Beruflich Dokumente
Kultur Dokumente
Instructions: Place a () check in the box to the right of each of the 15 symptom clusters to indicate how much this
type of feeling has been bothering you in the past several days. Make sure you answer all the questions. If you feel
unsure about any, put down your best guess. If you would like a weekly record of you progress, record your
answers on the separate Answer Sheet instead of filling in the spaces to the right.
Total Score
0-4
5-10
11-20
21-30
31-45
Degree of Depression
Minimal or no Depression
Borderline Depression
Mild Depression
Moderate Depression
Severe Depression
Date: ____/____/____
Copyright 1989 by David D. Burns, M.D., from The Feeling Good Handbook
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
TOTAL
SCORE
TODAYS
DATE
TOTAL
SCORE
TODAYS
DATE
Copyright 1989 by David D. Burns, M.D., from The Feeling Good Handbook