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Form48 - 7 What have you learned(in therapy or from anyone...

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[ FORM 48 —Use the top of this page for your letterhead.] Follow-Up Questionnaire 2 Therapist’s name: Today’s date: Date of last session: 6 12 24 What is your gender? q Male q Female How old are you? years Please feel free to add further comments about each question (use the back of this form if necessary). 1. What was the main problem that caused you to seek treatment? 2. When this therapist’s treatment ended, was this problem: q Resolved, no longer a problem? q Better? q About the same? q Worse? 3. If this problem was not completely resolved, have you gotten treatment from anyone else? q No. q Yes. If you have, whom have you seen? 4. Are these problem now q Resolved, not a problem? q Better? q About the same? q Worse? 5. Did any other problems come up during this therapist’s treatment? q No or not really. q Yes. a. If yes, what were these? b. Is this problem now q Resolved, not a problem? q Better? q About the same? q Worse? 6. What did the therapy or therapist do that was most helpful to you?
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Unformatted text preview: 7. What have you learned (in therapy or from anyone or anywhere) about your original problems that has been helpful to you? 8. What did the therapist do that was not helpful to you? 9. What could the therapist have done that he or she did not do or did not do enough of? 10. Has your therapy helped your performance at work? 11. Has your therapy helped you deal with any family problems? 12. Has your therapy helped you deal with any problems with friends or social organizations? 13. Do you have other comments and suggestions? 14. How many therapy/counseling sessions did you have? Thank you very much for your time and efforts. FORM 48. Client outcome follow-up questionnaire. From The Paper Office . Copyright 2008 by Edward L. Zuckerman. Permission to photocopy this form is granted to purchasers of this book for personal use only (see copyright page for details)....
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