Exit Interview

Name
Measures
Employment Status*
Highest level of education attained*
Can you share any successes you've experienced since participating in the program?*
Can you share any barriers you've experienced since participating in the program?*
Have you ever been charged for behavior associated with substance use?*
- Yes
- No
If so, were you convicted?
- Yes
- No
How many convictions have you faced due to substance use related challenges?*
Please enter a number greater than or equal to 0.
Were the convictions you faced deemed to be a felony or misdemeanor?*
- Felony
- Misdemeanor
- Both
- Not applicable

Importance*

	Not important at all	Not very important	Neutral	Important	Very Important
How important is it for people to have good leadership skills in recovery?
How important is it for people to know how to pursue education in their recovery?
How important is it for people to know how to find employment in recovery?
How important is it for people to have access to adequate housing in recovery?
How important is it for people to understand financial responsibility in their recovery?
How important is it for people to feel empowered in their recovery?
How important is it for people to understand their legal rights in recovery?

Preparedness*

	Not prepared at all	Not very prepared	Neutral	Somewhat prepared	Very Prepared
How would you rate your preparedness around Education?
How would you rate your preparedness around Employment?
How would you rate your preparedness around Housing?
How would you rate your preparedness around Finances?
How would you rate your preparedness to talk about your recovery after the program?

How would you rate your leadership skills?*
How would you rate your current dedication to your recovery?*
How would you rate your current feeling of empowerment?*
Hidden
How would you rate your current understanding of your legal rights as a person in recovery?*
How would you rate your current understanding of finances?*
How useful to you was the material covered in the program in preparing for your future?*
How comfortable do you feel with finding resources for your recovery in your daily life?*
How would you rate your ability to locate resources in your local community?*
How would you rate your ability to understand FAFSA (Free Application for Federal Student Aid) after the program?*
Did the workbook assignments help you gain a better understanding of the material that was covered in the group sessions?*
How connected do you feel to Young People in Recovery after participating in the program?*
How would your rate your ability to relate to the peer that led the program sessions?*
How likely are you to get involved with a YPR chapter?*
How confident do you feel in your ability to build and maintain healthy relationships?*
How confident do you feel in your ability to build and maintain a healthy physical, spiritual, and mental lifestyle?*
How confident are you in your ability to explain the neuroscience of substance use disorder to someone with no knowledge of the subject?*
Please Check the Following Applicable Statements:
I attended all of the program sessions
- I attended all of the program sessions
I am more comfortable setting goals for myself after the program
- I am more comfortable setting goals for myself after the program
I have a better understanding of my own leadership qualities
- I have a better understanding of my own leadership qualities
I believe more treatment facilities should offer life skills classes
- I believe more treatment facilities should offer life skills classes
I set future goals while in the program
- I set future goals while in the program
I completed at least one of the workbook assignments
- I completed at least one of the workbook assignments
I completed all of the workbook assignments
- I completed all of the workbook assignments
I met with a facilitator one-on-one
- I met with a facilitator one-on-one
How would you rate the quality of the meeting(s)?
Have you attended a YPR Chapter event?
What are some resources you learned while in the program?*
What was the most beneficial thing you learned in the program?*
Assessment of Recovery Capital
I am currently completely abstinent from substance use*
I feel I am in control of my substance use*
I have had no thoughts about reoccurrence*
I have had no recent periods of substance intoxication*
There are more important things to me in life than using substances*
I am able to concentrate when I need to*
I am happy with my appearance*
In general I am happy with my life*
What happens to me in the future mostly depends on me*
I cope well with everyday tasks*
I feel physically well enough to work*
I have enough energy to complete the tasks I set myself*
I have no problems getting around*
I sleep well most nights*
I am proud of the community I live in and feel part of it*
It is important for me to contribute to society and or be in involved in activities that contribute to my community*
It is important for me that I make a contribution to society*
It is important for me to do what I can to help other people*
My personal identity does not revolve around drug use or drinking*
I am happy with my personal life*
I am satisfied with my involvement with my family*
I get lots of support from friends*
I get the emotional help and support I need from my family*
I have a special person that I can share my joys and sorrows with*
I am actively involved in leisure and sport activities*
I am actively engaged in efforts to improve myself (training, education and/or self-awareness)*
I engage in activities that I find enjoyable and fulfilling*
Hidden
I have access to opportunities for career development (job opportunities, volunteering or apprenticeships)*
I regard my life as challenging and fulfilling without the need for using drugs or alcohol*
I am proud of my home*
I am free of threat or harm when I am at home*
I feel safe and protected where I live*
I feel that I am free to shape my own destiny*
My living space has helped to drive my recovery journey*
I am free from worries about money*
I have the personal resources I need to make decisions about my future*
I have the privacy I need*
I make sure I do nothing that hurts or damages other people*
I take full responsibility for my actions*
I am happy dealing with a range of professional people*
I do not let other people down*
I eat regularly and have a balanced diet*
I look after my health and wellbeing*
I meet all of my obligations promptly*
Having a sense of purpose in life is important to my recovery journey*
I am making good progress on my recovery journey*
I engage in activities and events that support my recovery*
I am coping with the stresses in my life*
I have a network of people I can rely on to support my recovery*
When I think of the future I feel optimistic*

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Exit Interview

Exit Interview

Measures

Please Check the Following Applicable Statements:

Assessment of Recovery Capital

CONNECT

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Contact

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Phone:

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