DCCCA Client Satisfaction Questionnaire Survey

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* 1. What DCCCA Treatment Program did you just completed?

Women’s Recovery Center (WRC)-Wichita

Options Adult-Wichita

First Step at Lakeview-Lawrence

DCCCA Outpatient Treatment-Lawrence

Elm Acres Recovery Services-Pittsburg

DCCCA Pratt

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* 2. What is your gender?

Male

Female

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* 3. What is your age?

Under 21

22-30

31-40

41-50

51-60

Over 60

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* 4. What race/ethnicity do you consider yourself to be?

White

White, of Latino or Hispanic Origin

African American/Black

Native American

Asian

Mixed

Other

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* 5. What is your approximate annual household income?

Less than $25,000 per year

$25,000 to $50,000 per year

$50 ,000 to $75,000 per year

More than $75,000 per year

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* 6. Are these situations now better, about the same, or worse than they were before you entered this treatment program?

	Better	About the Same	Worse
School or Work	School or Work Better	School or Work About the Same	School or Work Worse
Family Relations	Family Relations Better	Family Relations About the Same	Family Relations Worse
Legal Situation	Legal Situation Better	Legal Situation About the Same	Legal Situation Worse
Mental Health	Mental Health Better	Mental Health About the Same	Mental Health Worse
Physical Health	Physical Health Better	Physical Health About the Same	Physical Health Worse

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* 7. Do you now use alcohol and/or other drugs more, about the same, or less than you did before you entered this treatment program?

	More	About the same	Less	I never used this substance
Alcohol	Alcohol More	Alcohol About the same	Alcohol Less	Alcohol I never used this substance
Drugs	Drugs More	Drugs About the same	Drugs Less	Drugs I never used this substance

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* 8. Is this treatment program better, about the same, or worse than other treatment programs you have been in?

Better

About the Same

Worse

I have never been in treatment before, so I have no means of comparison.

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* 9. Overall, how satisfied are you with this treatment program?

Very Satisfied

Satisfied

Neither Satisfied Nor Dissatisfied

Dissatisfied

Very Dissatisfied

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* 10. How long were you in this treatment program?

Two weeks or less

2 - 4 weeks

1 - 2 months

2 - 4 months

4 - 6 months

More than 6 months

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* 11. How much did your family participate in your treatment?

A lot

Some

Not at all

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* 12. How many times have you been in treatment before coming to this program?

None – This is the first time I have been in treatment.

Once

Twice

Three times

Four times

More than 4 times

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* 13. The following questions ask about your experience with DCCCA's staff and your treatment.

	Yes	I’m not sure.	No
Did you get your first appointment in a timely manner?	Did you get your first appointment in a timely manner? Yes	Did you get your first appointment in a timely manner? I’m not sure.	Did you get your first appointment in a timely manner? No
Did you meet your counselor within 24 hours of coming to the program?	Did you meet your counselor within 24 hours of coming to the program? Yes	Did you meet your counselor within 24 hours of coming to the program? I’m not sure.	Did you meet your counselor within 24 hours of coming to the program? No
Were you treated courteously by the staff?	Were you treated courteously by the staff? Yes	Were you treated courteously by the staff? I’m not sure.	Were you treated courteously by the staff? No
Were the instructions clear about who to see, when and where?	Were the instructions clear about who to see, when and where? Yes	Were the instructions clear about who to see, when and where? I’m not sure.	Were the instructions clear about who to see, when and where? No
Was your counselor on time for your appointments?	Was your counselor on time for your appointments? Yes	Was your counselor on time for your appointments? I’m not sure.	Was your counselor on time for your appointments? No
Do you think your counselor did a good job as your counselor?	Do you think your counselor did a good job as your counselor? Yes	Do you think your counselor did a good job as your counselor? I’m not sure.	Do you think your counselor did a good job as your counselor? No
Did you participate in developing your treatment plan?	Did you participate in developing your treatment plan? Yes	Did you participate in developing your treatment plan? I’m not sure.	Did you participate in developing your treatment plan? No
Did you understand your treatment plan?	Did you understand your treatment plan? Yes	Did you understand your treatment plan? I’m not sure.	Did you understand your treatment plan? No
Did your treatment meet your needs, as identified in your assessment?	Did your treatment meet your needs, as identified in your assessment? Yes	Did your treatment meet your needs, as identified in your assessment? I’m not sure.	Did your treatment meet your needs, as identified in your assessment? No
Were you given a phone number and contact person to use if you have a problem or complaint?	Were you given a phone number and contact person to use if you have a problem or complaint? Yes	Were you given a phone number and contact person to use if you have a problem or complaint? I’m not sure.	Were you given a phone number and contact person to use if you have a problem or complaint? No

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* 14. If you paid a fee for treatment, was the fee determined in a way that was fair and understandable?

Yes

Neutral or Unsure

I didn’t pay for treatment.

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* 15. The following questions ask about myStrength.

	Yes	I'm not sure.	No
Were you helped to sign up for myStrength while in treatment?	Were you helped to sign up for myStrength while in treatment? Yes	Were you helped to sign up for myStrength while in treatment? I'm not sure.	Were you helped to sign up for myStrength while in treatment? No
Did you use myStrength while in treatment?	Did you use myStrength while in treatment? Yes	Did you use myStrength while in treatment? I'm not sure.	Did you use myStrength while in treatment? No
Is myStrength a helpful resource for your recovery process?	Is myStrength a helpful resource for your recovery process? Yes	Is myStrength a helpful resource for your recovery process? I'm not sure.	Is myStrength a helpful resource for your recovery process? No
Will you continue to use myStrength?	Will you continue to use myStrength? Yes	Will you continue to use myStrength? I'm not sure.	Will you continue to use myStrength? No

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* 16. What information source did you use to choose DCCCA as your treatment provider? (Check all that apply).

Court related brochure or referral

Phone book

On line search

Friend or family told me about DCCCA

Physician, hospital or other healthcare provider

Regional Alcohol and Drug Assessment Center

Mental health center or therapist

Another treatment provider

Other

Please Specify "Other"

DCCCA Client Satisfaction Questionnaire

1. Directions

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* 1. What DCCCA Treatment Program did you just completed?

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* 2. What is your gender?

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* 3. What is your age?

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* 4. What race/ethnicity do you consider yourself to be?

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* 5. What is your approximate annual household income?

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* 6. Are these situations now better, about the same, or worse than they were before you entered this treatment program?

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* 7. Do you now use alcohol and/or other drugs more, about the same, or less than you did before you entered this treatment program?

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* 8. Is this treatment program better, about the same, or worse than other treatment programs you have been in?

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* 9. Overall, how satisfied are you with this treatment program?

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* 10. How long were you in this treatment program?

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* 11. How much did your family participate in your treatment?

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* 12. How many times have you been in treatment before coming to this program?

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* 13. The following questions ask about your experience with DCCCA's staff and your treatment.

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* 14. If you paid a fee for treatment, was the fee determined in a way that was fair and understandable?

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* 15. The following questions ask about myStrength.

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* 16. What information source did you use to choose DCCCA as your treatment provider? (Check all that apply).

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* 17. Do you have any other comments, suggestions or questions?