Counselling/Psychotherapy Session Rating 諮詢/心理治療量表
Research shows that it is important to track progress and provide feedback to your clinician in order to achieve the best outcome in every counselling/psychotherapy session.  Please complete the following validated rating scales after your session to help you and your clinician track your progress by emailing the completed form to your clinician.
By continuing with these rating scales, you also give consent for the data with all identifying personal information removed to be used in research. Thank you for your valuable time and help so that clinicians can get the best training and you and others can receive the best care.
研究顯示追蹤進展並向幫助你的專業人士提供反饋是重要的,以便在每次諮詢/心理治療會談中得到最佳的結果. 請在會談結束後完成以下經過驗證的評分量表,讓你和幫助你的專業人士可以追蹤你的進展. 請將完成的表格通過電子郵件發送給幫助你的專業人士.
通過繼續使用這評分量表,你同意將刪除所有個人資料後的數據用於研究. 多謝你的寶貴時間和幫助,以便專業助人人士得到最好的培訓,讓你和其他人也能得到最好的治療.
Rating Scales 評分量表:
1. Outcome Rating Scale 成效評估表
2. Session Rating Scale 會談評估表
3. PHQ9 病人健康量表 (for depression 評估憂鬱)
4. GAD7 廣泛性焦慮量表 (for anxiety 評估焦慮)
(Total time required for the questionnaires is 6-10 minutes for the first time, and 5-7 minutes for subsequent times as you become more familiar with the instructions and format of the questions 第一次完成量表需要6-10分鐘,隨著你對問題的說明和格式越來越熟悉,隨後完成量表需要5-7分鐘)
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Email *
Please enter your age 請填你的年齡 *
Please indicate your gender 請表示你的性別 *
Please enter the first and last name of your clinician 請填寫幫助你的專業人士的名字和姓氏 *
Date of session 會談日期 *
MM
/
DD
/
YYYY
1. Outcome Rating Scale 成效評估表
You will be asked some questions about four different areas of your life, including your individual, interpersonal, and social functioning.  Each of these questions is based on a 1 to 10 scale, with 10 being high (or very good) and 1 being Low (or very bad.
你會被問一些關於你生活的四個不同領域的問題,包括你的個人情況、人際關係和社交關係. 每一個問題的答案都基於1到10的評級,10表示狀態極佳(或非常好),1表示情況極糟糕(或非常差).
Thinking back over the last week (or since our last conversation), how would you rate:
回想上週(或自從我們上次會談之後),你如何評估:
1.1 How you have been doing personally? (On the scale from 1 to 10) (personally means yourself, you as an individual or your personal functioning) 你的個人情況(個人身心狀況)?(從1到10的評級) *
low (or very bad)極糟糕(或非常差)
high (or very good)極佳(或非常好)
1.2 How have things been going in your relationships? (On the scale from 1 to 10) (relationships mean your family or close personal relationships) 你的人際關係(家人與較親密的人)?(從1到10的評級) *
low (or very bad)極糟糕(或非常差)
high (or very good)極佳(或非常好)
1.3 How have things been going for your socially? (On the scale from 1 to 10) (socially means your life outside the home or in your community, work, school, church) 你的社交關係(工作、學校、朋友)? (從1到10的評級) *
low (or very bad)極糟糕(或非常差)
high (or very good)極佳(或非常好)
1.4 So given your answers on these specific areas of your life, how would you rate how things are in your life overall? (On the scale from 1 to 10) 因此,鑑於你對生活中這些特定領域的評估,你如何評估你生活中的整體情況? (從 1 到 10 的評級) *
low (or very bad)極糟糕(或非常差)
high (or very good)極佳(或非常好)
2. Session Rating Scale 會談評估表
You will be asked some questions about your session today, including how well you felt understood, the degree to which we focused on what you wanted to talk about, and whether our work together was a good fit.  Each of these questions is based on a  1 to 10 scale, with 10 being high (or very good) and 1 being Low (or very bad).  
你將被問到有關今天的會談的一些問題,包括你感覺被了解的程度、我們探討你想探討的問題的程度以及輔導員的方法是否適合你. 每一個問題都基於1到10的評級,10為高(或非常好),1為低(或非常差).
Thinking back over our conversation, how would you rate:
回想一下我們的會談,請表示你對今天輔導過程的評價:
2.1 On a scale of 1-10, to what degree did you feel heard and understood today, 10 being completely and 1 being not at all? 基於1到10的評級,你今天感到被傾聽、被了解和被尊重的程度(10表示完全, 1表示根本沒有)? *
not at all 根本沒有
completely 完全
2.2 On a scale of 1-10, to what degree did we work on the issues that you wanted to work on today, 10 being completely and 1 being not at all? 基於1到10的評級,我們探討和處理你想探討和處理的問題的程度(10表示完全, 1表示根本沒有)? *
not at all 根本沒有
completely 完全
2.3 On a scale of 1-10, how well did my approach, the way I worked, make sense and fit for you? 基於1到10的評級,你認為輔導員的方法適合你的程度(10表示完全, 1表示根本沒有)? *
not at all 根本沒有
completely 完全
2.4 So, given your answers on these specific areas, how would you rate how things were in today's session overall, with 10 meaning that the session was right for you and 1 meaning that something important that was missing from the visit? 那麼,鑑於你對這些特定領域的評估,你如何評估今天會談的整體情況,10表示本節輔導很適合你,你對此感到滿意,1表示輔導過程缺失一些元素,你對本節輔導不滿意? *
something important was missing from the visit 輔導過程缺失一些元素
the session was right for you 本節輔導很適合你
3. Patient Health Questionnaire 病人健康問卷 (PHQ-9)
Over the last 2 weeks, how often have you been bothered by any of the following problems? 在過去兩個星期中,你有否經常受以下問題困擾? *
0 (Not at all完全沒有)
1 (Several days幾天)
2 (More than half the days過半數日子)
3 (Nearly every day幾乎每天)
Little interest or pleasure in doing things 做事缺乏興趣或樂趣
Feeling down, depressed, or hopeless 感到低落,沮喪,或絕望
Trouble falling or staying asleep, or sleeping too much 難以入睡或熟睡,或睡得太多
Feeling tired or having little energy 感到疲倦或精力不足
Poor appetite or overeating 食慾不振或過度飲食
Feeling bad about yourself or that you are a failure or have let yourself or your family down 覺得自己非常差勁,或覺得自己是個失敗者或令自己或家人失望
Trouble concentrating on things, such as reading the newspaper or watching television 難以集中精神,例如閱報或看電視
Moving or speaking so slowly that other people could have noticed. Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual 連別人也察覺得到你的動作或說話緩慢;或相反---心緒不寧或坐立不安而比平時更多的走動
Thoughts that you would be better off dead, or of hurting yourself 有尋死的念頭或有某程度自殘的想法
Total Score and Interpretation for Patient Health Questionnaire 病人健康問卷的總分和解釋 (PHQ-9)
Add the scores for questions 1 to 9 above to get a total score. Interpretation of Total Score:
總分是將上述第1至9題的分數加起來. 總分解釋:
Total Score 1-4: Minimal depression 總分1-4: 極少憂鬱
Total Score 5-9: Mild depression 總分5-9: 輕度憂鬱
Total Score 10-14: Moderate depression 總分10-14: 中度憂鬱
Total Score 15-19: Moderately severe depression 總分15-19: 中度嚴重憂鬱
Total Score 20-27: Severe depression 總分20-27: 嚴重憂鬱
Rate level of difficulty 評估困難程度 *
0 (Not difficult at all完全沒有困難)
1 (Somewhat difficult有些困難)
2 (Very difficult非常困難)
3 (Extremely difficult極度困難)
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? 如你有勾選任何問題,該問題有否在你工作,照顧家庭或與人相處上做成任何困難?
4. Generalized Anxiety Disorder 廣泛性焦慮量表 (GAD-7)
How often during the past 2 weeks have you felt bothered by any of the following problems? 在過去兩週,以下症狀會多常困擾你? *
0 (Not at all完全沒有)
1 (Several days幾天)
2 (More than half the days超過一半的天數)
3 (Nearly every day幾乎每天)
Feeling nervous, anxious, or on edge 覺得緊張,焦慮,心情不定
Not being able to stop or control worrying 覺得無法停止或控制焦慮
Worrying too much about different things 對很多不同的事感到擔憂
Trouble relaxing 難以放鬆
Being so restless that it is hard to sit still 焦躁不安到難以安靜坐著
Becoming easily annoyed or irritable 容易心煩或易怒
Feeling afraid as if something awful might happen 感到害怕,就像可怕的事情要發生
Total Score and Interpretation for Generalized Anxiety Disorder 廣泛性焦慮量表的總分和解釋 (GAD-7)
Add the scores for questions 1 to 7 above to get a total score. Interpretation of Total Score:
總分是將上述第1至7題的分數加起來. 總分解釋:
Total Score 1-4: Minimal anxiety 總分1-4: 極少焦慮
Total Score 5-9: Mild anxiety 總分5-9: 輕度焦慮
Total Score 10-14: Moderate anxiety  總分10-14: 中度焦慮
Total Score 15-21: Severe anxiety 總分15-19: 嚴重焦慮
Rate level of difficulty 評估困難程度 *
0 (Not difficult at all完全沒有困難)
1 (Somewhat difficult有些困難)
2 (Very difficult非常困難)
3 (Extremely difficult極度困難)
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? 如你有勾選任何問題,該問題有否在你工作,照顧家庭或與人相處上做成任何困難?
Please re-enter your email address to confirm (A copy of the completed form will be sent to you. We suggest you forward the completed form to your clinician to help track your progress and ensure that you are getting the best care) Thank you for your help. 請重新輸入你的電子郵件地址以便進行確認(填寫完成的表格副本將發送給你. 我們建議你將完成的表格轉發給幫助你的專業人士,以幫助追蹤你的進展並確保你能得到最好的輔導) 多謝你幫助我們. *
Other comments, explanations, questions 其他意見、解釋、問題: (please forward this completed form to your clinician 請將完成的表格轉發給幫助你的專業人士)
A copy of your responses will be emailed to the address you provided.
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