TherapyTime Client Feedback Survey

Thank you in advance for taking the time to answer the feedback questionnaire. Your honest opinion will be much appreciated. Please rest assured that the survey is completely anonymous, unless you wish to leave your name.

Ulteriore informazione per i clienti italiani: il questionario e' in inglese ma se preferite potete lasciare i vostri commenti in italiano.

1. In your opinion, as a result of your therapy how much have the following improved?

	n/a	No improvement	A small improvement	A fair improvement	A large improvement	A very large improvement
Your level of anxiety?	*In your opinion, as a result of your therapy how much have the following improved? Your level of anxiety? n/a	Your level of anxiety? No improvement	Your level of anxiety? A small improvement	Your level of anxiety? A fair improvement	Your level of anxiety? A large improvement	Your level of anxiety? A very large improvement
Your understanding of underlying causes of your psychological distress?	Your understanding of underlying causes of your psychological distress? n/a	Your understanding of underlying causes of your psychological distress? No improvement	Your understanding of underlying causes of your psychological distress? A small improvement	Your understanding of underlying causes of your psychological distress? A fair improvement	Your understanding of underlying causes of your psychological distress? A large improvement	Your understanding of underlying causes of your psychological distress? A very large improvement
Your overall mood?	Your overall mood? n/a	Your overall mood? No improvement	Your overall mood? A small improvement	Your overall mood? A fair improvement	Your overall mood? A large improvement	Your overall mood? A very large improvement
Your self-confidence?	Your self-confidence? n/a	Your self-confidence? No improvement	Your self-confidence? A small improvement	Your self-confidence? A fair improvement	Your self-confidence? A large improvement	Your self-confidence? A very large improvement
The quality of your relationships?	The quality of your relationships? n/a	The quality of your relationships? No improvement	The quality of your relationships? A small improvement	The quality of your relationships? A fair improvement	The quality of your relationships? A large improvement	The quality of your relationships? A very large improvement
The sense of meaningfulness in your life?	The sense of meaningfulness in your life? n/a	The sense of meaningfulness in your life? No improvement	The sense of meaningfulness in your life? A small improvement	The sense of meaningfulness in your life? A fair improvement	The sense of meaningfulness in your life? A large improvement	The sense of meaningfulness in your life? A very large improvement
The level of risk towards hurting yourself or others?	The level of risk towards hurting yourself or others? n/a	The level of risk towards hurting yourself or others? No improvement	The level of risk towards hurting yourself or others? A small improvement	The level of risk towards hurting yourself or others? A fair improvement	The level of risk towards hurting yourself or others? A large improvement	The level of risk towards hurting yourself or others? A very large improvement
The use of alcohol or drugs to help you cope?	The use of alcohol or drugs to help you cope? n/a	The use of alcohol or drugs to help you cope? No improvement	The use of alcohol or drugs to help you cope? A small improvement	The use of alcohol or drugs to help you cope? A fair improvement	The use of alcohol or drugs to help you cope? A large improvement	The use of alcohol or drugs to help you cope? A very large improvement

Further comments

2. How would you rate your psychotherapist on the following:

	Excellent	Very good	Good	Fair	Poor
Capacity to understand my problems	*How would you rate your psychotherapist on the following: Capacity to understand my problems Excellent	Capacity to understand my problems Very good	Capacity to understand my problems Good	Capacity to understand my problems Fair	Capacity to understand my problems Poor
Ability to help me develop self-awareness and insight	Ability to help me develop self-awareness and insight Excellent	Ability to help me develop self-awareness and insight Very good	Ability to help me develop self-awareness and insight Good	Ability to help me develop self-awareness and insight Fair	Ability to help me develop self-awareness and insight Poor
Ability to be non-judgemental	Ability to be non-judgemental Excellent	Ability to be non-judgemental Very good	Ability to be non-judgemental Good	Ability to be non-judgemental Fair	Ability to be non-judgemental Poor

Any further feedback welcome:

3. What - if anything - would you have liked to be different:

What - if anything - would you have liked to be different:

4. Finally, what did you like and/or found most helpful about your psychotherapy experience? (Write your name here if you wish the therapist to know who you are)

Finally, what did you like and/or found most helpful about your psychotherapy experience? (Write your name here if you wish the therapist to know who you are)

*
5. Permission to quote your comments anonymously

Permission to quote your comments anonymously Yes

TherapyTime Client Feedback
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1. Default Section

1. In your opinion, as a result of your therapy how much have the following improved?

2. How would you rate your psychotherapist on the following:

3. What - if anything - would you have liked to be different:

4. Finally, what did you like and/or found most helpful about your psychotherapy experience? (Write your name here if you wish the therapist to know who you are)

*
5. Permission to quote your comments anonymously

TherapyTime Client FeedbackExit this survey

1. Default Section

1. In your opinion, as a result of your therapy how much have the following improved?

2. How would you rate your psychotherapist on the following:

3. What - if anything - would you have liked to be different:

4. Finally, what did you like and/or found most helpful about your psychotherapy experience? (Write your name here if you wish the therapist to know who you are)

*5. Permission to quote your comments anonymously

TherapyTime Client Feedback
Exit this survey

*
5. Permission to quote your comments anonymously