SG ACT Pre Assessment

I achieved better grades than I had expected.

My overall grades are good.

My school attendance is not good.

I am able to break down a problem into smaller parts to work through them.

I am unable to tell if the information I received is reliable.

I make decisions based on facts.

I am able to find creative ways to solve problems.

I try to learn things in a creative way. (For example, I use acronyms to remember difficult concepts.)

What I learn now will not be useful for me later on in life.

I do not know what my goals are.

The short-term goals I set for myself are realistic.

I have a plan to reach my long-term goals.

I feel unsupported by adults in my life.

I am able to talk things through with my friends or family to solve problems.

I care about how my actions affect other people.

I like to work with others to solve problems.

I am able to work on a project with others.

I do not like to work in a team.

I can be counted on to lead my peers when needed.

I try to set a good example to my peers.

I am unable to organise others to do something.

I do not like spending time with others in my community.

I do things that can make a difference in people’s lives in the community.

It is important for me to be a good role model for others in the community.

I am aware of the traditions that other races practise.

I respect the different racial practices.

I do not enjoy being involved in my racial traditions.

I think my weight is unhealthy.

I take part in physical activities for at least 7 hours a week.

I am able to prepare food for myself with no help from others.

I do not have clear life goals.

I believe I can achieve my life goals.

It is important for me to do my best in what I set out to do.

I am able to manage in difficult situations.

I can conduct myself well in front of others.

I cannot cope with the changes in my life.

I avoid taking part in activities that may get me into trouble.

I am against bullying.

I engage in harmful behaviours (For example, smoking, self-harm, using drugs, being violent).

Section C: Consent
DATA PRIVACY CONSENT
Creative arts therapists are required to maintain a pictorial record of artwork produced during art therapy sessions. Typically, the creative arts therapist takes a digital photograph of the artworks. Clients may retain the original upon request and if appropriate from the therapeutic perspective of the art therapist. This consent can be withdrawn at any time without explanation by contacting RPS. Circle ‘YES’ or ‘NO’ as appropriate:
Statement	YES	NO
I consent to my artworks being photographed.
I give consent for photographs and videos of my artworks and session information to be used for documentation and discussion during clinical supervision.
I consent to RPS highlighting my story of therapeutic change to raise awareness about art therapy for education purposes, such as research and conferences. All personal information will be kept confidential.
I understand that the creative arts therapist(s) will adhere to professional guidelines and will not disclose personal information without my explicit consent, except in cases where there is reason to believe that I or others may be at risk of actual or potential harm.
Consent Type Client Consent & Acknowledgement Caregiver / Guardian Consent (Under 21)
Informed Consent and Acknowledgement by Client I (NRIC last 4 digits: ), hereby confirm that I understand and consent to the above.
For Caregivers of Clients under 21 years old I (NRIC last 4 digits: ), am the parent / legal guardian of the client (NRIC last 4 digits: ), who is under 21 years old .

SG ACT Tool - Pre Assessment

ACT Questions

Section C: Consent