RAGPS The Myth of the Selfless Therapist
How would you like your name to appear on your certificate?
Profession
Select Your Profession
Addictions & Substance Abuse Counselor
Counselor
Employee Assistance Professionals
Marriage and Family Therapist
Nurse
Other
Physician
Psychologist
Social Worker
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How many credit hours did you complete?
Credit Hours (maximum: 7.25)
Agreement
By completing this form, you attest that you have attended the number of hours you have indicated above.
I agree
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Please rate your satisfaction with the content and quality of the program:
Very Satisfied
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
Very Dissatisfied
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Was the educational content scientifically sound?
Yes
No
If no, please explain...
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Did you perceive any commercial bias or influence in the educational content?
Yes
No
If yes, what...
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Did this program improve your competence or performance?
Yes
No
If yes, how...
If no, please explain...
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What did you learn that will help you in your practice?
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Were the following objectives met?
Objective 1: Identify how your profession challenges work/life balance
Yes
No
Not sure
Were the following objectives met?
Objective 2: Recognize when personal issues affect professional practice
Yes
No
Not sure
Were the following objectives met?
Objective 3: Apply a decision-making model for managing the intersection between clinical requirements and therapist self-care
Yes
No
Not sure
Were the following objectives met?
Objective 4: Recognize when unidentified feelings of aggression signal mismanaged treatment issues and/or inadequate self-care
Yes
No
Not sure
Were the following objectives met?
Objective 5: Discuss the ways in which treatment modality (individual or group) impacts self-care and the use of self-disclosure
Yes
No
Not sure
Were the following objectives met?
Objective 6: Apply techniques for responding therapeutically to agrression expressed in the treatment setting
Yes
No
Not sure
Were the following objectives met?
Objective 7: Analyze when self-deisclosure and boundary shifts are clinically appropriate
Yes
No
Not sure
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The program was up-to-date and relevant to my professional practiceÂ
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Additional comments
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Was the location suitable?
Yes
No
The facilities were conducive to learning
Yes
No
Not sure
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Rate the following for all instructors
Instructor was knowledgeable about the content
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor presented the subject matter clearly
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor was responsive
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor used technology, hand outs and other learning aids effectively
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Additional questions about the instructor(s)
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What questions are you having in your practice that you would like to see addressed in an educational activity?
Questions, concerns and accommodations were addressed efficiently and in a timely manner
Additional comments
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