Family Christian Counseling Center - Evaluation of Therapy Question Title * 1. What is your therapists name? (this will only be seen by the director of the Center) Question Title * 2. Therapeutic Empathy Not at all true Somewhat true Moderately true Very true Completely true N/A My therapist seemed warm and supportive My therapist seemed warm and supportive Not at all true My therapist seemed warm and supportive Somewhat true My therapist seemed warm and supportive Moderately true My therapist seemed warm and supportive Very true My therapist seemed warm and supportive Completely true My therapist seemed warm and supportive N/A I felt safe to talk about my issues I felt safe to talk about my issues Not at all true I felt safe to talk about my issues Somewhat true I felt safe to talk about my issues Moderately true I felt safe to talk about my issues Very true I felt safe to talk about my issues Completely true I felt safe to talk about my issues N/A My therapist treated me with respect My therapist treated me with respect Not at all true My therapist treated me with respect Somewhat true My therapist treated me with respect Moderately true My therapist treated me with respect Very true My therapist treated me with respect Completely true My therapist treated me with respect N/A My therapist did a good job listening My therapist did a good job listening Not at all true My therapist did a good job listening Somewhat true My therapist did a good job listening Moderately true My therapist did a good job listening Very true My therapist did a good job listening Completely true My therapist did a good job listening N/A My therapist understood my feelings and concerns My therapist understood my feelings and concerns Not at all true My therapist understood my feelings and concerns Somewhat true My therapist understood my feelings and concerns Moderately true My therapist understood my feelings and concerns Very true My therapist understood my feelings and concerns Completely true My therapist understood my feelings and concerns N/A Question Title * 3. Helpfulness of therapy Not at all true Somewhat true Moderately true Very true Completely true N/A I was able to express my feelings during sessions I was able to express my feelings during sessions Not at all true I was able to express my feelings during sessions Somewhat true I was able to express my feelings during sessions Moderately true I was able to express my feelings during sessions Very true I was able to express my feelings during sessions Completely true I was able to express my feelings during sessions N/A I talked about the problems that are bothering me I talked about the problems that are bothering me Not at all true I talked about the problems that are bothering me Somewhat true I talked about the problems that are bothering me Moderately true I talked about the problems that are bothering me Very true I talked about the problems that are bothering me Completely true I talked about the problems that are bothering me N/A The techniques we used were helpful The techniques we used were helpful Not at all true The techniques we used were helpful Somewhat true The techniques we used were helpful Moderately true The techniques we used were helpful Very true The techniques we used were helpful Completely true The techniques we used were helpful N/A The approach my therapist used made sense The approach my therapist used made sense Not at all true The approach my therapist used made sense Somewhat true The approach my therapist used made sense Moderately true The approach my therapist used made sense Very true The approach my therapist used made sense Completely true The approach my therapist used made sense N/A I learned some new ways to deal with my problems I learned some new ways to deal with my problems Not at all true I learned some new ways to deal with my problems Somewhat true I learned some new ways to deal with my problems Moderately true I learned some new ways to deal with my problems Very true I learned some new ways to deal with my problems Completely true I learned some new ways to deal with my problems N/A Question Title * 4. Satisfaction with therapy Not at all true Somewhat true Moderately true Very true Completely true N/A I believe the therapy was helpful to me I believe the therapy was helpful to me Not at all true I believe the therapy was helpful to me Somewhat true I believe the therapy was helpful to me Moderately true I believe the therapy was helpful to me Very true I believe the therapy was helpful to me Completely true I believe the therapy was helpful to me N/A Overall I was satisfied with my therapy Overall I was satisfied with my therapy Not at all true Overall I was satisfied with my therapy Somewhat true Overall I was satisfied with my therapy Moderately true Overall I was satisfied with my therapy Very true Overall I was satisfied with my therapy Completely true Overall I was satisfied with my therapy N/A Question Title * 5. Negative feelings during therapy Not at all true Somewhat true Moderately true Very true Completely true N/A At times, my therapist did not seem to understand how I felt At times, my therapist did not seem to understand how I felt Not at all true At times, my therapist did not seem to understand how I felt Somewhat true At times, my therapist did not seem to understand how I felt Moderately true At times, my therapist did not seem to understand how I felt Very true At times, my therapist did not seem to understand how I felt Completely true At times, my therapist did not seem to understand how I felt N/A At times, I felt uncomfortable during the session At times, I felt uncomfortable during the session Not at all true At times, I felt uncomfortable during the session Somewhat true At times, I felt uncomfortable during the session Moderately true At times, I felt uncomfortable during the session Very true At times, I felt uncomfortable during the session Completely true At times, I felt uncomfortable during the session N/A I did not always agree with my therapist I did not always agree with my therapist Not at all true I did not always agree with my therapist Somewhat true I did not always agree with my therapist Moderately true I did not always agree with my therapist Very true I did not always agree with my therapist Completely true I did not always agree with my therapist N/A Question Title * 6. Difficulties with the questions Not at all true Somewhat true Moderately true Very true Completely true N/A It was hard to answer some of the questions honestly It was hard to answer some of the questions honestly Not at all true It was hard to answer some of the questions honestly Somewhat true It was hard to answer some of the questions honestly Moderately true It was hard to answer some of the questions honestly Very true It was hard to answer some of the questions honestly Completely true It was hard to answer some of the questions honestly N/A Sometimes my answers did not show how I really feel inside Sometimes my answers did not show how I really feel inside Not at all true Sometimes my answers did not show how I really feel inside Somewhat true Sometimes my answers did not show how I really feel inside Moderately true Sometimes my answers did not show how I really feel inside Very true Sometimes my answers did not show how I really feel inside Completely true Sometimes my answers did not show how I really feel inside N/A It would be too upsetting for me to criticize my therapist It would be too upsetting for me to criticize my therapist Not at all true It would be too upsetting for me to criticize my therapist Somewhat true It would be too upsetting for me to criticize my therapist Moderately true It would be too upsetting for me to criticize my therapist Very true It would be too upsetting for me to criticize my therapist Completely true It would be too upsetting for me to criticize my therapist N/A Question Title * 7. At this time, my counseling: is still in progress has been completed and I met most/all of my goals has ended, but I did not meet all of my therapy goals Question Title * 8. Why did you end therapy (if applicable)? Agreed with therapist that treatment was complete Logistics, such as time commitment/scheduling, transportation, unsupportive family member Unhappy with therapy process (i.e. brought up painful emotions) Unhappy with therapist (i.e. not a good fit finances other reason Question Title * 9. What did you like the LEAST about the therapy? Question Title * 10. What did you like the MOST about the therapy Question Title * 11. Please leave your name If you would like us to respond to your concerns in a personal way. Done