100% of survey complete.

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* 1. Please choose the facility you are receiving services at

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* 2. Please indicate your age or the age of the client

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* 3. What is your providers/counselors name?

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* 4. Therapeutic Empathy

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My therapist seemed warm, supportive, and concerned.
My therapist seemed trustworthy.
My therapist treated me with respect.
My therapist did a good job listening.
My therapist understood what I felt inside.

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* 5. Helpfulness of the Session

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I was able to express my feelings during session.
I talked about the problems that are bothering me.
The techniques we used were helpful.
The approach my therapist used made sense.
I learned some new ways to deal with my problems.

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* 6. Satisfaction with Today's Session

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I believe the session was helpful to me.
Overall, I was satisfied with today's session.

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* 7. Your Commitment

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I plan to do therapy homework before next session.
I intend to use what I learned in today’s session.

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* 8. Negative Feelings During the Session

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At times, my therapist didn’t seem to understand how I felt.
At times, I felt uncomfortable during the session.
I didn’t always agree with my therapist.

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* 9. Difficulties with the Questions

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It was hard to answer some of these questions honestly.
Sometimes my answers didn’t show how I really felt inside.
It would be too upsetting for me to criticize my therapist.

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* 10. What did you like the LEAST about the session?

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* 11. What did you like the BEST about the session?

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