Counseling Experience Evaluation counseling experience evaluation Therapist Name: Date: I gave my therapist the information necessary to facilitate the changes I wanted to make. Never Sometimes Always 12345 I kept my appointments. Never Sometimes Always 12345 I actively participated in exploring my problems. Never Sometimes Always 12345 I actively participated in exploring my options, solutions and their consequences. Never Sometimes Always 12345 I made an effort to learn new skills and get new information. Never Sometimes Always 12345 I used the new information and skills between sessions. Never Sometimes Always 12345 I established appropriate goals. Never Sometimes Always 12345 I attained my goals. Never Sometimes Always 12345 I felt comfortable enough to question, clarify and disagree with my therapist when appropriate. Never Sometimes Always 12345 My therapist was on time for my appointments. Never Sometimes Always 12345 My therapist and I worked well together. Never Sometimes Always 12345 My therapist respected me. Never Sometimes Always 12345 My therapist understood me and my problems. Never Sometimes Always 12345 My therapist helped me explore my options and Solutions. Never Sometimes Always 12345 My therapist helped me understand myself and the part I play in my problems(s). Never Sometimes Always 12345 My therapist helped me establish goals. Never Sometimes Always 12345 My therapist supported me in making the changes needed to accomplish my goals. Never Sometimes Always 12345 My therapist gave me new information and taught me new skills related to my goals. Never Sometimes Always 12345 My therapist kept our sessions focused. Never Sometimes Always 12345 My therapist held me accountable to the work I agreed to do. Never Sometimes Always 12345 My therapist was clear and on target. Never Sometimes Always 12345 Your name (optional): Comments: