Baker 4770

INDIVIDUAL ROLE-PLAY SESSION RATING FORM - CLIENT

Dr. Stephen Black, Counseling Techniques, PSYC 4770

Department of Psychology & Child Development

California State University, Stanislaus

PLEASE ENTER YOUR CODE NAME: *

AS THE CLIENT:
Complete this sentence ~ "TODAY'S SESSION WAS..."

*

Extremely hindering

Moderately hindering

Slightly hindering

Neither helpful nor hindering (neutral)

Slightly helpful

Moderately helpful

Extremely helpful

As the CLIENT:
How do you feel about the session you participated in today?
*

Perfect

Very good

Pretty good

Fair

Poor

Very poor

AS THE CLIENT:
How much progress do you feel was made in dealing with the "problems" in today's session?
*

A great deal of progress

Moderate progress

Some progress

A little progress

Didn't get anywhere in this session

In some ways problems became worse

As the CLIENT:
After today's session, I was able to see something from a different perspective than before.
*

Not at all

Slightly

Somewhat

Moderately

Considerably

Very much

Please indicate on the scale below the number which best describes your overall level of competence at this point in the course:

	0%-10% None	20%	30%	40% Somewhat	50%	60%	70%	80% Very much	90%	100% Completely
*