Assessments

Western Psychological & Counseling
Treatment with Jane Rekas at Western
Hypnosis adjunct to treatment
ADHD Treatment at Western
Jane Rekas, LCSW, CHt
880 82nd Dr., Gladstone, OR 97027 Building A
503-659-5515 x 1270

Submitdocs@westernpsychservices.com: 
Clients can submit documentation to be uploaded into the EHR by sending it to this email.

ew Patient FormsAdult Mental Health FormsChild & Adolescent Mental HealthAdult Substance Use Disorder FormsAdolescents Substance Use Disorder Forms (Under 18)Other FormsADHDAutismHealth PsychologyPublic Documents

ContactAdmin Contact InfoCrisis Contact Info

  

New client forms: We are launching the use of DocuSign to complete NEW client documentation. Front desk will send clients a link to fill in the intake forms online, which are then signed, sent in, and then uploaded into NextGen.

Western Psychological Safety Plan
CAMS suicide form
School Based Program
Medical Rule Outs

Release of Information form

Alcohol Screen AUDIT

Other Alcohol Screeners

Client Portal
Western has a client portal for clients who are in services with us! Features include viewing and requesting changes in appointments, view statements or balances, access medication information and more. You can also pay off your balance through the portal!

Click here to sign up for the portal

You can also use an app for Next Gen Patient Portal
https://itunes.apple.com/us/app/nextgen-patient-portal/id1165589210

TREATMENT GOAL PLANNERS PDF1 PDF2

---

ADHD
ADHD
Adult ADHD self report
Western Standards

Anxiety
Beck Anxiety Inventory
Burns Anxiety Inventory
GAD-7

Bipolar
Mood Check 
Goldberg Mania
Mood Disorder Questionnaire

Child

• SNAP
• Vanderbilt ADHD +
• Western Standards
• Parent Questionnaire JWE SLE
• Child Anxiety the SCARED
• CES-D child depresssion
• Children's Depression Rating Scale (CDRS)
• DMDD Questionnaire
• Highly Sensitive Child
• ODD brochure
• ODD rating scale
• PTSD child scale
• Barkley Home Situation scale 
• School Situation scale
• Social Challenges Questionnaire
• Trust Events Survey for Children and Adolescents
• Child PTSD Symptom Scale
• UCLA PTSD Adolescent Index and Scoresheet
• Child Dissociative Checklist
• Austism and https://www.aspergerexperts.com/
• Sensory Integration Services: https://sensorykidsot.com/
• Making Sense of Sensory Disorder
• Family Guide to Sensory Integration
• Sensory Checklist
• Sensory Integration Objectives

Core Beliefs

• How to identify Core/Negative Beliefs
• Developing Balanced Core Beliefs
• EMDR list of Negative and Positive Cognitions
• Abandonment
• Emotional Deprivation
• Core Beliefs Exercise 7 pages
• Core Beliefs 100 items
• Core Beliefs inventory just a different version

see also Filters

Couples
assessment

Depression

• CES-D
• CES-D child
• Major Depression Inventory
• Geriatric Depression Scale
• HAM-D
• PHQ-9
• Burns Depression
• Goldberg Depression

Filters

• Filters Questionnaire
• Another Filters Questionnaire

Neurotransmitters

• Neurotransmitter Imbalance Quiz
• Foods that raise Seratonin
• Foods that raise Dopamine
• Foods that raise Norepinephrine
• Foods that raise Gaba

Panic Disorder

Personality

• Keirsey MBTI Personality Test & Info. 
• Enneagram and Personal Growth 
• Happily Introverted 
• DISC

Positive Psychology:

• Authentic Happiness 
• Core Values Worksheet 
• Values Card Sort, Work Values Card Sort  
• Life Values Inventory

Protocols

Mental Health and CAM Protocols

Self-Esteem

• Rosenberg's Self Esteem Scale
• Self-Esteem Institute Questionnaire
• Self-Esteem Get Help
• Sorensen Self-Esteem Test
• Self Confidence Test
• Guilt and Shame Proneness pdf
• I thought it was just me
• Understanding and Coping with Guilt and Shame
• Shame and Attachment

Self Care

• NAMI self care questionnaire
• David Irvine self care inventory

Strengths

• Strengths Finder

Trauma

• Dissociative Experiences Scale  DES
• Dissociative Identity Scale
• Traumatic Stress Inventory
• Trauma Timeline Worksheet
• Timeline Therapy (create Timeline)
• How to create a Timeline 
• PTSD Inventory
• PCL-5 Stressors
• ACES score
• Trauma Symptom Checklist 

ASRM Bipolar Altman Self Rating Mania scale 

PHQ-2 depression

DES-B mod dissociation

PHQ15 somatic and illness anxiety

PID5 personality inventory

PCL-5 LEC Trauma