Pastoral Care: Sexual Health Assessment Checklist
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Reporting requirements | Yes | No | Don't Know | Plans for Improvement | |
---|---|---|---|---|---|
Do you know the state law about when clergy must violate confidentiality to: | Prevent a crime? | ||||
Report a crime? | |||||
Report child abuse? | |||||
Report child pornography use? | |||||
Protect someone from suicide? | |||||
Training | Yes | No | Don't Know | Plans for Improvement | |
Have you had training on counseling on sexuality issues in general? | |||||
Have you had training on premarital counseling? | |||||
Have you had training on working with couples with relationship issues? | |||||
Have you had training in divorce mediation? | |||||
Have you taken a course on pregnancy options counseling? | |||||
Have you taken a course on working with sexual abuse survivors? | |||||
Do you know the PLISSIT model? |
Yes | No |
Feel Comfortable Without |
Plans for Improvement |
||
---|---|---|---|---|---|
Have you had specialized training in these areas: | Adolescents? | ||||
Bisexual adults? | |||||
Couples counseling? | |||||
Couples affected by infidelity? | |||||
Couples during pre-marital counseling? | |||||
Couples struggling with infertility or ART's? | |||||
Disabled persons? | |||||
Intersex individuals and families with an intersex child? | |||||
Families with gender variant children? | |||||
Families with LGB children/grandchildren and families with LGB parents/grandparents? | |||||
Gay and lesbian adults? | |||||
People involved in alternative sexual communities? (i.e., kink, bdsm, online role playing) | |||||
People with cognitive disabilities? | |||||
People with HIV/AIDS? | |||||
People with mental health issues? | |||||
Polyamorous individuals/families? | |||||
Transgender adults? | |||||
Young adults 18 - 24? | |||||
LGBT youth? | |||||
Survivors of sexual abuse and/or domestic violence/sexual assault? | |||||
Persons convicted of sexual offenses? |
Yes | No | Plans for Improvement | ||
---|---|---|---|---|
Do you have up-to-date reading lists to give to congregants on these topics: | Adolescence? | |||
Bisexuality? | ||||
Couples Enrichment? | ||||
Infertility or ART's? | ||||
Sexuality and Disabilities? | ||||
Intersex | ||||
Gender variant children? | ||||
LGBT issues? | ||||
Alternative Sexual Communities? (i.e., kink, bdsm, online role playing) | ||||
HIV/AIDS? | ||||
Polyamory? | ||||
Transgender | ||||
LGBT youth? | ||||
Sexual abuse and domestic violence/sexual assault? |
Yes | No | Don't Know | Plans for Improvement | ||
---|---|---|---|---|---|
Do you have outside experts for referrals for: | Adolescents? | ||||
Bisexual adults? | |||||
Couples Affected by Infidelity? | |||||
Couples during pre-marital counseling? | |||||
Couples struggling with infertility or ART's? | |||||
Disabled persons? | |||||
Intersex individuals, including families with an intersex child? | |||||
Families with gender variant children? | |||||
Families with LGB children? | |||||
Gay and lesbian adults? | |||||
People involved in alternative sexual communities? (i.e., kink, bdsm, online role playing) | |||||
People with cognitive disabilities? | |||||
People with HIV/AIDS? | |||||
People with mental health issues? | |||||
Polyamorous individuals/families? | |||||
Transgender adults? | |||||
Young adults 18 - 24? | |||||
Couples? | |||||
LGBT youth? | |||||
Survivors of sexual abuse and/or domestic violence/sexual assault? | |||||
Sexual offenders? |
Referral Lists/ Networks / Network | Yes | No |
Plans for Improvement |
|
---|---|---|---|---|
Does your referral list include: | Certified Marriage and family therapists? | |||
Certified Sexuality counselors and therapists? | ||||
Sex Abuse Treatment Specialists? |