روانسنجی
اولین سایت تخصصی فارسی تست های روان سنجی ، روان شناسی

RAGS Client Interview
Regina Anti-Gang Services
(OJJDP‚ 2002‚ revised by Totten‚ 2008)

CLIENT I.D # _________________________ TODAY’S DATE (DD/MM/YY) _______________
STAFF NAME: _____________________________ PROGRAM:_________________________
MONTH/YEAR YOU FIRST HAD CONTACT WITH RAGS PROGRAM:________________________
1. What is your date of birth? ________________________________
2. Are you: Female - Male
3. What race/ethnicity do you consider yourself to be? (Choose one best answer.)
_ Aboriginal (if yes‚ indicate which group) __Saulteaux __Cree __Dakota __Nakota __Other
If you are Aboriginal‚ which Reserve/Band do you come from?___________________________
_ Metis  _ White/Caucasian   _ Other (Please specify) _______________________
4. What is the language you use most often at home? _ English _ Cree _ Saulteaux _ Other __
Experiences in child welfare and correctional facilities
5. Are you living in a correctional facility now (jail‚ prison‚ half-way house‚ youth facility)? _ No _ Yes
If yes‚ where:______________________________________________________________
5a) Have you lived in a correctional facility during the past 6 months? _ No _ Yes
If yes‚ where and for how long:________________________________________________
5b) During your life‚ about how many years in total have you been in correctional facilities (youth and adult):________
5c) Have you ever been in care of social services (foster home‚ group home)? _ No _ Yes
5d) How many different places (group/foster homes) have you been in care?
 _1 _2 _3-6 _7-10 _11 or more
5e) About how many years in total have you been in care?
_1 year _2 years _3-6 years _7-10 years _11 years or more
5f) Do you have an adult criminal record? _No _Yes
If yes‚ what have you been convicted of:……
5g) Do you have a youth criminal record? _No _Yes
If yes‚ what have you been convicted of: ……
6. What is your current relationship status?
_Dating _Married _Divorced _Common Law _Separated _Not in a relationship
7. Do you have any children? _No (if no go to question #8) _Yes‚ If yes‚ how many? ____
7a) How old were you when you first had a child? _____
7b) Who looks after your child(ren): _I do _Family member _The other parent _Child Protection
8. Has any of your family ever been in a gang? _Yes _No _Do Not Know _No Response
If yes‚ specify number of family members and relationship___________________________
9. Are you currently employed (in a job‚ not including crime)? _Yes _No (if no go to #9a) _Do Not Know _No Response
If yes‚ do you have a full-time job (35 hours/week or more?________________
If yes‚ do you have a part-time job (less than 35 hours/week)?________________
What type of work do you do?__________________________________
9a) Have you had a job (not including crime) in the past 6 months? _Yes _No (if no go to #10) _Do Not Know _No Response
If yes‚ did you have a full-time job (35 hours/week or more?________________
If yes‚ did you have a part-time job (less than 35 hours/week)?________________
What type of work did you do?________________________________________
School and Training Programs
10. Are you currently in school in the community or in a facility?
_Yes‚ in the community _Yes‚ in a facility _No _Do Not Know _No Response
11. If you are currently in school‚ what grade are you in? ________________
12. If you are not in school‚ what is the highest grade you have completed?
_Grade _____ _Do Not Know _No Response
13. Generally‚ what are/were your grades like?
_ Mostly As _Mostly Cs _Mostly Fs  _Mostly Bs _Mostly Ds
14. Are you currently in a training or treatment program in the community or in a facility?
_Yes‚ in the community _Yes‚ in a facility _No _Do Not Know _No Response
If you are in a program‚ please describe it (what is it‚ which organization runs it‚ what does it deal with?). ________________________________________________________
15. Have you ever dr‎opped out of school? _Yes _No _Do Not Know _No Response
If yes‚ what were the most recent reasons for dr‎opping out? _______________________
16. Have you ever been suspended from school? _Yes _No _Do Not Know _No Response
If yes‚ what were the most recent reasons for suspension? __________________________
17. Have you ever been expelled from school? _Yes _No _Do Not Know _No Response
If yes‚ what were the most recent reasons for expulsion? _____________________
18. In the last 6 months‚ how often have you witnessed any of the following gang activities at your school/Jail/Prison?
Use a 7-point scale: (1) Never/No Times‚ (2) 1 to 3 Times‚ (3) 4 to 10 Times‚ (4) 11 to 26 Times‚ (5) More than 26 Times‚ (6) Do Not Know‚ (7) No Response
___ Gang members selling drugs
___ Fights between members of different gangs
___ Fights between members of your own gang
___ Shooting
___ Gang intimidation
___ Gang recruiting
Community
19. Are there areas right now in your community where you are afraid to walk alone? _Yes  _No _Do Not Know _No Response
If yes‚ is it because of gang-related concerns? _Yes _No _Do Not Know _No Response
Please explain ___________
20. In the last 6 months‚ how often have you witnessed any of the following gang activities in your community/jail/prison?
Use a 7-point scale: (1) Never/No Times‚ (2) 1 to 3 Times‚ (3) 4 to 10 Times‚ (4) 11 to 26 Times‚ (5) More than 26 Times‚ (6) Do Not Know‚ (7) No Response
___ Gang members selling drugs
___ Fights between members of different gangs
___ Fights between members of your own gang
___ A drive-by shooting
___ Gang intimidation
___ Gang recruiting
21. In the last 6 months‚ for each crime‚ please rate how serious a crime problem you think this is in your community/jail/ prison?
Use a 7-point scale: (1) No Problem‚ (2) A Small Problem‚ (3) A Moderate Problem‚ (4) A Serious Problem‚ (5) A Very Serious Problem‚ (6) Do Not Know‚ (7) No Response
___ Vandalism/Graffiti
___ Burglary
___ Car Theft
___ Robbery
___ Threats/Intimidation
___ Gang to Gang Confrontations
___ Drug Dealing
___ Alcohol Use
___ Drive-By Shooting
___ Possession of Knife
___ Possession of Gun
___ Firearms Use
___ Firearms Dealing
___ Arson
___ Assault/Battery
___ Homicide/Murder
___ School Disruption
___ Other‚ please specify __________________________
22. Do you think there is a gang problem in your community/jail/prison? _Yes _No _Do Not Know _No Response
23. If so‚ what do you think are the top three causes of the gang problem in your community/jail/prison?
___ Poverty
___ School problems
___ Police labeling
___ Gang members move to community from other places
___ Boredom
___ Family problems
___ Power
___ Protection
___ Lack of activities
___ Prejudice
___ Family/friends in gangs
___ To feel loved/sense of belonging
___ Other‚ please specify __________________________
24. What do you think should be done about the gang problem in your community/jail/prison?
_____________________________________________________________________________
_____________________________________________________________________________
25. About how many people over the age of 18 years have you known personally who in the last 6 months have:
___ Used marijuana‚ crack‚ cocaine‚ or other drugs?
___ Sold or dealt drugs?
___ Done other things that could get them into trouble with police such as stealing‚ selling stolen goods‚ mugging or
assaulting others?
___ Gotten drunk?
26. Are any of your friends gang members? _Yes _No _Do Not Know _No Response
27. If you wanted to get a handgun‚ how easy would it be for you to get one?
_Very Hard _Somewhat Hard _Somewhat Easy _Very Easy _Do Not Know _No Response
28. If you wanted to get drugs like cocaine‚ LSD‚ amphetamines‚ crack‚ etc.‚ how easy would it be for you toget some? _Very Hard _Somewhat Hard _Somewhat Easy _Very Easy _Do Not Know _No Response
29. Are there people over the age of 18 years in your neighborhood or facility you can talk to about something important? _Yes _No _Do Not Know _No Response
Gang-Related Activities
30. Are you currently a gang member? _Yes _No _Do Not Know _No Response
31. In the last 6 months‚ have you been an active gang member? _Yes _No _Do Not Know _No Response
31a) Do you hang out or party with gang members? _Yes _No Details:_____________
31b) Do you have a boyfriend who is gang-involved? _Yes _No Details:________________
32. What is your most recent position or rank in the gang?
_ Leader (President‚ Captain‚ Boss‚ King Pin)
_ Core member/influential (with gang all of the time – also called Striker‚ Soldier‚ Higher Up)
_ Regular member (involved most of the time – also called associate‚ affiliate)
_ Peripheral member (minimally hangs out)
_ Wannabe (staff identified)
_ Veteran/Heavy/Old Gangster/Senior Gang Member
_ Do Not Know
_ No Response
33. Why did you join or associate with a gang? Please rank your answers from 1 (Most Important) to 9 (Least Important)
___For fun
___ For protection
___ A friend was in the gang
___ A brother or sister was in the gang
___ I was forced to join
___ To get respect
___ For money
___ To fit in better
___Prostitution
___ Other‚ please specify ___________________________
34. How old were you when you first belonged to a gang? About _______ years old
35. How much do you agree or disagree with the following statements?
Use a 7-point scale: (1) Strongly Disagree‚ (2) Disagree‚ (3) Neither Agree nor Disagree‚ (4) Agree‚ (5) Strongly Agree‚ (6) Do Not Know‚ (7) No Response
___ Being in my gang makes me feel important.
___ My gang members provide a good deal of support and loyalty for one another.
___ Being a member of a gang makes me feel respected.
___ Being a member of a gang makes me feel like I am a useful person to have around.
___ Being a member of a gang makes me feel like I really belong somewhere.
___ I enjoy being a member of my gang.
___ My gang is like a family to me.
___ Being in a gang is a good way to make money.
The next few questions ask about your activities involving crime‚ drugs‚ and alcohol.
36. In the last 6 months‚ have you:
Written gang graffiti on school property‚ neighborhood houses‚ stores‚ etc.? _Yes _No _Do Not Know _No Response
Thrown rocks or bottles at persons‚ vehicles or property? _Yes _No _Do Not Know _No Response
Destroyed property worth less than $300? _Yes _No _Do Not Know _No Response
Destroyed property worth $300 or more? _Yes _No _Do Not Know _No Response
Set fire to building or property? _Yes _No _Do Not Know _No Response
Stolen bicycle or bike parts? _Yes _No _Do Not Know _No Response
Stolen a motor vehicle? _Yes _No _Do Not Know _No Response
Stolen parts or property from a vehicle (hubcaps‚ stereo‚ cell phone‚ etc.)? _Yes _No _Do Not Know _No Response
Fenced or sold stolen goods (other than weapons)? _Yes _No _Do Not Know _No Response
Shoplifted? _Yes _No _Do Not Know _No Response
Entered a house‚ store‚ or building to commit a theft? _Yes _No _Do Not Know _No Response
Broken into a house‚ store‚ or building to commit a theft? _Yes _No _Do Not Know _No Response
Fenced or sold weapons or firearms? _Yes _No _Do Not Know _No Response
Threatened to attack a person without using a gun‚ knife‚ or other weapon? _Yes _No _Do Not Know _No Response
Threatened to attack a person using a gun‚ knife‚ or other weapon? _Yes _No _Do Not Know _No Response
Robbed someone by force or by threat of force without using a weapon? _Yes _No _Do Not Know _No Response
Robbed someone by force or by threat of force using a weapon? _Yes _No _Do Not Know _No Response
Beaten up or battered someone without using a weapon? _Yes _No _Do Not Know _No Response
Beaten up or battered someone using a weapon? _Yes _No _Do Not Know _No Response
Forced someone to have sex with you (used physical force‚ the threat of physical force‚ drugs or alcohol to get any kind of sexual contact – oral‚ vaginal‚ anal‚ touching)? _Yes _No _Do Not Know _No Response
Participated in a drive-by shooting? _Yes _No _Do Not Know _No Response
Participated in a homicide? _Yes _No _Do Not Know _No Response
Participated in other crimes‚ such as a home invasion‚ prostitution (specify) ______________
37. In the past 6 months‚ have you used or tried any drugs‚ inhalants‚ prescription or non-prescription drugs to get high? _Yes _No (if no‚ go to question #38) _Do Not Know _No Response
If yes‚ about how many days per month do you use any drugs? ___ Days ___ Do Not Know ___ No Response
37a) in the past 6 months‚ have you used marijuana (also called pot‚ hash‚ weed‚ reefer) to get high? _ 1 or 2 times_ 3 to 5 times _ 6 to 9 times_ 10 to 19 times_ 20 to 29 times _ 30 to 39 times _40 + times
37b) in the past 6 months‚ have you used any form of cocaine (including crack‚ powder‚ freebase)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37c) in the past 6 months‚ have you used heroin (also called smack‚ junk‚ China White)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37d) in the past 6 months‚ have you sniffed glue‚ breathed the contents of aerosol spray cans‚ inhaled any paints/sprays/gas? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37e) in the past 6 months‚ have you used methamphetamines (also called speed‚ crystal meth‚ crank‚ ice)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37f) in the past 6 months‚ have you used ecstasy (also called MDMA)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37g) in the past 6 months‚ have you used a needle to inject any illegal drug into your body? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37h) in the past 6 months‚ have you used prescription drugs to get high (such as morphine‚ anti-depressants‚ Oxycontin‚ Ritalin‚ painkillers‚ etc.)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37i) in the past 6 months‚ have you used over-the-counter drugs to get high (such as Gravol‚ Tylenol‚ cold medication‚ etc)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
37j) in the past 6 months‚ have you used any other drug to get high (please state which drugs)?  ______________________________________
_ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
38. In the past 6 months‚ have you sold any drugs?
_Yes _No _Do Not Know _No Response
If yes‚ did the money go to:
_Benefit the Gang _Personal Use _Do Not Know _No Response
39. In the past 6 months‚ have you used any kind of alcohol to get drunk? _Yes _No (if no‚ go to question #40) _Do Not Know _No Response
If yes‚ have you drunk:
_Wine
_Beer
_Hard Liquor
39a) Have you had 5 or more alcoholic drinks at one time (in a row‚ within a couple of hours)? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
40. In the past 6 months‚ have you had any arrests or police contacts? This may include being stopped‚ searched‚ questioned‚ or being brought to the police station at any time.
_Yes _No _Do Not Know _No Response
If yes‚ how many times? ______
If yes‚ please describe the incident(s) ________________________________________
41. For the incident(s) described above‚ please indicate if you were:
_Treated fairly by the police MOST of the time.
_Treated fairly by the police SOME of the time.
_NOT treated fairly by the police SOME of the time.
_NOT treated fairly by the police MOST of the time.
_Do Not Know
_No Response
42. Do you think you will ever leave the gang? _Yes _No _Do Not Know _No Response
42a) Have you already left your gang? _Yes _No _Do Not Know _No Response
42b) When did you leave your gang?__________________________________
43. If you will leave the gang/if you have left your gang‚ which of the following are reasons that will get you out of a gang/got you out of a gang? Identify all that apply.
Advice/pressure from a family member/relative _Yes _No _Do Not Know _No Response
Advice/pressure from someone else (specify who ________) _Yes _No _Do Not Know _No Response
Move out of neighborhood _Yes _No _Do Not Know _No Response
Because of a steady girlfriend/boyfriend/spouse _Yes _No _Do Not Know _No Response
Get married _Yes _No _Do Not Know _No Response
Become a parent _Yes _No _Do Not Know _No Response
Family responsibilities (specify what _________________) _Yes _No _Do Not Know _No Response
Obtain a job _Yes _No _Do Not Know _No Response
Get into school/education program _Yes _No _Do Not Know _No Response
Recreation/sports program _Yes _No _Do Not Know _No Response
Go to jail/prison _Yes _No _Do Not Know _No Response
Other‚ please specify___________________________________________
The next section asks about the sex trade in the past 6 months:
44) Have you traded sex to get something you wanted (money‚ drugs‚ place to stay)? _ Yes (if yes go to #44a) _ No (if No‚ go to #47)
44a) If yes‚ how often did you trade sex in the past 6 months? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
45) What have you traded sex for? _ money _ drugs _ food _ a place to stay _ to be part of a gang
46) How old were you when you first traded sex? _ 10 _ 11 _ 12 _ 13 _ 14 _ 15 _ 16 _ 17 _ 18 or older
46a) How did you get started in it?______________________________________
46b) How old were you when you had your first sexual experience (probe for sexual abuse)?________
47) Has anyone made you trade sex for something in the past 6 months? _ Yes _ No (if No‚ go to #49)
48) Who was it? (Circle all that apply) _ parent/other family member _ male friend _ female friend _ gang member _ other
48b) Have you ever made anyone work the street? _ Yes (if yes go to #48c) _ No (if No‚ go to #49)
Please provide details:__________________________________________________
48c) If yes‚ how often did you do make someone work the streets in the past 6 months? _ 1 or 2 times _ 3 to 5 times _ 6 to 9 times _ 10 to 19 times _ 20 to 29 times _ 30 to 39 times _ 40 + times
The final section asks about victimization by serious violence in the past 6 months:
49) In the last 6 months‚ how often have you had these things happen to you?
Use a 7-point scale: (1) Never/No Times‚ (2) 1 to 3 Times‚ (3) 4 to 10 Times‚ (4) 11 to 26 Times‚ (5) More than 26 Times‚ (6) Do Not Know‚ (7) No Response
___ been punched or beaten by another person (no weapon involved)?
___ been threatened with a knife?
___ been stabbed with a knife?
___ been threatened with another kind of weapon? List weapon(s)________________________________
___ been beaten with another kind of weapon? List weapon(s):____________________
___ been threatened with a gun?
___ been shot at?
___ been kidnapped (taken and held against your will in a place you could not escape from)?
50) Please describe the injuries you have suffered and medical attention you received as a result of any of these attacks:

This instrument can be found at: http://www.nccaregina.ca/wp-content/uploads/2011/11/RAGS_YGPF_Final_Evaluation_Report_Totten_March_24_2011.pdf & http://www.nccaregina.ca/wp-content/uploads/2011/11/Circle-Keeper-Report-Totten-May-10-2011.pdf

Ashcroft‚ John.‚ Daniels‚ Deborah J.‚ and Flores‚ R. J. (2000). OJJDP Annual Report 2002 [Office of Juvenile Justice and Delinquency Prevention (OJJDP)] Available from: https://ojjdp.ojp.gov/library/publications/ojjdp-annual-report-2002
Totten‚ M.‚ & Dunn‚ S. (2011). Final Evaluation Report for the North Central Community Association Regina Anti-Gang Services Project. Final Evaluation Report. Submitted to the National Crime Prevention Centre‚ Public Safety Canada. Available from: http://www.nccaregina.ca/reports_studies/  
National Crime Prevention Centre. (2012). Regina Anti-Gang Services. Evaluation Summary. Ottawa‚ ON: Public Safety Canada. Available from: http://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/rgn-nt-gng/index-eng.aspx