.	When I’m upset, I feel out of control.	1	2	3	4	5
20.	When I’m upset, I can still get things done.	1	2	3	4	5
21.	When I’m upset, I feel ashamed at myself for feeling that way.	1	2	3	4	5
22.	When I’m upset, I know that I can find a way to eventually feel better.	1	2	3	4	5
23.	When I’m upset, I feel like I am weak.	1	2	3	4	5
24.	When I’m upset, I feel like I can remain in control of my behaviors.	1	2	3	4	5
25.	When I’m upset, I feel guilty for feeling that way.	1	2	3	4	5
26.	When I’m upset, I have difficulty concentrating.	1	2	3	4	5
27.	When I’m upset, I have difficulty controlling my behaviors.	1	2	3	4	5
28.	When I’m upset, I believe there is nothing I can do to make myself feel better.	1	2	3	4	5
29.	When I’m upset, I become irritated at myself for feeling that way.	1	2	3	4	5
30.	When I’m upset, I start to feel very bad about myself.	1	2	3	4	5
31.	When I’m upset, I believe that wallowing in it is all I can do.	1	2	3	4	5
32.	When I’m upset, I lose control over my behavior.	1	2	3	4	5
33.	When I’m upset, I have difficulty thinking about anything else.	1	2	3	4	5
34.	When I’m upset, I take time to figure out what I’m really feeling.	1	2	3	4	5
35.	When I’m upset, it takes me a long time to feel better.	1	2	3	4	5
36.	When I’m upset, my emotions feel overwhelming.	1	2	3	4	5

Valued Living Questionnaire (VLQ)

Below are areas of life that are valued by some people. We are concerned with your quality of life in each of these areas. One aspect of quality of life involves the importance one puts on different areas of living. Rate the importance of each area (by circling a number) on a scale of 1 to 10. 1 means that area is not at all important. 10 means that area is very important. Not everyone will value all of these areas, or value all areas the same. Rate each area according to your own personal sense of importance.

Area	not at all extremelyimportant important
1. Family (other than marriage or parenting)	1 2 3 4 5 6 7 8 9 10
2. Marriage/couples/intimate relations	1 2 3 4 5 6 7 8 9 10
3. Parenting	1 2 3 4 5 6 7 8 9 10
4. Friends/social life	1 2 3 4 5 6 7 8 9 10
5. Work	1 2 3 4 5 6 7 8 9 10
6. Education/training	1 2 3 4 5 6 7 8 9 10
7. Recreation/fun	1 2 3 4 5 6 7 8 9 10
8. Spirituality	1 2 3 4 5 6 7 8 9 10
9. Citizenship/community life	1 2 3 4 5 6 7 8 9 10
10. Physical self-care (diet, exercise, sleep)	1 2 3 4 5 6 7 8 9 10

In this section, we would like you to give a rating of how consistent your actions have been with each of your values. We are not asking about your ideal in each area. We are also not asking what others think of you. Everyone does better in some areas than others. People also do better at some times than at others. We want to know how you think you have been doing during the past week. Rate each area (by circling a number) on a scale of 1 to 10. 1 means that your actions have been completely inconsistent with your value. 10 means that your actions have been completely consistent with your value.

During the past week
Area	not at all completely consistent with consistent withmy value my value
1. Family (other than marriage or parenting)	1 2 3 4 5 6 7 8 9 10
2. Marriage/couples/intimate relations	1 2 3 4 5 6 7 8 9 10
3. Parenting	1 2 3 4 5 6 7 8 9 10
4. Friends/social life	1 2 3 4 5 6 7 8 9 10
5. Work	1 2 3 4 5 6 7 8 9 10
6. Education/training	1 2 3 4 5 6 7 8 9 10
7. Recreation/fun	1 2 3 4 5 6 7 8 9 10
8. Spirituality	1 2 3 4 5 6 7 8 9 10
9. Citizenship/community life	1 2 3 4 5 6 7 8 9 10
10. Physical self-care (diet, exercise, sleep)	1 2 3 4 5 6 7 8 9 10

From Wilson, Sandoz, Kitchens, & Roberts (2010). Used with permission.

Emotion Efficacy Scale (EES)

Using the scale below, rate each statement as it applies to you to indicate how much you agree or disagree.

strongly agree
moderately agree
agree/disagree equally
moderately disagree
strongly disagree

1.	I usually know what I am feeling.	1	2	3	4	5
2.	I have skills to recover when I get upset.	1	2	3	4	5
3.	When I get upset, I believe I can manage my emotions.	1	2	3	4	5
4.	When I get upset, I believe I will lose control.	1	2	3	4	5
5.	When I’m upset, I always act on my emotions.	1	2	3	4	5
6.	I cannot function when I’m distressed	1	2	3	4	5
7.	When I become upset, I do everything I can to avoid feeling uncomfortable.	1	2	3	4	5
8.	When I’m upset, I can express what’s important to me.	1	2	3	4	5
9.	I usually fulfill my values and responsibilities, even when I get upset.	1	2	3	4	5
10.	I can identify what’s most important to me, even when I’m upset.	1	2	3	4	5

Developed by Aprilia West; copyright © 2016. This scale is in the process of being validated. If you would like to use it in your research, please contact us at emotionefficacy@gmail.com for permission.

Depression, Anxiety, and Stress Scale–21 (DASS–21)

Name: Date:
Please read each statement and circle a number—0, 1, 2, or 3—which indicates how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement.
The rating scale is as follows: 0 Did not apply to me at all 1 Applied to me to some degree, or some of the time 2 Applied to me to a considerable degree, or a good part of the time 3 Applied to me very much, or most of the time
1.	I found it hard to wind down.	0 1 2 3
2.	I was aware of dryness of my mouth.	0 1 2 3
3.	I couldn’t seem to experience any positive feeling at all.	0 1 2 3
4.	I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion).	0 1 2 3
5.	I found it difficult to work up the initiative to do things.	0 1 2 3
6.	I tended to overreact to situations.	0 1 2 3
7.	I experienced trembling (e.g., in the hands).	0 1 2 3
8.	I felt that I was using a lot of nervous energy.	0 1 2 3
9.	I was worried about situations in which I might panic and make a fool of myself.	0 1 2 3
10.	I felt that I had nothing to look forward to.	0 1 2 3
11.	I found myself getting agitated.	0 1 2 3
12.	I found it difficult to relax.	0 1 2 3
13.	I felt downhearted and blue.	0 1 2 3
14.	I was intolerant of anything that kept me from getting on with what I was doing.	0 1 2 3
15.	I felt I was close to panic.	0 1 2 3
16.	I was unable to become enthusiastic about anything.	0 1 2 3
17.	I felt I wasn’t worth much as a person.	0 1 2 3
18.	I felt that I was rather touchy.	0 1 2 3
19.	I was aware of the action of my heart in the absence of physical exertion (e.g., sense of heart rate increase, heart missing a beat).	0 1 2 3
20.	I felt scared without any good reason.	0 1 2 3
21.	I felt that life was meaningless.	0 1 2 3

From S. H. Lovibond & P. F. Lovibond (2005).

Acceptance and Action Questionnaire (AAQ-2)

Below you will find a list of statements. Please rate how true each statement is for you by circling a number next to it. Use the scale below to make your choice.

Never true
Very seldom true
Seldom true
Sometimes true
Frequently true
Almost always true
Always true

1.	It’s okay if I remember something unpleasant.	1	2	3	4	5	6	7
2.	My painful experiences and memories make it difficult for me to live a life that I would value.	1	2	3	4	5	6	7
3.	I’m afraid of my feelings.	1	2	3	4	5	6	7
4.	I worry about not being able to control my worries and feelings.	1	2	3	4	5	6	7
5.	My painful memories prevent me from having a fulfilling life.	1	2	3	4	5	6	7
6.	I am in control of my life.	1	2	3	4	5	6	7
7.	Emotions cause problems in my life.	1	2	3	4	5	6	7
8.	It seems like most people are handling their lives better than I am.	1	2	3	4	5	6	7
9.	Worries get in the way of my success.	1	2	3	4	5	6	7
10.	My thoughts and feelings do not get in the way of how I want to live my life.	1	2	3	4	5	6	7

From Bond et al. (2011).