Promoting Older Women's Engagement in Recovery (POWER) Seeking Safety Training Survey

Institute for Health and Recovery Form Approved

OMB No. 0990-

Exp. Date 06/30/2020

Seeking Safety Training Survey

Please complete this evaluation for today’s Seeking Safety training. Your responses will help us to understand how best to support you in your work to prevent and raise awareness of issues concerning substance use and trauma among women aged 55+. IHR relies on your honest opinions & suggestions for improvement of future trainings. All of your responses will be kept confidential and will only be reported in the aggregate. Your name will not be used in any reports put together for this project.

Content of Training

As a result of the training to what extent do you agree with the following statements?

	Strongly Agree	Agree	Disagree	Strongly Disagree
The information presented will be useful to my work.
The information presented was clear & understandable.
The skills presented will be useful to my work.
I am comfortable implementing the components of Seeking Safety.
I am able to teach clients grounding skills to manage psychological distress.
can select components of Seeking Safety to use with older adults who are struggling with psychological distress and risky substance use.

Please rate your understanding of the following aspects of Seeking Safety:

	Excellent	Good	Poor	Fair
The connection between trauma and substance misuse.
The clinical importance of establishing safety.
The many elements that signify safety.
The basic components of using Seeking Safety individually.
The basic components of using Seeking Safety in a group setting.

To what extent has this training increased your knowledge on the following topics?

	A lot	Somewhat	A little	Not at All
Substance use and addiction in older women
Auxiliary risk factors for older women in misuse of substances (e.g. trauma, physical or emotional abuse)

Presentation

To what extent do you agree with the following statements?

	Strongly Agree	Agree	Disagree	Strongly Disagree
The presenter was well prepared.
The presenter had good knowledge of subject.
The presenter delivered material well.
Presenter used time effectively.

What is your title/role? (Select One)

• Social worker

• Doctor

• Nurse

• Other Clinical Staff – Please specify: ___________

• Case Manager

• Personal Care/Home Care Attendant

• Medical Assistant

• Activity Assistant

• Other: _________

How can we improve this training?

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0379. The time required to complete this information collection is estimated to average 5 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer