Fişă de anamneză psihologica

Numele şi prenumele: _________________________________________________________________

Data, an naştere, localitate: _____________________________________________________________

Domiciliul stabil al părinţilor: ___________________________________________________________

Profesia: ____________________________________________________________________________

Vechimea in functie: __________________________________________________________________

Experienta profesionala: _______________________________________________________________

Studii anterioare: _____________________________________________________________________

1. Date asupra mediului familial – structura familiei

a. Familia

Numele membrilor familiei

Varsta parintilor la nastere

Data naşterii

Pregătirea şcolară Profesiunea Venituri

Observaţii

Tata

Mama

Fraţi

b. Atmosfera în familie (relaţiile de familie cu persoane ce dispun de functii importante; regim şi climat educativ, climat afectiv etc.):

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c. Ordinea in fratrie: _________________________________________________________________________________________

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d. Proiectele părinţilor privind viitorul copilului( influenta parintilor va arata gradul de sugestibilitate, de dependenta sau de maturizare:

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2. Date privind activitatile de joaca: a. Grupul de joaca (varsta 3-5 ani) – existenta si structura grupului (detalii despre calitatile

relationale si comunicationale):

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b. Preferinta pentru anumite meserii in timpul jocului:

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c. Pozitia subiectului fata de lider (fata de autoritate):

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3. Date asupra şcolarităţii (perioada adolescentei 16-18 ani) – afirmarea Eului, structurarea liniei si a idealului de viata

a. Situaţia şcolară in urma studiului fisei scolare:

Clasa Secţia Media anualăObiecte cu rezultate Repetenţe,

corigenţeMai bune Mai slabe

a IX-aa X-aa XI-a a XII-a

b. Succese deosebite la concursuri:_________________________________________________________________________________________

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c. Manifestări în timpul lecţiei (atenţie, receptivitate, participare la discuţii – frecvenţa şi valoarea intervenirii etc.):

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d. Modul de pregătire a lecţiilor (cu regularitate, din proprie iniţiativă, prin efort propriu etc.):_________________________________________________________________________________________

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e. Eficienta scolara (comportamentul invatarii, cu sau fara strategii de invatare)_________________________________________________________________________________________

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f. Chiulul (absenta sau prezenta lui):_________________________________________________________________________________________

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g. Factorii explicativi ai succesului sau ai insuccesului (aptitudini, sârguinţă, interes, deprinderi de muncă, lacune în pregătirea şcolară, aspiraţii profesionale, stare de sănătate, condiţii de mediu etc.):

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4. Integrarea socială a elevului (varsta 3-7 ani – adaptarea si integrarea scolara)

A. Conduita în familie:a. faţă de părinţi (ascultare, ataşament, independenţă, nesupunere etc.)

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b. relaţiile cu fraţii (ocrotire, înţelegere, dominare etc.):_________________________________________________________________________________________

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c. participare la activitatea familiei (autoservire, ajutorare etc.):_________________________________________________________________________________________

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B. Conduita în şcoală:a. Relaţiile elev – profesori (disciplinat, politicos, docil, rezervat, impertinent etc.):

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b. Atitudinea pozitiva/ negativa fata de acea perioada:_________________________________________________________________________________________

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c. Relatia cu persoanele importante (primul invatator, primul diriginte):_________________________________________________________________________________________

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d. Relaţiile cu colegii (solidaritate, colegialitate, prietenie, rezervă, tendinţă de dominare sau de supunere, egoism, apreciere, influenţa lui în cadrul colectivului etc.):

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e. Interese manifestate pentru anumite meserii:_________________________________________________________________________________________

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C. Conduita între prieteni (natura prietenilor, rolul în grup, influenţe asupra elevului etc.):_________________________________________________________________________________________

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5. Caracteristicile personalităţii a. Procese intelectuale (nivel de dezvoltare intelectuală, memorie, gândire, imaginaţie, limbaj etc.):

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b. Trăsături de afectivitate (sentimente legate de personalitate, reacţii faţă de succes şi insucces, sensibilitate, timiditate, echilibru emotiv etc.):

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c. Aptitudini, interese, aspiraţii – evidenţiate prin activităţile şcolare şi preocupările din timpul liber_________________________________________________________________________________________

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d. Increderea in sine (inalta capacitate de evaluare, autoreglare si actiune, stare de spirit optimista, stenica, siguranta in reusita proprie si colectiva):

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6. Trăsături de temperament: a. Energie (capacitate de efort, rezistenţă la oboseală), mobilitate (ritm de activitate, adaptare la

situaţii noi) şi echilibru psihic (stăpânire de sine impulsivitate):_________________________________________________________________________________________

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b. Introversiune (închis, retras) – extraversiune (deschis, sociabil): - deschis – disponibilitatea de a-si relata obiectiv si sincer trecutul:

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c. Atitudine faţă de societate şi de oameni ( comportare civilizată, solicitudine, ataşament faţă de colectiv, onestitate etc.):

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d. Atitudine faţă de sine (demnitate, modestie, spirit autocritic etc.):

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7. Aprecieri de ansamblu

a. Pregătirea raportată la aptitudini, starea de sănătate şi condiţii de muncă:_________________________________________________________________________________________

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b. Gradul de maturizare psihică (intelectuală, afectivă, temperamentală):_________________________________________________________________________________________

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8. Conduita in munca a. Relatia subordonat – sef:

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b. Relatiile cu colegii de munca:_________________________________________________________________________________________

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c. Integrarea in organizatie (conformism):_________________________________________________________________________________________

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d. Eficienta obtinuta in organizatie:_________________________________________________________________________________________

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e. Interesul profesional:_________________________________________________________________________________________

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Observaţii – raport (profilul psihologic):

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