STRESS INDEX FOR PARENT OF ADOLESCENTS (SIPA)

Respondent Name: ____________________________________________________________________

Client ID: ___________ Relationship to Child: ________________ Respondent DOB: _____________
Age: ____________ Ethnicity: __________________________ Marital Status: __________________

Child’s Name: _________________________________________________________________________

Gender: _________________________ Child’s DOB: __________________________ Age: ___________

SECTION 1

Read each of the following statements carefully. Please focus on the adolescent you are currently
concerned about, and select the response which best represents your opinion. Although you may not
find a response that exactly states your feelings, please circle the response that comes closest to
describing how you feel.

YOUR FIRST REACTION TO EACH QUESTION SHOULD BE YOUR ANSWER.

Questions about you “spouse or partner” refer to your husband or wife, or other parenting partner (i.e.,
the other person who is most involved in the parenting of your child). If you do not currently have a
spouse or partner, respond no spouse or partner.

Statement Strongly Disagree Not Sure Agree Strongly

Disagree Agree
My child has sudden
changes of feelings or
moods
My child has many friends
My child has never been in
trouble with the police
My child does his or best in
school
My child shows affection
toward me
My child becomes very
upset or angry when he or
she does not get his or her
own way
My child has little or no
energy
My child has become
physically violent
My child seems motivated
to work hard
My child talks to me about
problems
My child has a negative
attitude
 Statement Strongly Disagree Not Sure Agree Strongly
Disagree Agree
It bothers me that my child
is so quiet
I think my child steals
things
My child does poorly in
school
My child tells me where he
or she is going
My child is grouch and
irritable
My child has no close
friends
My child is always telling
lies
My child must get a great
deal of attention in order
to work well
My child stays out too late
at night
My child has a bad temper
My child is not liked by
other children the same
age
My child has done serious
damage to our home
My child gives up easily
My child has the same
moral values that I have
My child seems very
moody
My child is frequently
bossed around or bullied
by others
My child respects the
property of others
My child could do better in
school by trying harder
I believe that my child
drinks more alcohol than I
would like
My child gets upset over
little things
My child is shy with others
of the same age
 Statement Strongly Disagree Not Sure Agree Strongly
Disagree Agree
I believe that my child skips
school
My child completes the
tasks he or she starts
My child avoids me at
home
My child yells at me or my
spouse/partner
My child gets teased a lot
and it bothers me
My child has threatened to
hurt people
My child has a short
attention span
My child likes to do things
with the whole family
My child thinks I am unfair
My child never seems to do
anything
My child is disobedient at
school
I worry that my child does
not do his or her school
work
My child does things for
me that make me feel good
My child argues too much
I often wonder if my child
is lonely
My child often gets in
trouble when he or she is
with his or her friends
My child puts forth a lot of
effort to reach his or her
goals
My child thinks I do not
love him or her
Since having a teenager, I
have a lot fewer chances to
see my friend and to make
new friends
Since having a teenager, I
don’t seem to spend as
much time with in-laws
and relatives as I would like
 Statement Strongly Disagree Not Sure Agree Strongly
Disagree Agree
I feel alone and without
friends
I am usually a positive and
cheerful person
Since my child became a No
teenager, my Spouse/Partner
spouse/partner and I don’t
spend as much time
together as a couple as I
had expected
I find myself giving up
more of my life to meet my
child’s needs than I ever
expected
I often have the feeling
that other people my own
age don’t particularly like
my company
When I go to a party, I
don’t expect to enjoy
myself
Having a teenager does not
leave me enough time for
my own friends
My spouse/partner often No
hurts my feelings Spouse/Partner
I can’t make decisions
without help
I often feel guilty after I get
angry at my child
Since my child became a No
teenager, my Spouse/Partner
spouse/partner and I have
been less physically
affectional than I would
like
Having a teenager has No
caused more problems Spouse/Partner
than I expected in my
relationship with my
spouse/partner
I often feel “left out” when
I am around other people
I feel that I am an excellent
parent
 Statement Strongly Disagree Not Sure Agree Strongly
Disagree Agree
Since my child became a
teenager, I feel that I am
almost never able to do
things that I like to do
I often need to work hard No
to avoid conflict with my Spouse/Partner
spouse/partner
I am as capable as most
other parents I know
I often have feelings that I
cannot handle things very
well
Since my child became a No
teenager, my Spouse/Partner
spouse/partner and I don’t
do as many things together
My spouse/partner No
distrusts my judgment as a Spouse/Partner
parent
Since my child became a No
teenager, my Spouse/Partner
spouse/partner has not
given me as much help and
support as expected
When I think about myself
as a parent of a teenager, I
believe I can handle
anything that happens
Since my child became a
teenager, my sexual
relationship(s) has (have)
been less satisfying
I frequently argue with my No
spouse/partner about how Spouse/Partner
to raise my child
I don’t have anyone who
listens to my frustrations
I feel every time my child
does something wrong it is
really my fault
I felt sadder and more
depressed than I expected
when my child became a
teenager
 Statement Strongly Disagree Not Sure Agree Strongly
Disagree Agree
My spouse/partner and I No
disagree on the best way Spouse/Partner
to discipline my child
I can talk to my No
spouse/partner about Spouse/Partner
anything
When my child does things
that bother me on
purpose, I don’t know what
to do
It is easy for me to
understand what my child
wants or needs
I expected to have closer
and warmer feelings for my
child at this age than I do
My child comes to me for
help more than to other
people
When I think about the
kind of parent I am, I often
feel guilty or bad about
myself
I am usually successful at
getting my child to do what
I ask
I enjoy being the parent of
a teenager
I cannot get my child to
listen to me
When my child misbehaves
or gets in trouble, I feel
responsible, as if I didn’t do
something right

SECTION 2

During the last 12 months, have any of the following events occurred in your immediate family?
Yes No
Divorce
Marital Reconciliation
Marriage
Separation
Pregnancy
Other relative moved into household
Went deeply into debt
Income increased substantially (20% or more)
Moved to a new location
Promotion at work
Income decreased substantially
Alcohol or drug problem
Death of a close family friend
Began new job
Entered new school
Trouble with superiors at work
Trouble with teachers at school
Legal problems
Death of immediate family member
Demands/illness of aging parent
Serious injury or medical problem
Continuing or chronic medical condition (diabetes, heart disease, etc)