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    2012 W. Highway 160 Suite 9 | Fort Mill, SC 29708
    kirsten@carolinacommunitycounseling.org | 866-652-0093 Fax: 1-844-836-7106

  • Carolina Community Counseling

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    Maternal Mental Health Questionnaire

    Have you thought about starting counseling? We encourage you take this brief questionnaire as you consider if how counseling may benefit you.

    1. How often have you felt overwhelmed or stressed about being a parent or changes in your life?

    • Rarely
    • Occasionally
    • Frequently
    • Almost always

    2. Have you experienced feelings of sadness, hopelessness, or low mood in the past two weeks?

    • Not at all
    • Some of the time
    • Most of the time
    • All of the time

    3. Do you find it difficult to bond with your baby or enjoy activities you used to love?

    • Not at all
    • Occasionally
    • Frequently
    • Almost always

    4. How often do you experience feelings of guilt, shame, or inadequacy as a mother?

    • Rarely
    • Occasionally
    • Frequently
    • Almost always

    5. Do you find it hard to sleep, eat, concentrate, even when you have the opportunity to rest?

    • Not at all
    • Occasionally
    • Frequently
    • Almost always

    6. Have you had thoughts of harming yourself, your baby, or feelings of extreme fear about your baby’s well-being?

    • Never
    • Occasionally
    • Frequently
    • Almost always

    If you answered “frequently” or “almost always” to questions 2, 3, or 6 please consider reaching out immediately to the Postpartum Support International Helpline at 800-944-4773.

    We are here to help you and your family THRIVE and FLOURISH.

    Contact us at 866-652-0093 or at kirsten@carolinacommunitycounseling.org to schedule an appointment.

    2012 W. Highway 160 Suite 9
    Fort Mill, SC 29708

    866-652-0093
    kirsten@carolinacommunitycounseling.org
    Fax: 1-844-836-7106

    Contact Today

    Therapy & Support for Moms in Fort Mill & Online

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    Carolina Community Counseling, LLC
    kirsten@carolinacommunitycounseling.org | 866-652-0093
    Fax: 1-844-836-7106

    Now Offering Mid-Morning Appointments

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