Feedback - Adults and CYP

WC CIC Feedback Survey - Adults and Young People. This is confidential.

Your experience of our services counts and we would like to invite you to take 5 minutes to fill in this customer evaluation. With your help we can continue to improve our services.

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* 1. Was having access to counselling that was either free/affordable

	Agree Strongly	Agree	Disagree	Disagree Strongly
really important	really important Agree Strongly	really important Agree	really important Disagree	really important Disagree Strongly
quite important	quite important Agree Strongly	quite important Agree	quite important Disagree	quite important Disagree Strongly
not important	not important Agree Strongly	not important Agree	not important Disagree	not important Disagree Strongly
help you prioritise your mental health	help you prioritise your mental health Agree Strongly	help you prioritise your mental health Agree	help you prioritise your mental health Disagree	help you prioritise your mental health Disagree Strongly
help you prioritise the mental health of someone in your family	help you prioritise the mental health of someone in your family Agree Strongly	help you prioritise the mental health of someone in your family Agree	help you prioritise the mental health of someone in your family Disagree	help you prioritise the mental health of someone in your family Disagree Strongly

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* 2. Did you feel you got your appointment quickly enough?

Yes

No

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* 3. How did you find out about our services?

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* 4. Approximately how many counselling sessions did you have with us?

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* 5. We would like some information of your experience with your counsellor.

	Strongly Agree	Agree	Disagree	Strongly Disagree
My first impression of my counsellor was a positive one.	My first impression of my counsellor was a positive one. Strongly Agree	My first impression of my counsellor was a positive one. Agree	My first impression of my counsellor was a positive one. Disagree	My first impression of my counsellor was a positive one. Strongly Disagree	My first impression of my counsellor was a positive one.
I feel my counsellor is easy to talk to.	I feel my counsellor is easy to talk to. Strongly Agree	I feel my counsellor is easy to talk to. Agree	I feel my counsellor is easy to talk to. Disagree	I feel my counsellor is easy to talk to. Strongly Disagree	I feel my counsellor is easy to talk to.
I feel my counsellor is someone who really listens.	I feel my counsellor is someone who really listens. Strongly Agree	I feel my counsellor is someone who really listens. Agree	I feel my counsellor is someone who really listens. Disagree	I feel my counsellor is someone who really listens. Strongly Disagree	I feel my counsellor is someone who really listens.
I feel my counsellor is supportive.	I feel my counsellor is supportive. Strongly Agree	I feel my counsellor is supportive. Agree	I feel my counsellor is supportive. Disagree	I feel my counsellor is supportive. Strongly Disagree	I feel my counsellor is supportive.
I feel my counsellor is someone who gives me confidence.	I feel my counsellor is someone who gives me confidence. Strongly Agree	I feel my counsellor is someone who gives me confidence. Agree	I feel my counsellor is someone who gives me confidence. Disagree	I feel my counsellor is someone who gives me confidence. Strongly Disagree	I feel my counsellor is someone who gives me confidence.
I feel my counsellor is someone who has helped me deal with some difficult issues.	I feel my counsellor is someone who has helped me deal with some difficult issues. Strongly Agree	I feel my counsellor is someone who has helped me deal with some difficult issues. Agree	I feel my counsellor is someone who has helped me deal with some difficult issues. Disagree	I feel my counsellor is someone who has helped me deal with some difficult issues. Strongly Disagree	I feel my counsellor is someone who has helped me deal with some difficult issues.
I feel my counsellor is someone who does not judge me.	I feel my counsellor is someone who does not judge me. Strongly Agree	I feel my counsellor is someone who does not judge me. Agree	I feel my counsellor is someone who does not judge me. Disagree	I feel my counsellor is someone who does not judge me. Strongly Disagree	I feel my counsellor is someone who does not judge me.

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* 6. Please enter the first name of your counsellor:

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* 7. How helpful have you found counselling?

	Strongly Agree	Agree	Disagree	Strongly Disagree
It has helped me to see things more clearly.	It has helped me to see things more clearly. Strongly Agree	It has helped me to see things more clearly. Agree	It has helped me to see things more clearly. Disagree	It has helped me to see things more clearly. Strongly Disagree	It has helped me to see things more clearly.
It has helped me to understand my problems.	It has helped me to understand my problems. Strongly Agree	It has helped me to understand my problems. Agree	It has helped me to understand my problems. Disagree	It has helped me to understand my problems. Strongly Disagree	It has helped me to understand my problems.
It has helped me to understand myself better as a person.	It has helped me to understand myself better as a person. Strongly Agree	It has helped me to understand myself better as a person. Agree	It has helped me to understand myself better as a person. Disagree	It has helped me to understand myself better as a person. Strongly Disagree	It has helped me to understand myself better as a person.
It has helped me to start to make some changes.	It has helped me to start to make some changes. Strongly Agree	It has helped me to start to make some changes. Agree	It has helped me to start to make some changes. Disagree	It has helped me to start to make some changes. Strongly Disagree	It has helped me to start to make some changes.
It has helped me to feel better.	It has helped me to feel better. Strongly Agree	It has helped me to feel better. Agree	It has helped me to feel better. Disagree	It has helped me to feel better. Strongly Disagree	It has helped me to feel better.
It has helped me to feel more confident about myself.	It has helped me to feel more confident about myself. Strongly Agree	It has helped me to feel more confident about myself. Agree	It has helped me to feel more confident about myself. Disagree	It has helped me to feel more confident about myself. Strongly Disagree	It has helped me to feel more confident about myself.

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* 8. If you needed to, would you use the counselling service again in the future?

Yes

No

Other (please specify)

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* 9. Please leave a short review of the service that we could use as a testimonial or to improve our service.

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* 10. Would you recommend the counselling service to other people?

Yes

No