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Therapist Self-Assessment Questionnaire

Please fill out the following form.

First name(Required)

Last name(Required)

Email(Required)

Section 1: Clinical Competency & Therapeutic Approach

What therapeutic modalities do you use most frequently in your practice? (Check all that apply)(Required)

CBT

DBT

EFT

Internal Family Systems (IFS)

EMDR

Trauma-Informed Care

Faith-Based Counseling

Other

How comfortable are you working with clients in crisis situations?(Required)

Very comfortable, I have extensive experience handling crises and high-risk clients.

Somewhat comfortable, I have managed crises but may need additional guidance.

Neutral, I have limited experience and would need support.

Uncomfortable, I have little to no experience handling crises.

Other

How do you handle clients who struggle with engagement or have difficulty committing to therapy? (Required)

Section 2: Client Engagement & Retention

What strategies do you use to maintain long-term client engagement and improve retention? (Required)

Have you worked in a setting where client retention and satisfaction were tracked? (Required)

Yes, and I actively contributed to improving these metrics.

Yes, but I was not responsible for tracking or improving retention.

No, I have not worked in such a setting.

On a scale of 1-5, how do you rate your ability to build strong, lasting therapeutic relationships? (1 = Weak, 5 = Excellent) (Required)

1

2

3

4

5

Who are you with the client? (Required)

Section 3: Communication & Collaboration

How do you handle collaboration with interdisciplinary teams, such as medical professionals, caseworkers, or other therapists? (Required)

Have you worked in an environment where you had to communicate case details and updates in team meetings? (Required)

Yes, frequently.

Occasionally.

Rarely.

No, I have not.

How would your previous colleagues describe your communication style? (Required)

How do you advocate for your self? (Required)

Section 4: Administrative & Organizational Skills

How comfortable are you with insurance, billing, and credentialing processes? (Required)

Very comfortable, I am experienced in handling insurance-related administrative tasks.

Somewhat comfortable, I have some experience but may need guidance.

Not comfortable, I have limited to no experience with these processes.

How do you ensure accurate, timely, and HIPAA-compliant documentation? (Required)

“When faced with a new challenge or responsibility, how do you take initiative? Can you share an example of a time when you proactively tackled a task or problem without needing direction?”(Required)

Section 5: Cultural & Therapeutic Fit

Why are you interested in working at Voyages Counseling? (Required)

What do you look for in a counseling center to feel supported and thrive in your work? (Required)

Our practice integrates creativity, tradition, and relational-based counseling model. How does this align with your approach to therapy? (Required)

Where do you see yourself in your career in five years? (Required)

Once completed, this self-assessment will be reviewed before your interview to help facilitate a more meaningful conversation.

I declare that the info I’ve provided is accurate and complete.

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For New Clients Please Call: (720) 729-7372

For Administrative support please get in touch with us at:

Admin@VoyagesCounseling.com

Fax: (720) 202-1681 - Phone: (720) 415-5313

© Copyright - Voyages Counseling, LLC. All Rights Reserved.

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