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

 1 2 3 4 5

I kept my appointments.

Never
Sometimes
Always

 1 2 3 4 5

I actively participated in exploring my problems.

Never
Sometimes
Always

 1 2 3 4 5

I actively participated in exploring my options, solutions and their consequences.

Never
Sometimes
Always

 1 2 3 4 5

I made an effort to learn new skills and get new information.

Never
Sometimes
Always

 1 2 3 4 5

I used the new information and skills between sessions.

Never
Sometimes
Always

 1 2 3 4 5

I established appropriate goals.

Never
Sometimes
Always

 1 2 3 4 5

I attained my goals.

Never
Sometimes
Always

 1 2 3 4 5

I felt comfortable enough to question, clarify and disagree with my therapist when appropriate.

Never
Sometimes
Always

 1 2 3 4 5

My therapist was on time for my appointments.

Never
Sometimes
Always

 1 2 3 4 5

My therapist and I worked well together.

Never
Sometimes
Always

 1 2 3 4 5

My therapist respected me.

Never
Sometimes
Always

 1 2 3 4 5

My therapist understood me and my problems.

Never
Sometimes
Always

 1 2 3 4 5

My therapist helped me explore my options and Solutions.

Never
Sometimes
Always

 1 2 3 4 5

My therapist helped me understand myself and the part I play in my problems(s).

Never
Sometimes
Always

 1 2 3 4 5

My therapist helped me establish goals.

Never
Sometimes
Always

 1 2 3 4 5

My therapist supported me in making the changes needed to accomplish my goals.

Never
Sometimes
Always

 1 2 3 4 5

My therapist gave me new information and taught me new skills related to my goals.

Never
Sometimes
Always

 1 2 3 4 5

My therapist kept our sessions focused.

Never
Sometimes
Always

 1 2 3 4 5

My therapist held me accountable to the work I agreed to do.

Never
Sometimes
Always

 1 2 3 4 5

My therapist was clear and on target.

Never
Sometimes
Always

 1 2 3 4 5

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