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Type of Provider
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Group Topics Discussed
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Module
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Therapists
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Agenda: Group Topics Discussed
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Facilitated by
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Group Behavior Ratings
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Seemed interested in the group
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Initiated positive interactions
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Shared emotions
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Helpful to others
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Focused on group tasks
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Disclosed information about self
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Seemed to benefit from the session
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Participated in group topics
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Understood group topics
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Treatment considerations addressed
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Showed listening skills / empathy
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Offered opinions / suggestions / feedback
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Monthly Evaluation (fill out in last group monthly)
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Discusses issues
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Participation
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Motivation
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Insight
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Stays on task
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Emotional expression
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Objectives being met
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Suggestions
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If other, please specify
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Individual Contributions This Session
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Time Started
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Time Finished
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