Facilitator Group Experience Evaluation The following evaluation seeks to help Change, Inc. understand facilitator perspectives of the Change, Inc. Group Experience. Reflect on your participation, and then answer to what extent do you agree or disagree with each of the following statements, or provide an answer to the questions which solicit information. This form should be completed within 72-hours of your facilitation, per your contract. Thank you!!!. NOTE: Please answer truthfully -- therapists may be made aware of facilitator perspectives in keeping with the Group Experience Informed Consent Agreement, but will not be addressed punitively as a result.Facilitator Name(Required) First Last Facilitator Email(Required) Enter Email Confirm Email Today's Date(Required) MM slash DD slash YYYY Date of Group Experience being evaluated(Required) MM slash DD slash YYYY 1. Overall, group members were open and receptive to the experience I facilitated.(Required)Strongly DisagreeDisagreeNeutral -- Neither Agree nor DisagreeAgreeStrongly Agree2. The group’s overall reaction to me was positive -- I felt accepted and empowered to do my job.(Required)Strongly DisagreeDisagreeNeutral -- Neither Agree nor DisagreeAgreeStrongly Agree3. What are at least 2 specific positive therapeutic moments you experienced within the group?(Required)(e.g., a particularly vulnerable share, a real point of connection between group members, a moment of visible growth or insight in a group member, etc.)4. What are at least 2 specific negative therapeutic moments you experienced within the group?(Required)(e.g., feeling as though the group was stuck, particular members being resistant or tangential or otherwise difficult, etc.)5. Were there any group members you had particular concerns about in terms of disclosures that lead you to believe that they are impaired in work with clients or within our environment? (NOTE: This may include individuals you may or may not have mentioned above)?(Required)NoYes5a. Please explain -- be as concrete and descriptive as possible.(Required)6. How could the Group Experience be improved for you as a facilitator? What might've made it easier, more fun, clearer?(Required)7. How could the Group Experience be improved for therapist participants?(Required)8. The thing I was most surprised about regarding the Group Experience was __________________.(Required)Additional comments? Δ
