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A. FOR LIBRARIANS & EDUCATION STAFF
1. Are youth reading Power Source outside of the context of facilitated groups?
yes no
2. How many youth would you estimate have read Power Source in your facility/school?
Please feel free to add any comments about the book and youth's reaction to it.
(Please proceed to question #10)
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B. FOR COUNSELORS and CLINICAL STAFF
In order to indicate your answer click in the box next to the appropriate
response(s). |
1. Have you used Power Source with groups of youth?
no (please proceed to question #8)
yes (continue to question #2)
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2. Please answer the following about groups you have conducted using Power Source:
a. How many youth have typically been in the group?
b. Have youth dropped out of the groups? no
yes
If yes, please indicate the reason(s) youth dropped out (check all that apply):
behavior difficulties that could not be managed in the group
lack of interest in the Power Source content
inability to emotionally tolerate the Power Source content
transferred/released from facility
other (please explain)
c. How many new groups do you start in a year?
d. Have you found Power Source to be beneficial in your group work with youth?
no yes
If No, please explain.
If yes, please indicate the benefits you have observed using Power Source with groups of youth (check all that apply)
youth discuss difficult issues more freely
youth are more willing to participate in group discussions/activities
youth attend groups with greater regularity
groups are easier to manage
Other (please explain)
Please indicate the beneficial effects you have observed among youth who have participated: (check all that apply):
youth engage in fewer physical altercations with peers
youth engage in fewer verbal altercations with peers
youth receive fewer rule infractions, demerits, or punishment in the facility
youth appear to engage in fewer incidents of conflict with authority figures
youth appear to have better anger management skills
youth appear to have greater impulse control
youth appear to have increased ability to identify and label emotions
youth appear to have more insight into their offending or at-risk behavior
youth have higher school attendance
counselors report that youth who have participated are more engaged in individual sessions
youth are more willing to seek individual mental health counseling after participating
Other (please elaborate)
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3. Have you observed any negative effects of using Power Source with youth (in group or individual treatment)? no
yes
If yes, please explain.
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4. How many Power Source modules have you used with a typical group?
one or two modules
between three and five modules
between six and eight modules
between nine and eleven modules
all eleven modules
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5. Please indicated the extent to which you followed the Power Source Facilitator's Manual when leading the group:
I used SOME of the exercises from the modules I used
I used MANY of the exercises from the modules I used
I used MOST of the exercises from the modules I used
I used ALL of the exercises from the modules I used
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6. Have you used any other programs in conjunction with Power Source? (Please indicate the names and/or
type(s) of program(s) you have used with youth).
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7. Have you incorporated any other subjects with groups of youth that are not included in the Power Source manual?
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8. Have you used Power Source or the Power Source Facilitator's Manual in individual treatment?
no - please proceed to question #9
· Has the effectiveness of individual treatment improved since utilizing Power Source?
yes - If yes, please explain how you have used Power Source with individual youth. (e.g., used some of the exercises with individual youth; gave youth the book to read and discussed it in individual sessions, etc.)
Please indicate the benefits you have observed using Power Source in individual treatment with youth (check all that apply)
youth engage in fewer physical altercations with peers
youth engage in fewer verbal altercations with peers
youth receive fewer rule infractions, demerits, or punishment in the facility
youth appear to engage in fewer incidents of conflict with authority figures
youth appear to have better anger management skills
youth appear to have greater impulse control
youth appear to have increased ability to identify and label emotions
youth appear to have more insight into their offending or at-risk behavior
youth have higher school attendance
youth are more engaged in individual counseling sessions
Other (please elaborate)
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9. Are there specific ways that you track successes after using Power Source?
no yes
If so, please elaborate.
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10. Population in the institution/school:
Total# Male#
Female # Ages
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11. Type of Institution: Check one:
Juvenile Detention
Residential School
Nonresidential School
Private
Public
Group Home
Program in Adult facility
Community Program
Other (please specify)
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Thank you so much for taking the time to complete this survey.
If there are any other comments you wish to offer, please feel free to do so here.
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