The Correctional Outpatient Treatment Forms include a set of data collection instruments focused on assessing services and treatment process in outpatient settings.
These forms have been updated conceptually and technically, however, as part of the more current TCU Core Forms. Interested users are strongly encouraged to consider a customized assessments approach based on selective “packaging” of the TCU Core Forms for intake and progress evaluations.
(Listed in sequence in which forms occur during treatment; times indicate typical length to administer.)
Counseling Session Records
The Counseling Session Record — Individual (Counselor) describes the length and type of session as well as the issues addressed. [5 minutes]
- Counseling Session Record — Individual (by Counselor)
[PDF; 8K; 1 page] [DOC; 8 KB; 1 page]
The Counseling Session Record — Group (Counselor) describes the length and type of session as well as the issues addressed. [5 minutes]
- Counseling Session Record — Group (by Counselor)
[PDF; 10 KB; 2 pages] [DOC; 55 KB; 2 pages]
The Evaluation of Self and Treatment records probationer ratings of the counselor, therapeutic groups, and the program in general. It also contains scales assessing psychological adjustment, social functioning, and motivation. [15 minutes]
- Evaluation of Self and Treatment [PDF; 24 KB; 8 pages] [DOC; 47 KB; 8 pages]
- Scoring Guide for Evaluation of Self and Treatment [PDF; 15 KB; 4 pages]
The Services Tracking Record (Monthly) serves as the overall monitoring record of client services and transactions, and is completed each month by agency staff. It contains information concerning counseling session attendance, medications prescribed, urinalyses results, and ancillary services provided. (Time to complete this form varies, depending on agency record-keeping systems.)
- Services Tracking Record (Monthly) [PDF; 10 KB; 2 pages] [DOC; 28 KB; 2 pages]
The Discharge Report documents dates and reasons for leaving treatment. [5 minutes]
- Discharge Report [PDF; 10 KB; 2 pages] [DOC; 24 KB; 1 page]