Time to Listen logo

We specialise in working with children, young people and families, but also provide counselling for adults

Initial Evaluation Form

 1. What do you think about where the counselling takes place?

 

Agree

Neither agree nor disagree

Disagree

Did you like the room you were in?

Was it quiet?

Did you feel safe?

2. We would like some information about your counsellor.

First name of Counsellor

 

Agree

Neither agree nor disagree

Disagree

My first meeting with my counsellor

Happy

Neither happy or unhappy

Unhappy

My counsellor was easy to talk to

They listened to me

I felt safe with them

I was able to feel I could trust my counsellor

They have started to help me with my problem(s)

3. How helpful have you found the counselling?

It is starting to help me to:-

Agree

Neither agree nor disagree

Disagree

See things more clearly

Understand my problems

Understand myself better as a person

Start to make clearer decisions

Feel better

Feel more confident about myself

4. Would you recommend the counselling service to other people in need of help?

Yes No

5. Is there anything that you do not like about your counselling sessions, so far?

6. What do you think could improve the counselling service?

Is there anything else you would like to tell us?

Date form completed

Name of the person completing the form

Would you be willing for your comments to be anonymously used in our publicity and service evaluations? For example, cited on our website and shared with Ofsted?

Yes No

Are you happy for your comments to be shared with your counsellor / therapist and other members of the Time to Listen Team?

Yes No

Your completed form will be shared with your Social Worker, if applicable, as part of our regular review process.

Thank you for taking the time to complete this form and sharing your feedback