CBSQ Child form: Scoresheet for practitioners
Child form: SCORESHEET for practitioner
Main section (initial and review forms)
The scores for each answer are shown below. For each sentence, an increase between the initial and review score
shows a positive change for the child.
As long as they have answered all the questions, you can also calculate a mean score for this section. First, add
together the scores for each sentence. Then, divide this by the total number of sentences they answered. This will
give you a mean score of between 0.0 and 3.0. Again, an increase in this mean score between the initial and review
form shows a positive change.
1. I’ve got someone to talk to if
I’m worried or sad
2. I get on ok at school
3. I know what happened when
they died
4. I get on ok with my family
5. I worry a lot
6. Sometimes I feel happy
……………………………...
Total score for this section
divided by 6
(only calculate if all 6
sentences answered)
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
3
2
1
0
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3
=
……………………....
Average score to 1
decimal place
Record this
average score on
the child’s form
Feedback questions (review form only)
The higher the score, the better the feedback rating
I feel that the people who saw
me listened to me
If a friend needed this sort of
help, I would tell them to come
here
© A Penny 2014
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3
Not
like me
A bit like
me
Quite a lot
like me
Totally like
me
0
1
2
3