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Weekly Group Note

Date: Group Session #:

Counselor:

Focus of Group:
1.
2.
3.

Overall Group Cohesion Assessment

Please rate (highlight) to what extent most members of the group:

Not at all Somewhat Extremely


Seemed interested in the group 1____2____3____4____5
Shared emotions 1____2____3____4____5
Focused on group tasks 1____2____3____4____5
Disclosed information about themselves 1____2____3____4____5
Participated in activities 1____2____3____4____5
Showed listening skills/empathy 1____2____3____4____5
Seemed to benefit from session 1____2____3____4____5
Offered feedback to counselor 1____2____3____4____5

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