Client Outcome Measure (COM-P)Name* First Last Date of Birth* MM slash DD slash YYYY Therapist's name* 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, your adolescent’s behavior is 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, your adolescent’s behavior is a lot better 3 – Some better Some of the things you tried to change in counseling were successful, your family gets along some better, your adolescent’s behavior is 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, your adolescent’s behavior is 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 counseling, your adolescent’s behavior is worse than before counselingPlease answer the following questions using the number from the scale above. Remember – answer 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 adolescent’s behavior changed?* 5 – very much better 4 – a lot better 3 – some better 2 – only a little better 1 – things are no better 0 – things are worse 4. How much have you improved your 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 you changed your ability to supervise your adolescent?* 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 Please answer the following questions according to events that have occurred SINCE you began counseling.7. Has your adolescent been charged with a misdemeanor or felony since counseling began?* Yes No Number of misdemeanor charges*Number of felony charges*8. Has your adolescent been charged with crimes involving weapons, drugs, or violence?* Yes No Number of crimes involving weapons*Number of crimes involving drugs*Number of crimes involving violence*Has your adolescent been to detention since counseling began?* Yes No Number of times your adolescent has been to detention since counseling began*Has your adolescent ran away since counseling began?* Yes No Number of times your adolescent has ran away*Is your adolescent attending school?* Yes No Has your adolescent been kicked out of school since counseling began?* Yes No Number of times your adolescent has been kicked out of school*Alcohol use by your adolescent since counseling began* None Use Use that disrupts daily functioning Drug use by your adolescent since counseling began None Use Use that disrupts daily functioning Thank you for your help
