Self Evaluation of Counseling Session

Self Evaluation of Counseling Session

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Name of Learner____Don Joe________________ Your Name_Done Joe____________________________
Skills Used?
√ yes Was this Helpful + to the session in general or therapeutic alliance or not – Comments or things that could be done differently. Be as specific as possible.
Showed empathy and positive regard Yes It was helpful. Showing empathy made the student open up more.
Non-verbally demonstrated interest and attention to student Yes Therapeutic The student will be aware that the counselor is being attentive to him.
Paraphrased content yes It was helpful Making sure the student knows that we understand and care.
Reflected feelings Yes Therapeautic
Summarized Not
Clarified Not
Observed student non-verbals Yes Helpful The non verfbals helps identify how they are feeling.
Attended to diversity and social-cultural factors Not
Used student’s language Yes
Addressed issue of concern Yes
Used silence Yes
Stayed in the “here and now”; Used immediacy Yes
Avoided closed questions including “Why” Yes
Identified students irrational or faulty beliefs No
Provided encouragement and support Yes
Operated from a strengths perspective No
Avoided giving advice No
Focused on student’s decision making yes
Summarized session Yes
Write in Other


Learner Reflection—Answer all questions completely

One thing I really liked about my counseling in this session is:

Targeted Feedback: I want to make sure I get individual or group feedback on:

Follow up: What insight did you gain from supervision about this?

Trying New Behaviors: Did you risk trying to experiment with new responses or utilize new skills? How so and how did it go?

Distractibility: Did you feel distracted at any time? If so, what happened that led to the distraction, and how did you recover? What did you learn about yourself?

Countertransferrance: Did you feel yourself reacting to the student in a way that may be caused by your own life experiences and bias? What came up and how will you utilize this to continue improve your counseling skills?

Cultural Competency: What if any cultural issues are there at work with this student? How are or are you not appropriately addressing these?

Redo: After completing the above checklist and receiving feedback from your supervisor, discuss two places in your session you would like a redo. Clearly state what they were and discuss what specifically you would do differently and how it might impact the session outcome. If you want to, you could use this as an opportunity to do the redo as a role play in your group supervision.

Goals: What is a short term goal for developing your skills to continue to work with this student? What is one general goal for continuing to develop your counseling skills?

Intern Signature and Date ____ Otero_______________________________________________________

I have reviewed this form with my intern and have provided feedback on his or her self analysis.

Site Supervisor Signature and Date ___________________________________________________

Self Evaluation of Counseling Session

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