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Client's Evaluation of WCS experience
This evaluation form will help Wells Counseling Services evaluate the counseling that you received. Thanks for filling it out.
It is adapted from Dr. David Burn’s 1988 “Client’s Report of Counseling Session.”
Using the scale from 0 to 3 below, rate the extent to which you feel each of these statements is true.
0 – I do not feel this statement is valid.
1 – I feel this statement is somewhat valid.
2 – I feel this statement is moderately valid.
3 – I feel this statement is extremely valid.
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* Indicates required question
I benefited from the sessions with my counselor.
*
Not Valid
0
1
2
3
Extremely valid.
I feel that I can trust my counselor.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor sometimes does not seem to be completely genuine.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor thinks I am worthwhile.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor pretends to like me more than he or she really does.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor demonstrated an appropriate range of knowledge in addressing the issues during the counseling session.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor provided insights to the issues that I was facing.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor usually understands what I say to him or her.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor sometimes does not seem to care what happens to me.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor was friendly and warm to me.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor sometimes does not understand my description of how I feel.
*
Not Valid
0
1
2
3
Extremely Valid
My counseling I received was from a Biblical perspective.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor is sympathetic and concerned about me.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor sometimes acts condescending and talks down to me.
*
Not Valid
0
1
2
3
Extremely Valid
My counselor offered a good level of spiritual guidance and interaction with the Bible.
*
Not Valid
0
1
2
3
Extremely Valid
I would feel comfortable recommending my counselor to someone I know.
*
Not Valid
0
1
2
3
Extremely Valid
Comments:
Was anything said during the sessions that irritated you, rubbed you the wrong way, or which you disagreed with?
Describe any negative feelings you had during or about the session:
Your answer
Was anything in the sessions particularly helpful or useful? Was there anything learned that you would like to further develop?
Briefly describe key points covered:
Your answer
I wish to be contacted about this evaluation
*
Yes
No
Required
If yes, please leave your email or phone number.
Your answer
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