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HED - 1.10.20 Unraveling the “Survival Knot” Three-Day Clinical Training for Couples Therapists
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How would you like your name to appear on your certificate?



What activities did you attend at the event?
Agreement
By completing this form, you attest that you have participated in all selected activities in thier entirety.
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
The instructor was knowledgeable about the content
Only Florida licensees need to answer this question. Notice to Florida Licensees: In order for us to report your hours to CE Broker, you MUST provide us with your Florida alpha-numberic license number (e.g., CDCA.XXXXXX, LICDCII.XXXXXX, LCDCII.XXXXXX, LICDC.XXXXXX). Please be sure to enter this number accurately, or CE Broker will not record your hours. 
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
The teaching methods used were appropriate to the objectives
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
The instructor presented the subject matter clearly
Objective 2: Recognize the difference in a couples exchange between the adaptive survival dance and the dance of life in connection with special attention given to the relational developmental stages of a couple.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
The teaching methods used were appropriate to the objectives
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
The instructor was responsive to participants
Objective 3: Practice rituals and skills to assist couples in becoming.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
The teaching methods used were appropriate to the objectives
The instructor used technology effectively
An introduction to the psychological/ philosophical/scientific underpinnings of the EcCT approach.
The instructor used technology effectively
Giving participants a visceral experience of the zone of the Encounter.
The instructor used technology effectively
Establishing the first step of the roadmap which allows couples to experience a paradigm shift from a content orientation to a new understanding of a process orientation.
The instructor used technology effectively
Integration of theoretical basis for the distinction between content and process.
The instructor used technology effectively
Giving participants a methodology that allows them to guide couples with the understanding that the map is not the territory.
The instructor used technology effectively
Giving participants a chance to experience the difference between the meeting of the minds, the dialogical domain, and the communion of the spirit, the domain of the encounter.
The instructor used technology effectively
Achieving a deeper integration of the distinctions individual/relational, content/process, mind/spirit.
The instructor used technology effectively
Introducing participants to a guiding principle based on the Relational. Paradigm as opposed to couple’s work based on the Individual Paradigm
The instructor used technology effectively
The development of atunement of the couples therapist to elements of internal regulation for the couple and the mutual quietening of the central nervous system.
The instructor used technology effectively
Giving participants a chance to experience the new findings of Relational Neurobiology as it pertains to the regulation of the central nervous system through limbic resonance between the couple.
The instructor used technology effectively
Giving participants an added biological dimension to their work with couples in terms of the possible biological changes of the wiring in the brain.
The instructor used technology effectively
A look at where the couples therapists themselves get triggered and “hijacked” in their therapeutic work with couples.
The instructor used technology effectively
Give participants a sense of how to integrate the work in the clinic with the journey when the couples are at home in their daily life.
The instructor used technology effectively
Give participants a chance to examine their own learning curve.
The instructor used technology effectively
Teach the distinction between adaptive, gradual change and actual transformation through the re-wiring of the brain.
The instructor used technology effectively
Give participants an understanding of different types of intelligences; emotional, sexual, spiritual as well as relational intelligence.
The instructor used technology effectively
Show participants a way to welcome the most challenging part of couples therapy, the impasse issue, where one person’s most desperate need meets the other person’s most dogged resistance.
The instructor used technology effectively
Giving the participants new eyes for their work.
The instructor used technology effectively
Giving participants clarity of purpose and of execution.
The instructor used technology effectively
Grounding of the new paradigm.
Please rate the following:
The program was relevant to my work.
Content matched stated objectives.
Usefulness of handouts/AV.
Quality of facilities and facility accommodations.
How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names?
If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain in detail (e.g. session title, speaker name, situtation):
Please tell us about any sessions you found particularly good or bad
Please tell us about any objectives you feel we accomplished well or poorly 
Please tell us about any presenters you found particularly good or bad
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional activities?
Was the educational content scientifically sound?
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
Was the mode of education effective to learning?
If you answered "No" to any of the above questions, please explain.
Did you perceive any product/service/company/commercial bias in any educational session you attended or materials you received?
If you answered "Yes" to the above question, please detail the situation below (e.g. session title, speaker name):
Were you solicited by sales personnel in an educational room (other areas do not matter) while you attended this educational activity?
If you answered "Yes" to the above question, please explain in detail (e.g. who, when, where):
How much did you learn as a result of this education program?
What specifically did you learn during this activity that you intend to integrate into your practice?

What questions have arisen in your practice for which you need answers/strategies that you can implement?

What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients/clients communicating to you that need attention or follow up?

Are you interested in basic, intermediate or advanced level trainings?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?

Additional comments:

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