Client-Therapist Feedback

This form allows you an opportunity to provide feedback to your therapist after your sessions have finished. This willhelp your therapist's professional development as well as helping to improve the service offered to others.You DO NOT need to identify yourself.Please place a mark in the box which most closely corresponds to how you feel about each statement.

About the Working Relationship With Your Counsellor

My therapist listened to me effectively*

My therapist understood things from my point of view.

My therapist focused on what was important to me.

My therapist accepted what I said without judging me.

My therapist showed warmth toward me.

My therapist fostered a safe and trusting environment.

Thank you!

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Claudia Diez, PhD, ABPP


All rights Reserved Claudia Diez

Claudia Diez, PhD, ABPP


All rights Reserved Claudia Diez