Counselor Interview Rating Form printable pdf download

Counselor Interview Rating Form

North Carolina State University

Counselor Education Program

Counselor Interview Rating Form

Masters Techniques of Counseling Class/ Practicum

(circle one)

Student Name: _______________________

Evaluator: ____________________________

Please rate the student on a scale of 1 to 5 in the following areas using this rating system:

1-Student does not meet expectations

2-Student is slightly below expectations

3-Student meets expectations

4-Student slightly exceeds expectations

5-Student exceeds expectations

Give ONLY ONE number for each skill

Note: You might not demonstrate each of the below skills in every tape so there may be skills

that will not be rated.

Counseling Process:

Skill

Rating

Examples/ Comments

Stage of the Session

Stage 1: Empathic

Developing rapport, greeting,

Relationship:

structuring the session

Initiating the Session

Stage 2: Story and

Attending Behavior (Visual,

Strengths/ Gathering

vocal , verbal tracking, body

Data

language, nonverbal matching)

Empathy

Open-ended Questions

Stage 3: Setting Goals

Appropriate Closed Questions

(Stages 1,2, and 3 use

Encouragers (“nodding, “uh

the skills from the

huh”; key word encouragers)

basic listening

sequence)

Paraphrasing

Reflection of feeling

Summarizing

Counselor Interview Rating Form

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