Activity Structuring Form
MAIN ACTIVITY
ACTIVITY COMPONENT #1
ACTIVITY COMPONENT #2
ACTIVITY COMPONENT #3
ACTIVITY COMPONENT #4
Where do you want to go after you click the Next button?
Activity Component 1
Activity Component 2
Activity Component 3
Activity Component 4
Back
Next
Main Activity
Details of Activity Component #1
Before the activity
What will you do?
When will you do it?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What part of the day?
Morning
Afternoon
Evening
Night
Where will you do it?
Which other people will be involved? What will be their task?
After the activity
Did you perform the planned activity?
Yes
No
I did something else
Keep trying!
What did you do?
How did you feel?
Pleasant feelings
Difficult / unpleasant feelings
_page 2 collapse-start
Pleasant feelings
Alive
Good
Happy
Interested
Love
Open
Positive
Strong
Alive
Animated
Courageous
Energetic
Free
Frisky
Impulsive
Liberated
Optimistic
Playful
Provocative
Spirited
Thrilled
Wonderful
Other
Happy
Cheerful
Delighted
Ecstatic
Elated
Festive
Fortunate
Gay
Glad
Gleeful
Great
Important
Joyous
Jubilant
Lucky
Merry
Overjoyed
Proud
Satisfied
Sunny
Thankful
Other
Good
At ease
Blessed
Bright
Calm
Certain
Clever
Comfortable
Content
Encouraged
Free and easy
Peaceful
Pleased
Quiet
Reassured
Relaxed
Serene
Surprised
Other
Interested
Absorbed
Affected
Concerned
Curious
Engrossed
Fascinated
Inquisitive
Intrigued
Nosy
Snoopy
Passionate
Other
Love
Admiration
Affectionate
Attracted
Close
Compforted
Considerate
Devoted
Drawn toward
Loved
Loving
Passionate
Sensitive
Sympathy
Tender
Touched
Warm
Other
Open
Accepting
Amazed
Confident
Easy
Free
Interested
Kind
Receptive
Reliable
Satisfied
Sympathetic
Understanding
Other
Positive
Anxious
Bold
Brave
Challenged
Confident
Daring
Determined
Earnest
Enthusiastic
Excited
Hopeful
Inspired
Intent
Optimistic
Re-enforced
Other
Strong
Certain
Dynamic
Free
Hardy
Impulsive
Rebellious
Secure
Sure
Tenacious
Unique
Other
Difficult / unpleasant feelings
Afraid
Angry
Confused
Depressed
Helpless
Hurt
Indifferent
Sad
Afraid
Alarmed
Anxious
Cowardly
Doubtful
Fearful
Frightened
Menaced
Nervous
Panic
Quaking
Restess
Scared
Shaky
Suspicious
Terrified
Threatened
Timid
Wary
Worried
Other
Angry
Aggressive
Annoyed
Bitter
Boiling
Cross
Enraged
Fuming
Hateful
Hostile
Incensed
Indignant
Inflamed
Infuriated
Insulting
Irritated
Offensive
Provoked
Resentful
Sore
Unpleasant
Upset
Worked Up
Other
Confused
Dissilusioned
Distrustful
Doubtful
Embarrassed
Hesistant
Indecisive
Lost
Misgiving
Perplexed
Pessimistic
Shy
Skeptical
Stupefied
Tense
Unbelieving
Uncertain
Uneasy
Unsure
Upset
Other
Depressed
A Sense Of Loss
Abominable
Ashamed
Bad
Despicable
Detestable
Diminished
Disappointed
Discouraged
Disgusting
Dissatisfied
Guilty
In Despair
Lousy
Miserable
Powerless
Repugnant
Sulky
Terrible
Other
Helpless
Alone
Despair
Distresssed
Dominated
Empty
Fatigued
Forced
Frustrated
Hesitant
In A Stew
Incapable
Inferior
Paralyzed
Pathetic
Tragic
Useless
Vulnerable
Woeful
Other
Hurt
Aching
Afflicted
Agonized
Alienated
Apalled
Crushed
Dejected
Deprived
Heartbroken
Humiliated
Injured
Offended
Pained
Rejected
Tormented
Tortured
Victimized
Wronged
Other
Indifferent
Bored
Cold
Disinterested
Dull
Insensitive
Lifeless
Neutral
Nonchalant
Preoccupied
Reserved
Weary
Other
Sad
Anguish
Desolate
Desparate
Dismayed
Grief
Grieved
Lonely
Mournful
Pained
Pessimistic
Sorrowful
Tearful
Unhappy
Other
_page 2 collapse-end
Remarks
Where do you want to go after you click the Next button?
Main page
Activity Component 2
Activity Component 3
Activity Component 4
Back
Next
Main Activity
Details of Activity Component #2
Before the activity
What will you do?
When will you do it?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What part of the day?
Morning
Afternoon
Evening
Night
Where will you do it?
Which other people will be involved? What will be their task?
After the activity
Did you perform the planned activity?
Yes
No
I did something else
Keep trying!
What did you do?
How did you feel?
Pleasant feelings
Difficult / unpleasant feelings
Pleasant feelings
Alive
Good
Happy
Interested
Love
Open
Positive
Strong
Alive
Animated
Courageous
Energetic
Free
Frisky
Impulsive
Liberated
Optimistic
Playful
Provocative
Spirited
Thrilled
Wonderful
Other
Happy
Cheerful
Delighted
Ecstatic
Elated
Festive
Fortunate
Gay
Glad
Gleeful
Great
Important
Joyous
Jubilant
Lucky
Merry
Overjoyed
Proud
Satisfied
Sunny
Thankful
Other
Good
At ease
Blessed
Bright
Calm
Certain
Clever
Comfortable
Content
Encouraged
Free and easy
Peaceful
Pleased
Quiet
Reassured
Relaxed
Serene
Surprised
Other
Interested
Absorbed
Affected
Concerned
Curious
Engrossed
Fascinated
Inquisitive
Intrigued
Nosy
Snoopy
Passionate
Other
Love
Admiration
Affectionate
Attracted
Close
Compforted
Considerate
Devoted
Drawn toward
Loved
Loving
Passionate
Sensitive
Sympathy
Tender
Touched
Warm
Other
Open
Accepting
Amazed
Confident
Easy
Free
Interested
Kind
Receptive
Reliable
Satisfied
Sympathetic
Understanding
Other
Positive
Anxious
Bold
Brave
Challenged
Confident
Daring
Determined
Earnest
Enthusiastic
Excited
Hopeful
Inspired
Intent
Optimistic
Re-enforced
Other
Strong
Certain
Dynamic
Free
Hardy
Impulsive
Rebellious
Secure
Sure
Tenacious
Unique
Other
Difficult / unpleasant feelings
Afraid
Angry
Confused
Depressed
Helpless
Hurt
Indifferent
Sad
Afraid
Alarmed
Anxious
Cowardly
Doubtful
Fearful
Frightened
Menaced
Nervous
Panic
Quaking
Restess
Scared
Shaky
Suspicious
Terrified
Threatened
Timid
Wary
Worried
Other
Angry
Aggressive
Annoyed
Bitter
Boiling
Cross
Enraged
Fuming
Hateful
Hostile
Incensed
Indignant
Inflamed
Infuriated
Insulting
Irritated
Offensive
Provoked
Resentful
Sore
Unpleasant
Upset
Worked Up
Other
Confused
Dissilusioned
Distrustful
Doubtful
Embarrassed
Hesistant
Indecisive
Lost
Misgiving
Perplexed
Pessimistic
Shy
Skeptical
Stupefied
Tense
Unbelieving
Uncertain
Uneasy
Unsure
Upset
Other
Depressed
A Sense Of Loss
Abominable
Ashamed
Bad
Despicable
Detestable
Diminished
Disappointed
Discouraged
Disgusting
Dissatisfied
Guilty
In Despair
Lousy
Miserable
Powerless
Repugnant
Sulky
Terrible
Other
Helpless
Alone
Despair
Distresssed
Dominated
Empty
Fatigued
Forced
Frustrated
Hesitant
In A Stew
Incapable
Inferior
Paralyzed
Pathetic
Tragic
Useless
Vulnerable
Woeful
Other
Hurt
Aching
Afflicted
Agonized
Alienated
Apalled
Crushed
Dejected
Deprived
Heartbroken
Humiliated
Injured
Offended
Pained
Rejected
Tormented
Tortured
Victimized
Wronged
Other
Indifferent
Bored
Cold
Disinterested
Dull
Insensitive
Lifeless
Neutral
Nonchalant
Preoccupied
Reserved
Weary
Other
Sad
Anguish
Desolate
Desparate
Dismayed
Grief
Grieved
Lonely
Mournful
Pained
Pessimistic
Sorrowful
Tearful
Unhappy
Other
Remarks
Where do you want to go after you click the Next button?
Main page
Activity Component 1
Activity Component 3
Activity Component 4
Back
Next
Main Activity
Details of Activity Component #3
Before the activity
What will you do?
When will you do it?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What part of the day?
Morning
Afternoon
Evening
Night
Where will you do it?
Which other people will be involved? What will be their task?
After the activity
Did you perform the planned activity?
Yes
No
I did something else
Keep trying!
What did you do?
How did you feel?
Pleasant feelings
Difficult / unpleasant feelings
Pleasant feelings
Alive
Good
Happy
Interested
Love
Open
Positive
Strong
Alive
Animated
Courageous
Energetic
Free
Frisky
Impulsive
Liberated
Optimistic
Playful
Provocative
Spirited
Thrilled
Wonderful
Other
Happy
Cheerful
Delighted
Ecstatic
Elated
Festive
Fortunate
Gay
Glad
Gleeful
Great
Important
Joyous
Jubilant
Lucky
Merry
Overjoyed
Proud
Satisfied
Sunny
Thankful
Other
Good
At ease
Blessed
Bright
Calm
Certain
Clever
Comfortable
Content
Encouraged
Free and easy
Peaceful
Pleased
Quiet
Reassured
Relaxed
Serene
Surprised
Other
Interested
Absorbed
Affected
Concerned
Curious
Engrossed
Fascinated
Inquisitive
Intrigued
Nosy
Snoopy
Passionate
Other
Love
Admiration
Affectionate
Attracted
Close
Compforted
Considerate
Devoted
Drawn toward
Loved
Loving
Passionate
Sensitive
Sympathy
Tender
Touched
Warm
Other
Open
Accepting
Amazed
Confident
Easy
Free
Interested
Kind
Receptive
Reliable
Satisfied
Sympathetic
Understanding
Other
Positive
Anxious
Bold
Brave
Challenged
Confident
Daring
Determined
Earnest
Enthusiastic
Excited
Hopeful
Inspired
Intent
Optimistic
Re-enforced
Other
Strong
Certain
Dynamic
Free
Hardy
Impulsive
Rebellious
Secure
Sure
Tenacious
Unique
Other
Difficult / unpleasant feelings
Afraid
Angry
Confused
Depressed
Helpless
Hurt
Indifferent
Sad
Afraid
Alarmed
Anxious
Cowardly
Doubtful
Fearful
Frightened
Menaced
Nervous
Panic
Quaking
Restess
Scared
Shaky
Suspicious
Terrified
Threatened
Timid
Wary
Worried
Other
Angry
Aggressive
Annoyed
Bitter
Boiling
Cross
Enraged
Fuming
Hateful
Hostile
Incensed
Indignant
Inflamed
Infuriated
Insulting
Irritated
Offensive
Provoked
Resentful
Sore
Unpleasant
Upset
Worked Up
Other
Confused
Dissilusioned
Distrustful
Doubtful
Embarrassed
Hesistant
Indecisive
Lost
Misgiving
Perplexed
Pessimistic
Shy
Skeptical
Stupefied
Tense
Unbelieving
Uncertain
Uneasy
Unsure
Upset
Other
Depressed
A Sense Of Loss
Abominable
Ashamed
Bad
Despicable
Detestable
Diminished
Disappointed
Discouraged
Disgusting
Dissatisfied
Guilty
In Despair
Lousy
Miserable
Powerless
Repugnant
Sulky
Terrible
Other
Helpless
Alone
Despair
Distresssed
Dominated
Empty
Fatigued
Forced
Frustrated
Hesitant
In A Stew
Incapable
Inferior
Paralyzed
Pathetic
Tragic
Useless
Vulnerable
Woeful
Other
Hurt
Aching
Afflicted
Agonized
Alienated
Apalled
Crushed
Dejected
Deprived
Heartbroken
Humiliated
Injured
Offended
Pained
Rejected
Tormented
Tortured
Victimized
Wronged
Other
Indifferent
Bored
Cold
Disinterested
Dull
Insensitive
Lifeless
Neutral
Nonchalant
Preoccupied
Reserved
Weary
Other
Sad
Anguish
Desolate
Desparate
Dismayed
Grief
Grieved
Lonely
Mournful
Pained
Pessimistic
Sorrowful
Tearful
Unhappy
Other
Remarks
Where do you want to go after you click the next button?
Main page
Activity Component 1
Activity Component 2
Activity Component 4
Back
Next
Main Activity
Details of Activity Component #4
Before the activity
What will you do?
When will you do it?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What part of the day?
Morning
Afternoon
Evening
Night
Where will you do it?
Which other people will be involved? What will be their task?
After the activity
Did you perform the planned activity?
Yes
No
I did something else
Keep trying!
What did you do?
How did you feel?
Pleasant feelings
Difficult / unpleasant feelings
Pleasant feelings
Alive
Good
Happy
Interested
Love
Open
Positive
Strong
Alive
Animated
Courageous
Energetic
Free
Frisky
Impulsive
Liberated
Optimistic
Playful
Provocative
Spirited
Thrilled
Wonderful
Other
Happy
Cheerful
Delighted
Ecstatic
Elated
Festive
Fortunate
Gay
Glad
Gleeful
Great
Important
Joyous
Jubilant
Lucky
Merry
Overjoyed
Proud
Satisfied
Sunny
Thankful
Other
Good
At ease
Blessed
Bright
Calm
Certain
Clever
Comfortable
Content
Encouraged
Free and easy
Peaceful
Pleased
Quiet
Reassured
Relaxed
Serene
Surprised
Other
Interested
Absorbed
Affected
Concerned
Curious
Engrossed
Fascinated
Inquisitive
Intrigued
Nosy
Snoopy
Passionate
Other
Love
Admiration
Affectionate
Attracted
Close
Compforted
Considerate
Devoted
Drawn toward
Loved
Loving
Passionate
Sensitive
Sympathy
Tender
Touched
Warm
Other
Open
Accepting
Amazed
Confident
Easy
Free
Interested
Kind
Receptive
Reliable
Satisfied
Sympathetic
Understanding
Other
Positive
Anxious
Bold
Brave
Challenged
Confident
Daring
Determined
Earnest
Enthusiastic
Excited
Hopeful
Inspired
Intent
Optimistic
Re-enforced
Other
Strong
Certain
Dynamic
Free
Hardy
Impulsive
Rebellious
Secure
Sure
Tenacious
Unique
Other
Difficult / unpleasant feelings
Afraid
Angry
Confused
Depressed
Helpless
Hurt
Indifferent
Sad
Afraid
Alarmed
Anxious
Cowardly
Doubtful
Fearful
Frightened
Menaced
Nervous
Panic
Quaking
Restess
Scared
Shaky
Suspicious
Terrified
Threatened
Timid
Wary
Worried
Other
Angry
Aggressive
Annoyed
Bitter
Boiling
Cross
Enraged
Fuming
Hateful
Hostile
Incensed
Indignant
Inflamed
Infuriated
Insulting
Irritated
Offensive
Provoked
Resentful
Sore
Unpleasant
Upset
Worked Up
Other
Confused
Dissilusioned
Distrustful
Doubtful
Embarrassed
Hesistant
Indecisive
Lost
Misgiving
Perplexed
Pessimistic
Shy
Skeptical
Stupefied
Tense
Unbelieving
Uncertain
Uneasy
Unsure
Upset
Other
Depressed
A Sense Of Loss
Abominable
Ashamed
Bad
Despicable
Detestable
Diminished
Disappointed
Discouraged
Disgusting
Dissatisfied
Guilty
In Despair
Lousy
Miserable
Powerless
Repugnant
Sulky
Terrible
Other
Helpless
Alone
Despair
Distresssed
Dominated
Empty
Fatigued
Forced
Frustrated
Hesitant
In A Stew
Incapable
Inferior
Paralyzed
Pathetic
Tragic
Useless
Vulnerable
Woeful
Other
Hurt
Aching
Afflicted
Agonized
Alienated
Apalled
Crushed
Dejected
Deprived
Heartbroken
Humiliated
Injured
Offended
Pained
Rejected
Tormented
Tortured
Victimized
Wronged
Other
Indifferent
Bored
Cold
Disinterested
Dull
Insensitive
Lifeless
Neutral
Nonchalant
Preoccupied
Reserved
Weary
Other
Sad
Anguish
Desolate
Desparate
Dismayed
Grief
Grieved
Lonely
Mournful
Pained
Pessimistic
Sorrowful
Tearful
Unhappy
Other
Remarks
Where do you want to go after you click the Back button?
Main page
Activity Component 1
Activity Component 2
Activity Component 3
Back
Next
Should be Empty: