Psych Exam:Interview Form
Psych Exam:Interview Form
_______________________________
Nickname: _______________ Year/Course: __________________
EMOTIONAL INTELLIGENCE SCALE
By NICHOLAS C. HALL, Institute of Health and Human Performance
Directions: In the space provided before the following statements, please write the number which best describes your
agreement with the item, using the scale below:
1 – Disagree very much 3 – Disagree slightly 5 – Agree moderately
2 – Disagree moderately 4 – Agree slightly 6 – Agree very much
___ 1. I use both negative and positive emotions as a source of wisdom about how to navigate my life.
___ 2. Negative feelings help me to address what I need to change in my life.
___ 3. I have the ability to monitor my feelings from moment to moment.
___ 4. When the time is right, I face my negative feelings and work through what the issue is.
___ 5. Knowing my true feelings is crucial to my well-being.
___ 6. People who are aware of their true feelings are better pilots of their lives.
___ 7. I am calm under pressure.
___ 8. I am in charge of how I feel.
___ 9. After something has upset me, I find it easy to regain my composure.
___ 10. I do not recycle and dwell on negative emotions.
___ 11. I am capable of soothing myself after an upsetting event.
___ 12. I can easily shake off negative feelings.
___ 13. When challenged, I am good at getting calm and focused to flow.
___ 14. When challenged, I am able to summon a wide range of positive emotions such as fun, joy, fighting spirit and humor.
___ 15. I am able to motivate myself to try and try again in the face of setbacks.
___ 16. I try to be creative with life’s challenges.
___ 17. I can easily enter into a “zone” state, or a state characterized by calmness, alertness, and focus.
___ 18. I can easily set negative feelings aside when called upon to perform.
___ 19. I am effective at listening to other people’s thought.
___ 20. I am sensitive to the emotional needs of others.
___ 21. I am good at understanding the emotions of other people, even when the emotions are not directly expressed.
___ 22. I am adept at reading people’s feelings by their facial expressions.
___ 23. I am aware of subtle social signals that indicate what others need.
___ 24. I am strongly attuned to other’s feelings.
___ 25. I have a calming influence on other people.
___ 26. I respond appropriately to other people’s moods, motivations, and desires.
___ 27. People view me as an efficient coach of other’s emotions.
___ 28. I am often able to improve the moods of others.
___ 29. I am a good person to come to for advice about handling relationships.
___ 30. I help others use their motivations to achieve their personal goals.
EMOTIONAL INTELLIGENCE SCALE
SCORING AND INTERPRETATION (FOR INTERVIEWERS ONLY)
Emotional Managing Self Motivation Empathy Coaching
Awareness One’s Emotions Others
Interpretation: Interpretation: Interpretation: Interpretation: Interpretation:
GUIDE FOR INTERPRETATION:
Emotional Definite Strength Needs some Needs Substantial
Competency Development Development
Emotional 31 or above 26-30 25 or below
Awareness
Managing One’s 32 or above 27-31 26 or below
Emotions
Self Motivation 31 or above 27-30 26 or below
Empathy 31 or above 26-30 25 or below
Coaching Others’ 30 or above 25-29 24 or below
Emotions
CHECKED BY: ___________________________
Name of Interviewee: _________________________________________ Date & Time: _______________
Name of Interviewer(s): ________________________________________
Note: The interview per person should last only within 20 minutes, thus each question should be answered within 4
minutes. Remind the interviewee to be as honest and candid as he/she can be and to answer the questions based on
what he/she would actually do and not hypothetically.
Interview Questions:
WHAT IS PEPS? What do you know about PEPS?
1) How would you like us to call you? Represent the letters of your nickname with words that you feel describe
yourself, your attitudes, emotions and personality traits and briefly explain. (i.e. L-oyal, I-ntelligent, A-dorable)
2) You know what is unconditional positive regard? Just to clarify it means that you wholeheartedly accept and
support a person regardless of what the person says or does. Can you tell us an instance that you believe you
were able to greatly communicate unconditional positive regard to one of your peers?
3) One day, your classmate who you are not that close with approaches you for advice, crying. He/She says that
he/she is on the verge of suicide because of (choose a reason below). What do you do or say?
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His/her girlfriend/boyfriend broke up with him/her and is now in a relationship with someone else.
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His/her parents are getting a divorce. He/She feels that it is his/her fault that led them to break up.
4) A UPM Student feels that no matter how hard he/she studies; he/she could not receive grades as good as his/her
classmates. He/she feels unmotivated and plans to cut classes. What do you do or say?
Checklist of Competencies:
1 2 3 4 5 6
Able to describe one’s self; shows self-awareness and confidence
Communication skills; able to communicate with warmth and empathy
Able to give unconditional positive regard
Effective and sound problem-solving strategy on issues regarding relationships and suicide
Effective and sound problem-solving strategy on issues regarding family and suicide
Effective and sound problem-solving strategy on issues regarding academic problems
6- Very Outstanding; 5- Outstanding; 4 - Very Good; 3 - Good; 2 - Average; 1 – Poor
Interviewer’s Notes:
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Inform the person:
1) The results will be announced via the FB Page of the UPM PEPS.
2) A text message will also be sent to him/her if she has been accepted as a PEPS volunteer.
3) Thank you for participating.