Client Outcome Measure (COM-A)Name* First Last Date of Birth* MM slash DD slash YYYY Therapist Name* First Last Today's Date* MM slash DD slash YYYY Instructions:Please help us understand what has changed since you and your family began counseling. Please use this scale to answer the questions below. 5 – Very much better Most all of the things you tried to change in counseling were successful, your family gets along very much better 4 – A lot better Many but not all of the things you tried to change in counseling were successful, your family gets along a lot better 3 – Some better Some of the things you tried to change in counseling were successful, your family gets along some better 2 – Only a little better Few of the things you tried to change in counseling were successful, your family gets along only a little better 1 – Things are no different The things you tried to change in counseling are no different, your family does not get along any better 0 – Things are worse The things you tried to change in counseling are worse, your family gets along worse than before counselingPlease answer the following questions using the number from the scale above. Remember – answe according to how much has changed since you began counseling.1. In general, how much has the family changed since you began counseling?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no different 0 – things are worse 2. How much has the family changed its communication skills?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no different 0 – things are worse 3. How much has your behavior changed?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no different 0 – things are worse 4. How much have your parents improved their parenting skills?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no different 0 – things are worse 5. How much have your parents changed their ability to supervise you?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no different 0 – things are worse 6. How much change has occurred in the family conflict level?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no different 0 – things are worse
