Course Feedback - Dare to Dream Counselling & Psychotherapy

This is a feedback form in relation to the “Managing Emotions” Course to help us improve future courses. Your responses help us create a better student experience and will be kept confidential. Thank you for your participation.

Name (an alias may be used to maintain confidentiality)

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Private Email Address (This is a required field so we can contact you, IF you give us permission - Please see final Question 16.3) *

1.1 What am I worth, really? (-5 to +5 units of awesomeness)

1.11 What am I worth, really? (Based on Commodities Values, as per the "Worth Calculator")

As much (or more) as my weight in Gold
As much (or more) as my weight in Platinum
As much (or more) as my weight in Chocolate
As much (or more) as my weight in Bananas
As much (or more) as my weight in Caviar
As much (or more) as my weight in Plutonium
Who cares? I am fine exactly as I am.
Why do you even ask? I am Priceless!
It's none of your damned business!

1.12 What am I worth, really? (Any other observations or comments)

1.2 Who gets to decide what I am worth? (i.e. Who is the expert on my value?)

1.3 How much do I currently accept myself, exactly as I am right now (0-5)?

1.4 How much do others accept me, exactly as I am right now (0-5)?

1.5 If I don’t accept myself as much as I'd like to right now, what ideas could I try out to be more accepting of myself?

2.1 How well do my emotions currently serve me (Minus five through to Plus Five)?

2.2 How might my emotions be more useful (Nearer +5/5)?

3.1 What are my top three challenging emotions (in order of most challenging first)?

3.2 What are my preferred alternatives to my top three challenging emotions?

4.1 What makes me lose energy?

4.2 What makes my life unpleasant?

4.3 What makes my life more unpleasant?

4.4 What would I like to be good at that I'd really like to improve upon?

4.5 When I get triggered, I will use at least one of the following to calm down:

5.1 What makes me gain energy?

5.2 What makes my life pleasant/enjoyable?

5.3 What makes my life more pleasant/enjoyable?

5.4 What makes me awesome already (Skills, Strengths, Knowledge, Experience, Gifts, Talents)?

5.5 When I have calmed down, I will do one of the following to enjoy my life more:

6.0 I know when to use the Mood Meter (And what each colour is for - Add a Red, Blue, Gold/Yellow and Green Feeling below).

6.1 I am likely to use the Mood Meter(+5 = "Yes, definitely", through to -5 = "No, absolutely not")

7.0 I will create my own Mood Meter that works for me

8.0 I know how to use the 5 RULER Questions (and know what RULER stands for - Add the 5 words for each letter below)

8.1 I am likely to use the 5 RULER questions (+5 = "Yes, definitely", through to -5 = "No, absolutely not")

9.0 It's helpful to think about the River of Wellbeing and the Banks of Chaos ("Scribble") and Rigidity ("Bricks")

9.1 I am likely to use the River of Wellbeing / Window of Tolerance (+5 = "Yes, definitely", through to -5 = "No, absolutely not")

10.0 I'd rather be Mellow than Grumpy or Scream (Most of the time). Give up to 3 reasons why / why not.

10.1 I'd rather be Mellow than Grumpy or Scream (Most of the time) (+5 = "Yes, definitely", through to -5 = "No, absolutely not")

11.0 Each Emotion has its uses. (There's no such thing as good and bad emotions). Give up to 3 reasons why / why not.

11.1 Each Emotion has its uses. (There's no such thing as good and bad emotions). (+5 through to -5)

12.0 BRAMBLE is a useful acronym I will remember to use (And I know what it stands for). Write it in here.

12.1 BRAMBLE is a useful acronym I will remember to use (And I know what it stands for). (+5 through to -5)

13.0 Here's 2 or 3 emotions I could afford to use LESS often:

13.1 Here's 2 or 3 emotions I could afford to use MORE often:

14.0 Can I come up with a T Shirt slogan or catchphrase to remind me that life is worth living? (List up to 3 below).

14.1 What belief(s) (if any) do I need to let go of to remind me that life is worth living?

15.0 The exercises I will try out/practice from BRAMBLE (From CHAOS to Wellbeing) are:

15.1 The exercises I will try out/practice from BRAMBLE (From Rigidity to Wellbeing) are:

16.0 What was most useful about the course? List up to 3 of the biggest benefits or most useful ideas.

16.1 What was least useful about the course? List up to 3 things we could do better next time.

16.2 I would recommend this course to others (+5 = "Yes, definitely", through to -5 = "No, absolutely not")

16.3 I give you permission to contact me about future courses *

IMPORTANT: 1) By pressing the submit button, I am agreeing to help shape future courses only, on a confidential, purely voluntary basis and as a result of my goodwill. 2) By pressing submit, I am NOT in any way obliged to partake in any related offerings in the future and I will definitely NOT be hassled with annoying marketing messages, sales pressure or SPAM as a result of my participation.