My Evaluation of a Therapist, Based on My Personal Experience

Therapist: ___________________________________ Date: ________________ (put notes on the back) This form is a way to EVALUATE your experience of a therapist you are considering working with. Ask questions which help you get a sense of each of the 5 areas in each category below. Then place a mark into each appropriate column which corresponds to your sense of evaluation. Use the blank columns if you want to add your own criteria. The higher the score on the SKILL, CONNECTION, and DEPTH categories, the better the match. But watch out for a high score in LIMITATION.

S K

L
Flexible, responsive creative out of the box HIGH Safe warm

C O N N E C T I O N
Good listener & responder Good leader "Gets" me I like her/him

Good breadth Good Amount Ability to Approaches of Training of Practical get Practical are congruent Training to my needs HIGH LOW

LIMITATION
Has his/her I do too much I feel own personal leading or generalized issues/stuff directing too much HIGH He/she is too "text-booky" or rigid Price Asks good deepening questions HIGH Confident & competent in going deeper

LOW

D E P T H
Maintains the Big Picture Good sense Facilitates good of Direction perspective & Focus & insights

LOW

Even if you are evaluating only 1 therapist, this chart enables you to see what it is that may be driving the attraction or hesitation of working with the therapist. This may help you make a decision grounded in perspective rather than desperation, overwhelm, seduction, transference, codependence, etc. Use the space below as well as the other side of this sheet for writing notes from either your phone consultation or, after the fact, your in person session. 2011, Jim Lehrman http://jimlehrman.com

LOW