Therapist Adherence Measure
1.
Family Name: (optional)
2.
How many times has the therapist met with your family within the last week?
3.
If zero, on what date did the therapist last see anyone in the family?
4.
The therapist tried to understand how my family’s problems all fit together.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
5.
My family and the therapist worked together effectively.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
6.
My family knew exactly which problems we were working on.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
7.
The therapist recommended that family members do specific things to solve our problems?
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
8.
The therapist’s recommendations required family members to work on our problems almost every day.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
9.
The therapist understood what is good about our family.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
10.
My family and the therapist had similar ideas about ways to solve problems.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
11.
The therapist tried to change some ways that family members interact with each other.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
12.
The therapist tried to change some ways that family members interact with people outside the family.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
13.
My family and the therapist were honest and straightforward with each other.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
14.
The therapist’s recommendations should help the children to learn to regulate or identify their emotions.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
15.
Family members and the therapist agreed upon the goals of the session.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
16.
My family talked with the therapist about how well we followed her/his recommendations from the previous session.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
17.
My family talked with the therapist about the success (or lack of success) of her/his recommendations from the previous session.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
18.
We got much accomplished during the therapy session.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
19.
My family was sure about the direction of treatment.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
20.
The therapist’s recommendations made good use of our family’s strengths.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
21.
My family accepted that part of the therapist’s job is to help us change certain things about our family.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
22.
The therapist’s recommendations should help family members to become more responsible.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
23.
The therapist talked to family members in a way we could understand.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
24.
Our family agreed with the therapist about the goals of treatment.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
25.
Did the therapist assign homework to practice a new skill?
Not at all
A Little
Some
Pretty Often
A Lot
Other (please specify)
26.
The therapist checked to see whether homework was completed from the last session.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
27.
The therapist did whatever it took to help our family with tough situations.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
28.
The therapist helped us to enforce rules for the child.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
29.
The therapist helped family members talk with each other to solve problems.
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
30.
The therapist helped us keep our child from hanging around with troublesome friends.
Not an Issue
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
31.
The therapist helped us improve our child’s behavior at school.
Not an Issue
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)
32.
The therapist helped us get our child to stay in school every day.
Not an Issue
Not at All
A Little
Some
Pretty Much
Very Much
Other (please specify)