My SNAP Assessment for Recovery

This worksheet will help us talk with you about your mental health treatment here at Cincinnati VAMC. There are four
parts for you to share with us about your Strengths, Needs, Abilities and Preferences. Please check and/or list the items
which best fit you at this time.

STRENGTHS Open minded Takes personal responsibility Good Problem Solver

Friendly Strong personal or spiritual values Good Decision Maker
What personal Creative Independent Dependable
qualities do you Good Listener Assertive Motivation
have which we
Quick Learner Hard Worker Good health
can build upon
Good Grooming Able to learn from my experiences Other (Please List)
in treatment?
Organized Can collaborate/ work with others

NEEDS Increase my knowledge of resources that Increasing effective communication skills to improve my relationships with
provide me with support others
What would Referral to resources for job training or Learn how to talk about my concerns/issues/feelings
help you education Practice my coping skills in a safe environment
achieve your Access to medical care for health related Learn more about effective coping skills related to:
goals? Please, concerns Improving my sleep
check your most Staying in a sober environment to help Reducing anxiety and using relaxation
important me not use drugs and or alcohol
needs. Managing my depression
Gain more knowledge and understanding Leisure skills
about: Organizing daily activities
(Prioritize your
My mental health diagnosis Managing anger
top three)
My medication(s) Mood Regulation
My symptoms / behaviors related Improving reality-based thinking
to my mental health diagnosis
Eating Healthy
Get help to stop smoking
Learn how to empower myself to take a
Other (Please List)
more active role in my treatment

Abilities Basic ability to read and write Ability to make healthy decisions about my life
Computer knowledge and skills Job Skills _________________________________________________
What skills do Ability to work effectively with others Education / Training_____________________________________________
you possess? Knowledge or tools that I use to help me Leisure Skills___________________________________________________
manage my emotions Ability to manage my time and structure my daily activities
Ability to have positive relationships with Other (Please List)
others

Preferences I prefer my family or friends to be I would like to live: I am interested in learning more about
involved in my treatment Independently, on Outpatient programming
How do you I would like to have a family my own Community resources
want your meeting Independently, with Other areas of interest
treatment? I learn new information better: community support (Please List)
Face to face With others
Hands on instruction and practice Other ideas I have
Reading written material about my living
Alone situation (Please List)
In discussion with others
Sharing information in a group of
my peers

Developed for Inpatient Psychiatry, Cincinnati VAMC, 8/10/2010, DDB