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Appendix 1: Sarason Social Support Questionnaire (Short Form) SSQSR

This document provides instructions for completing the Sarason Social Support Questionnaire Short Form (SSQSR). The questionnaire asks respondents to list up to 9 people who provide them with different types of social support. For each question, respondents rate their satisfaction with the overall support received on a 6-point scale. The document explains how to score the SSQSR by calculating averages based on the number of supports listed and satisfaction ratings provided.

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Raafi Puristya Aries Darmawan
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707 views3 pages

Appendix 1: Sarason Social Support Questionnaire (Short Form) SSQSR

This document provides instructions for completing the Sarason Social Support Questionnaire Short Form (SSQSR). The questionnaire asks respondents to list up to 9 people who provide them with different types of social support. For each question, respondents rate their satisfaction with the overall support received on a 6-point scale. The document explains how to score the SSQSR by calculating averages based on the number of supports listed and satisfaction ratings provided.

Uploaded by

Raafi Puristya Aries Darmawan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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APPENDIX 1:

SARASON SOCIAL SUPPORT QUESTIONNAIRE (Short Form)


SSQSR

INSTRUCTIONS:

The following questions ask about people in your life who provide you with help or support
.Each question has two parts. For the first part, list all the people you know, excluding
yourself, who you can count on for help or support in the manner described. Write the
person’s initials and their relation to you (see example). Do not list more than one person
next to each of the numbers beneath the question.

For the second part, circle how satisfied you are with the overall support you have.

If you have no support for a question, circle the words “No one,” but still rate your level of
satisfaction. Do not list more than nine people per question.

Please answer all the questions the best you can. All your responses will be kept confidential.

Example:

Who do you know who you can trust with information that can get you into trouble?

No one 1.)T.N. (brother) 4.) D.N. (father) 7.)


2.) L.M. (friend) 5.) W.T. (employer) 8.)
3.) R.S. (friend) 6.) 9.)

How satisfied?

6 – very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

1. Who can you really count on to be dependable when you need help?

No one 1.) 4.) 7.)


2.) 5.) 8.)
3.) 6.) 9.)
2. How satisfied?

6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


Satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

3. Who can you really count on to help you feel more relaxed when you are under
pressure or tense?

No one 1.) 4.) 7.)


2.) 5.) 8.)
3.) 6.) 9.)

4. How satisfied?

6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


Satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

5. Who accepts you totally, including both your worst and best points?

No one 1.) 4.) 7.)


2.) 5.) 8.)
3.) 6.) 9.)

6. How satisfied?

6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


Satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

7. Who can you really count on to care about you, regardless of what is happening to you?

No one 1.) 4.) 7.)


2.) 5.) 8.)
3.) 6.) 9.)

8. How satisfied?

6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


Satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

9. Who can you really count on to help you feel better when you are feeling down-in-the-
dumps?

No one 1.) 4.) 7.)


2.) 5.) 8.)
3.) 6.) 9.)
10. How satisfied?

6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


Satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

11. Who can you count on to console you when you are very upset?

No one 1.) 4.) 7.)


2.) 5.) 8.)
3.) 6.) 9.)

6. How satisfied?

6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1- very


Satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied

TO SCORE SSQSR:

1. Count the total number of people for each of the odd-numbered items. Add the
total together (Max = 54). Divide by 6 per item SSQ Number Score, or SSQN.

2. Add the total satisfaction scores for the 6 even-numbered items (Max = 36).
Divide by 6 per item SSQ Satisfaction Score or SSQS.

3. You can also compute a Family score and a Non-Family score by using the
method in #1 for all people describes as family members, or not described as
family members respectively.

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