“EFFECTS OF HAVING A BROKEN FAMILY”
1. With whom you are living with?
2. Since when you experienced having a broken family?
3. How many siblings do you have?
[pic] Only Child
[pic] 3 and above
4. How many friends do you have?
[pic] 1-3 friends
[pic] 4-7 friends
[pic] 8 and above
5. What was your first reaction when you knew that your mom and dad will never be together?
[pic] others: (pls. specify) __________________________ 6. Fill in the blank. My life will not be completed w/out my_________.
[pic] Others . . . why?
7. Was there any instances that you decided to live on your own?
8. Is there any circumstances that you personally approach your parents and ask what happened to their relationship?
9. What are you idea/s why their relationship does not work?
[pic] Financial problem
[pic] 3rd party [pic] Problem with relatives
Others (pls. specify) ___________________________________
10. In your own opinion, whom do you consider the reason why a broken family arises? Is it because of a nagger wife or a polygamous husband? ____________________________________________________________
11. With your existence in this earth, will you consider yourself a good husband/wife in the future?
12. Do you have any communication with your Mom/ Dad?
[pic] None (if none proceed to number 14)
13. If yes, do they support you?
[pic] In financial aspects
[pic] In emotional aspects
14. Do you believe that identity crisis may occur if you belong to a broken family?
[pic] Yes (why?)
[pic] No (why not?)...
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