Clinician Supervisor (survey)

ATTACHMENT 2

Clinician Supervisor’s Survey of the Quality of Psychosocial Care for Treatment of Adults with Post Traumatic Stress Disorder (PTSD)

INSTRUMENT FOR ASSESSING the Quality of Psychosocial Care for Treatment of Adults with Post Traumatic Stress Disorder (PTSD): SUPERVISOR VERSION

Instructions: Please complete this survey based on your observation of INSERT THERAPIST’S NAME’S recent (INSERT DATE) therapy session with INSERT CLIENT NAME.

Note: Not every therapeutic element will be delivered in every therapy session. Only endorse “yes” to those survey items that reflect the treatment you observed provided in this session. If the item did not occur in this session, please mark “no”. Your responses will be kept confidential and not be shared with your supervisee.

During this session:			Please circle one response:
1.	Did the therapist set an agenda?		Yes / No
2.	Did the therapist go over the agenda with the client?		Yes / No
3.	Did the therapist provide background on the treatment rationales and concepts during this session (i.e., why the therapist is asking the client to do something or explaining why something is occurring within the session)?		Yes / No
4.	Did the therapist discuss or check-in on the client’s treatment expectations (i.e., what will happen, how treatment will progress, expectations for improvement)?		Yes / No
5.	Did the therapist and his/her client mutually set or check-in on goals for treatment?		Yes / No
6.	Did the therapist identify salient problem areas related to the trauma? Problem areas might include self-blame, other blame, power and control issues, beliefs impacted by the trauma (e.g., the world is a dangerous place), self- esteem, safety, trust, intimacy, and perception of danger.		Yes / No
7.	Did the therapist use cognitive restructuring techniques (techniques to address cognitive issues such as negative thoughts, distortions, false beliefs or perceptions and replace them with accurate and more useful cognitions) to work on the identified problem areas?		Yes / No
8.	Did the therapist use a Socratic discussion method, that is, statements or questions designed for the client to examine his/her beliefs? For example: How do you know this? Can you give me an example? What are some other ways of viewing this? What are the pros and cons to your way of thinking about this? How did you come to this conclusion? What evidence do you have to justify this?		Yes / No
9.	Did the therapist facilitate the development of alternative hypotheses (i.e., alternative viewpoints or explanations) to problematic beliefs? Examples of alternative hypotheses to problematic thinking might include: Distortion: People in authority can’t be trusted. More Helpful Thought: People in authority are individuals, and they don’t all share the same strengths and weaknesses Distortion: Everyone is out to hurt me. I can’t trust anyone More Helpful Thought: There are some dangerous people out there, but not everyone is out to harm you		Yes / No
10.	Did the therapist identify areas of trauma related avoidance, where the trauma has shifted or restricted daily patterns of living (i.e., the trauma has influenced daily functioning)? For example, a client may avoid places with loud noises and lots of people.		Yes / No
11.	Did the therapist use techniques to systematically approach areas of trauma related avoidance, where the trauma has shifted daily patterns of living (i.e., the trauma has influenced daily functioning) from easier to more difficult situations? For example, a person in a motor vehicle accident may be fearful of driving. An approach from easy to more difficult might look like: Easy: Encouraging the client to ride in a car as a passenger for a short period of time. Difficult: Encouraging the client to drive on street and then a freeway, etc.		Yes / No
12.	Did the therapist use any of the following techniques to deal with trauma related avoidance?		Yes / No
	a. Ask the client to imagine their traumatic experience for longer than 10 mins		Yes / No
	b. Ask the client to write about their traumatic experience		Yes / No
	c. Socratic discussion method (i.e., “How do you know this? Can you give me an example?”)
	d. Real world experiments like visiting a place related to the traumatic experience with the client for longer than 10 mins		Yes / No
13.	Did the therapist discuss and process the details of the client’s recounting of the trauma, including the emotions surrounding the event?		Yes / No
14.	Did the therapist struggle to manage time for any of the reasons below: Client talked incessantly or tangentially Client had trouble keeping on task Session time was abbreviated The therapist had trouble keeping the client on task		Yes / No
15.	Was the therapist directive (i.e., followed the agenda or guided the client to relevant discussion) during this session?		Yes / No
16.	Did the therapist ask the client for feedback or input on his/her treatment (i.e., “how is this working?”; “Are we working on things that you think are important?”)? This would not include progress monitoring.		Yes / No
17.	Did the therapist ask the client for feedback on himself/herself?		Yes / No
18.	Did the therapist assign his/her client homework or practice assignments (to be completed by the next session) to deal with issues surrounding PTSD symptoms (i.e., avoidance, thought monitoring, problematic beliefs, anxiety) or issues related to the trauma?		Yes / No
19.	Did the therapist review the assignment instructions and verify the client has a thorough understanding of the homework for the next session?		Yes / No
20.	Did the therapist address difficulties or barriers related to completing of homework from the previous session?		Yes / No
21.	Did the therapist work with the client to come up with solutions to difficulties, barriers, or issues in completing the homework from the previous session?		Yes / No
22.	Did the therapist review and discuss the client’s homework assigned during the previous session?		Yes / No
23.	When reviewing the homework assigned from the previous session, did the therapist encourage the client or provide him/her with constructive feedback?		Yes / No
For the following questions, please think about the overall course of treatment with this client rather than the last session.
24.	I am confident in the therapist’s ability to help this client.	Never / Rarely / Occasionally / Sometimes / Often / Very Often / Always
25.	I believe this client likes the therapist.	Never / Rarely / Occasionally / Sometimes / Often / Very Often / Always
26.	This client and the therapist have built mutual trust.	Never / Rarely / Occasionally / Sometimes / Often / Very Often / Always
27.	a. To your knowledge, has the therapist ever conducted a suicide risk assessment with this client?		Yes / No
	b. Did the therapist conduct suicide risk assessment during this session?		Yes / No
28.	a. To your knowledge, has the therapist ever used information from your suicide risk assessment to influence treatment or monitor progress with this client?		Yes / No
	b. Did the therapist use information from the suicide risk assessment to influence treatment or monitor progress during this session?		Yes / No
29.	To your knowledge, has the therapist used any valid standardized instruments (e.g., The Revised PTSD Checklist) or psychometric scales to monitor PTSD symptoms and assess change?		Yes / No
	Did the therapist use any valid standardized instruments (e.g., The Revised PTSD Checklist) or psychometric scales to monitor PTSD symptoms and assess change during this session?		Yes / No
30.	a. To your knowledge has the therapist ever provided the client with education on their symptoms (i.e., education on avoidance, flashbacks, etc.)?		Yes / No
	b. Did the therapist provide the client with education on their symptoms (i.e., education on avoidance, flashbacks, etc.) during this session?		Yes / No
31.	a. To your knowledge, has the therapist ever provided the client with specific education on the nature of the traumatic event (i.e., changes in viewpoint or perception or facts about the type of trauma)? For example, this might include education on the nature of acquaintance rape vs. stranger rape. Or how sexual assault generally influences view points and beliefs. Or how a perpetrator may groom their victim before an assault.		Yes / No
	b. Did you provide provided the client with specific education on the nature of the traumatic event (i.e., changes in viewpoint or perception or facts about the type of trauma) during this session?		Yes / No
32.	a. To your knowledge, has the therapist ever provided the client with an outline or overview of the treatment process (i.e., what will happen over the course of treatment)?		Yes / No
	b. Did the therapist provide the client with an outline or overview of the treatment process (i.e., what will happen over the course of treatment) during this session?		Yes / No

Thank you for your participation!

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