法鼓文理學院諮商輔導暨校友聯絡中心：學生校園生活回饋表 Counseling and Alumni Center: Scale for Campus Life in DILA
請依您的實際狀況點選適當的空格。
請保持輕鬆的心情填答，若有任何疑問，歡迎您主動與本中心聯絡，學校心理師偉玲將會親自回覆您。
諮商輔導暨校友聯絡中心 敬啟
聯絡信箱：schoolcounseling@dila.edu.tw

   Please choose an appropriate blank according to your conditions.
   Take your time, fill out your answer as honestly as possible. Answer each question with how you truely feel. If you have any questions or issues want to talk about, you can contact us by email as follow, the counseling psychologist will reply you personally.

Sincerely yours

DILA Counseling and Alumni Center
Contact E-mail：schoolcounseling@dila.edu.tw
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【學生校園生活回饋表施測同意書】(1)施測方法：採線上施測，大約花您5~10分鐘。(2)這份測驗可以幫助您了解自己的身心狀態，及自我適應校園生活的情況，作為規劃校園生活的參考；並協助學校諮商輔導中心了解您的身心健康狀況，針對個人需求給予適當之關懷並提供您可以運用的資源。(3)結果報告：只有本校諮商輔導中心的輔導老師於必要時才可調閱，並遵守保密原則及相關倫理。若導師或其他人士申請調閱時，需經過同學本人之同意。【Consent】(1)Method: Scale for Campus Life in DILA adopt on line scale, it will spend you about 5-10 minutes to fill out.(2)This scale could help you to understand your mental health status and your adapted condition in campus life. And it also could assist you to plan your campus life or help us (Counseling and Alumni Center in DILA) to understand your mental health condition.(3)Scale Result: only counseling psychologist in DILA could read your scale result when necessary situation happens. The counseling psychologist will comply with confidentiality agreement and related counseling ethics.If your teacher or other people apply for your scale result, the counseling psychologist will ask your agreement. *
Required
1.目前在校園生活中，我和他人的互動良好。Currently my interaction with others is good.) *
非常不同意(completely disagree)
非常同意(completely agree)
2.目前在課業學習上，我能掌握自己的學習進度。(Now I can handle my learning progress.) *
非常不同意(completely disagree)
非常同意(completely agree)
3.我已熟悉學校環境，對環境有安全感。(I have been familiar to campus, and feel security to the environment.) *
非常不同意(completely disagree)
非常同意(completely agree)
4.在生活上，我有些很談得來的同學或朋友。(In campus, there are some classmates or friends that can get along with me very well.) *
非常不同意(completely disagree)
非常同意(completely agree)
5.我認為自己有能力可以處理自己的生活與學習。(I think I have capability to deal with my life and learning.) *
非常不同意(completely disagree)
非常同意(completely agree)
請注意，以下第6題至第10題: 選0為非常同意、選5為非常不同意。(Attention! From 6th to 10th options: if you choose "0", it means completely agree; if you choose "5", it means completely disagree.)
6.目前我覺得生活壓力很大。(Currently I feel high pressure in my daily life.) *
非常同意(completely agree)
非常不同意(completely disagree)
7.我覺得我碰到困難時，找不到可以協助的人。(When I encounter difficulties, I couldn’t find person that can help me.) *
非常同意(completely agree)
非常不同意(completely disagree)
8.對於生活的某些情況，我覺得我快撐不下去。(For some circumstances in my life, I feel I almost can’t stand.) *
非常同意(completely agree)
非常不同意(completely disagree)
9.我希望有師長可以給現在的我一些生活上的協助。(I hope there could be have some teachers or staffs to assist my campus life.) *
非常同意(completely agree)
非常不同意(completely disagree)
10.最近我的心情經常低落。( Recently I often feel down in my mood.) *
非常同意(completely agree)
非常不同意(completely disagree)
請填入你的中文姓名。(Please fill in your name in Chinese.) *
請填入你的學號。(Please fill in your student ID number.) *
請填入你常用的電子信箱。(Please fill in your frequently used email.) *
當您的得分在0~10分之間，諮商輔導中心師長將主動與您聯繫，瞭解您的情況並給予相關的支持。您如果收到諮商輔導中心寄的信，請讓我們知道你有收到。我們會依您的情況定期或不定期的關心您的生活適應情況，給予您情緒支持。我們一同努力來改善校園生活適應狀況。若有任何疑問或想聊聊天，歡迎您親自來中心走走，偉玲心理師竭誠歡迎您。(We want reminding you if you get scores between 0 and 10, we will contact you by email, please let us know you’ve received our caring letter. After contacting or caring you, we will still concern about your condition regular or irregular by email (depends on your own condition), the same, please let us know you’ve received our caring letter. Hope we can improve your campus life.)
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