SESSION RATING
©1994, 1997 by Lynn D. Johnson, all rights reserved. See below for duplication information.
Name_____________________________________________ Date_____________________
Therapy is a cooperative relationship. Please rate today's session. Be honest
and frank, to be the most helpful to your counselor. Read each set of
descriptions and circle the number that best describes your reaction, from 0 to 4.
Use the rating system below:
AGREE WITH THIS SIDE NEUTRAL AGREE WITH THIS SIDE.
4 3 2 1 0
(Under each set of statements, circle the number that best describes your
feelings about today's session)
1. ACCEPTANCE
I felt accepted. I felt criticized or
judged.
4 3 2 1 0
2. LIKING, POSITIVE REGARD
My therapist liked me. The therapist pretended
to like me or seemed to
not like me.
4 3 2 1 0
3. UNDERSTANDING
My counselor understood me My counselor didn't under-
and my feelings. stand me or my feelings.
4 3 2 1 0
4. HONESTY AND SINCERITY
My therapist was My therapist was not
honest and sincere. sincere, was pretending.
4 3 2 1 0
5. AGREEMENT ON GOALS
We worked on my goals; We worked on my counselor's
my goals were important. goals; my goals didn't
seem important.
4 3 2 1 0
6. AGREEMENT ON TASKS
I approved of the things I didn't like what we did
we did in the session or in today's session or what
what I was asked to do I was asked to do as a
as a homework assignment. homework assignment.
4 3 2 1 0
7. SMOOTHNESS OF THE SESSION
The session was smooth; The session was rough; I
I felt comfortable. felt uncomfortable.
4 3 2 1 0
8. DEPTH OF THE SESSION
The session was deep. The session was shallow.
We got to the heart We stayed on the surface.
of things.
4 3 2 1 0
9. HELPFULNESS, USEFULNESS
I found the session The session was not
helpful. helpful.
4 3 2 1 0
10. HOPE
I felt hopeful after I felt hopeless after
the session. the session.
4 3 2 1 0
One more thing: What could help the next session go better?
(Please continue on the back if necessary).________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
First published in Dr. Johnson's text
"Psychotherapy in the age of accountability" (1995: W.W.Norton).
This form may be duplicated if the copyright notice is attached and if the individual or organization duplicating this form does not charge patients or colleagues for copying costs.
It is expressly forbidden to charge for distribution or copying.
For more information, or to share suggestions,
contact Lynn Johnson, Ph.D.
(ljohnson@inconnect.com),
at the Brief Therapy Center of Utah, 166 East 5900 South, Suite #B-108, Murray, UT 84107
Session Rating Form Serial # 00
Converted to html by Richard Ebling, LCSW