PTR Evaluation

Parenting Through Recovery Evaluation (Mid Point & End Point)

Name of person completing this form (Last Name, First Name)

Date (mm/dd/yyyy)

Client Code

Please describe the client's progress in the program at the time of scale completion

Please describe the client's progress in the program at the time of scale completion
	Current Phase			Phase History


	Phase 1	Phase2	Phase 3	1st Attempt at Current Phase	2nd Attempt at Current Phase	3rd Attempt at Current Phase
Client Progress

Enter the number that reflects your satisfaction with the following components of group.

Enter the number that reflects your satisfaction with the following components of group.
	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
The way this group was delivered (such as classroom, computer, video) was an effective way for me to learn this subject matter.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my knowledge of neglect and trauma event(s) that happened to my child/family.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my knowledge of how my substance use impacted my child(ren)	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my knowledge of recognition and understanding of usage of thinking errors	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my knowledge of my own childhood trauma on me	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my knowledge of how trauma has impacted my child(ren)	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my parenting skills.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
This group increased my confidence in parenting.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
I am likely to apply the knowledge I have learned in this group.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
The amount of material covered in the group was appropriate.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
The information I have received from this group is important.	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree

Please think of the group as a whole as you respond to each item.

Please think of the group as a whole as you respond to each item.
	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members liked and cared about each other.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members tried to understand why they do the things they do, tried to reason it out.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members avoided looking at important issues going on between themselves.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members felt what was happening was important and there was a sense of participation.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members depended upon the group leader(s) for direction.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
There was friction and anger between the members.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members were distant and withdrawn from each other.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members challenged and confronted each other in their efforts to sort things out.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members appeared to do things the way they thought would be acceptable to the group.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members rejected and distrusted each other.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members revealed sensitive personal information or feelings.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely
The members appeared tense and anxious.	Not at all	A little bit	Somewhat	Moderately	Quite a bit	A great deal	Extremely

Rate the degree to which you felt your Parenting through recovery group leader(s) did the following.

Rate the degree to which you felt your Parenting through recovery group leader(s) did the following.
	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist and I agreed about the things I needed to work on in this therapy.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
What we did in this therapy gave me new ways of looking at my issues.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
I believe this therapist likes me.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist does not understand what I want to accomplish in this therapy.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
I was confident in this therapist’s ability to help me.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist worked with me toward goals that made sense to me.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
I felt that this therapist appreciated me.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist and I agreed on what was important for us to work on.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist and I trusted one another.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist and I had different ideas about what issues were important.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
This therapist and I established a good understanding of the kind of changes that would be good for me.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
I believe the way we worked on strengthening my relationships was correct.	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
During your therapy, to what extent did this therapist use personal examples from his/her own relationships and experiences in life?	Never (1)	2	3	Sometimes (4)	5	6	Always (7)
When this therapist used personal examples from his or her own relationships and experiences in life, how helpful was it?	Never (1)	2	3	Sometimes (4)	5	6	Always (7)