Counselor Evaluation Form

COUNSELOR EVALUATION FORM

Counselor’s Name: ______Number of Sessions Attended: ______

Answer the following questions according to the scale below. Please read and mark each answer carefully. Your feedback is confidential and will not be shared with your counselor until the end of the semester.

A B C D E F

_____ 1. I was disappointed in the amount of emotional support I received from

counseling.

_____ 2. Counseling helped me to develop a greater appreciation of myself.

_____ 3. Counseling provided me with a better understanding of my problems and personal

goals.

_____ 4. I felt just as much personal discomfort (anxiety, depression, anger, grief, etc.)

after counseling as when I first came in.

_____ 5. Counseling has helped me to define my needs and values more clearly.

_____ 6. Counseling has enhanced my willingness and ability to cope with my present life

situation.

_____ 7. Counseling has helped me to develop specific skills (communication,

decision making, problem solving, assertiveness, relaxation).

_____ 8. Counseling has not helped me to improve my relationships.

_____ 9. Counseling has increased my willingness and ability to make changes in my

behavior and/or my present life situation.

_____ 10. Counseling helped me to assume greater responsibility for my own growth and

well-being.

_____ 11. My counselor seemed to have little understanding of what I felt and meant.

_____ 12. I was reluctant to freely express myself for fear of being judged.

_____ 13. I didn’t really feel that my counselor respected me as a person or my potential for

growth.

_____ 14. My counselor helped me identify specific behaviors or feelings so I could work

with them more productively.

_____ 15. I had some doubts about my counselor’s sincere interest in my problem.

_____ 16. My counselor helped me recognize what I do that is self-defeating.

_____ 17. My counselor’s expression of his/her own experiences helped me to better

understand and accept my own.

_____ 18. My counselor helped me look at alternate ways of coping with my problems and

gave me useful advice.

_____ 19. I see my counselor as an effective person.

_____ 20. I would recommend my counselor to a friend.

Other comments about your counseling experience:

______