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          parenting questionnaire

           

          This is a read-only copy of the parenting survey that was administered to viewers of DrPhil.com as well as audience members in the studio before the Dr. Phil show. A total of 20,031 volunteers participated in the study. Click here to view the Phase I results of the responses.

          1. Are you or have you been a parent?
          Yes
          No

          2. Your age:
          16 - 20
          21 - 25
          26 - 30
          31 - 35
          36 - 40
          41 - 45
          46 - 50
          51 - 55
          56 - 60
          61 +

          3. Your gender:
          Male
          Female

          4. Race:
          Caucasian
          African American
          Hispanic
          Asian
          American Indian
          Other

          5. Residence address:
          Northern U.S.
          Southern U.S.
          Western U.S.
          Eastern U.S.
          Central U.S.
          Southeast U.S.
          Northwest U.S.
          Southwest U.S.
          Northeast U.S.
          Canada

          6. How many children are you raising or have you raised?
          1
          2
          3
          4
          5
          6
          7
          8
          More than 8

          Please indicate their ages according to the their gender:

          7. First girl
          3-4
          5-6
          7-8
          9-10
          11-12
          13-14
          15-16
          16-17
          None of the above
          Not applicable

          8. Second girl
          3-4
          5-6
          7-8
          9-10
          11-12
          13-14
          15-16
          16-17
          None of the above
          Not applicable

          9. First boy
          3-4
          5-6
          7-8
          9-10
          11-12
          13-14
          15-16
          16-17
          None of the above
          Not applicable

          10. Second boy
          3-4
          5-6
          7-8
          9-10
          11-12
          13-14
          15-16
          16-17
          None of the above
          Not applicable

          11. What is your role in the household?
          Mother
          Father
          Stepmother
          Stepfather
          Aunt
          Uncle
          Grandparent
          Sibling
          Other

          12. Do you:
          Stay at home with the kids
          Work away from home
          Other

          13. How would you describe your type of family structure?
          Biological mother and father present with child(ren)
          Biological parent and step-parent with available biological co-parent
          Biological parent and step-parent with no available or little availability of co- biological parent
          No biological parents available (i.e., adoption)
          Single parent

          14. Do you have children with any kind of learning or physical disabilities?
          Mental retardation
          Learning disabilities
          Sight problems
          Hearing difficulties
          Motor difficulties (walking and handling)
          Mental difficulties
          Other
          Not applicable

          15. What was the first crisis you faced in child rearing?
          Teaching eating habits
          Potty training
          Disobedience
          Temper tantrums
          Unwillingness to listen
          A fearful child's response
          Developing trust
          Sleep habits
          Rebellion
          None of the above (See question 16 for more)

          16. What was the first crisis you faced in child rearing? (continued from above)
          Hiding activities
          Bad influences, such as friends
          Drugs/alcohol
          Sexual promiscuity
          None of the above

          17. When it comes to discipline, which works best?
          Corporal punishment, such as spankings
          Sitting down with your child and discussing consequences
          A system of rewards and punishments
          Letting the child express his/her needs while you try to understand the behavior as a communication
          Time-outs
          Give up and hide

          To what extent do you perceive these as problems with American families today?

          Not a problem Serious problem
          18. Loss of family values
          1
          2
          3
          4
          5
          6
          7
          19. Parents not spending enough time with their kids
          1
          2
          3
          4
          5
          6
          7
          20. Both parents working away from home
          1
          2
          3
          4
          5
          6
          7
          21. Increase in divorce rate
          1
          2
          3
          4
          5
          6
          7
          22. Lower academic school systems
          1
          2
          3
          4
          5
          6
          7
          23. No real heroes for children to follow
          1
          2
          3
          4
          5
          6
          7

          In describing an ideal parent, how important are the following?

          Not important Important
          24. Being permissive
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          25. High expectations
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          26. Selflessness
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          27. Giving
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          28. Sensitivity
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          29. Easygoing
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          30. Authoritative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          31. Understanding
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          32. Democratic
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          33. Religious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          In describing an ideal child, how important are the following traits?

          Not important Important
          34. Smart
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          35. Reliable
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          36. Cooperative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          37. Religious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          38. Selfless
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          39. Ambitious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          40. Creative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          41. Abides by rules
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          42. Respectful
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          43. Demanding
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          How would you rank yourself in the following parenting skills?

          Poor Superior
          44. Authoritative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          45. Understanding
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          46. Permissive
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          47. Democratic
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          48. Easygoing
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          49. High expectations
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          50. Religious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          51. Selfless
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          52. Giving
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          53. Sensitive
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          Describe how your child (or children collectively) fits the characteristics below.

          Poor Superior
          54. Smart
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          55. Reliable
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          56. Cooperative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          57. Religious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          58. Selfless
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          59. Ambitious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          60. Creative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          61. Abides by rules
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          62. Respectful
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          63. Demanding
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          To what extent do the following characteristics describe the way you were raised?
          Your caregivers were:
          Not descriptive Descriptive
          64. Too authoritative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          65. Not understanding
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          66. Too permissive
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          67. High expectations
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          68. Too religious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          69. Selfish
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          70. Psychologically unsound
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          71. Too rule-ridden
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          Do you find your parents responsible for any of the issues below that you may have experienced?
            N/A Parents not responsible Parents responsible
          72. Anxiety
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          73. Depression
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          74. Obsessive tendencies
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          75. Dependency
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          76. Avoidance of people
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          77. Instability
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          78. Low self-confidence
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          79. Self-loathing
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          80. Drug/alcohol problems
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          To what extent do you perceive the following values as crucial?
            Unimportant Crucial
          81. Respect
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          82. Manners
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          83. Work ethic
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          84. Compassion
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          85. Kindness
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          86. Loyalty
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          87. Independence
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          88. Accountability
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          89. Self-pride
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          90. Self-discovery
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          From the perspective of your children, rank what you think they value about your parenting style:
            Not valued Highly valued
          91. Authoritative
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          92. Understanding
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          93. Permissive
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          94. Democratic
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          95. Easygoing
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          96. High expectations
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10
          97. Religious
          1
          2
          3
          4
          5
          6
          7
          8
          9
          10

          98. Rate the level of resentment you feel because of the sacrifices you've made as a parent:
          None
          A little, but it does not interfere with my life
          Some, but it rarely bothers me in my life
          Some, and it troubles me significantly
          A lot, and I can get very emotional about it

          99. Which best describes the methods of how you teach your children?
          Specific classes or direction
          Stories
          Focusing on the demonstrations by others
          Discussing family rules or identification as a family unit
          Reading or giving them literature about these values
          Relying on school or religious organization
          No planned effort
          Other

          ESSAY QUESTIONS
          1. What are the three most important things you want to know about raising kids?

          2. What is the biggest mistake you made in child rearing?
          3. What problems have you had with each child regarding sleep habits? (i.e., bedtime battles, being afraid, staying in parents' bed too long, etc.)

          4. What problems have you had in developing close relationships with each child? (i.e., bonding, participating as a friend, dealing with issues of death or illness, dealing with spiritual issues, etc.)

          5. What problems have you had with each child regarding co-parenting your children? (i.e., splitting parent responsibilities, blended families, co-custody, single-parenting, dealing with ex-spouse, in-laws, taking anger out on children, etc.)

          6. What problems have you had with each child regarding discipline and guidance? (i.e. spoiling them, losing control, making punishments like time-outs work, finding discipline that works for each child, dealing with hitting, bullying, step-children differences, etc.)
          7. What problems have you had with each child regarding anxieties and fears? (i.e., coping with stress, assigning blame to others, goal-setting, depression, etc.)

          8. What problems have you had with each child regarding health habits? (i.e., diet, drugs, alcohol, sex, etc.)

          9. What problems have you had with each child regarding specific developmental issues? (i.e., school performance, special learning problems, learning to build trusting relationships, self-confidence, friendship development, boy-girl relationships, having a sense of purpose, physical development, spiritual development, values, etc.)

          10. What problems would you want advice on, now or in the future? (i.e., getting your child to listen, getting respect, having your child to do better in school)

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