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TAM-R Form

2021: Owned by Amber Zoschke

confidential family TAM-R Form

Family's Last Name *

Date Completed Form (Today's Date)

YYYY

How many times has a therapist met with your family this past week? *

If a therapist met with your family more than five times this past week, how many times did they meet with them?

Please enter a number:

If a therapist has not seen your family in the last week, please estimate when they last met with your family.

Select a date to the best of your ability.

YYYY

Please rate the remaining statements regarding your last 2-3 sessions, regardless of when they occurred, based on how true they are for you. *

If a statement is not applicable, please select "neutral."

1. The therapist tried to understand how my family’s problems all fit together.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

2. My family and the therapist worked together effectively.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

3. My family knew exactly which problems we were working on.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

4.The therapist recommended that family members do specific things to solve our problems.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

5. The therapist’s recommendations required family members to work on our problems almost every day.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

6. The therapist understood what is good about our family.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

7. My family and the therapist had similar ideas about ways to solve problems.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

8. The therapist tried to change some ways that family members interact with each other.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

9. The therapist tried to change some ways that family members interact with people outside the family.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

10. My family and the therapist were honest and straightforward with each other.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

11. The therapist’s recommendations should help the children to mature.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

12. Family members and the therapist agreed upon the goals of the session.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

13. My family talked with the therapist about how well we followed her/his recommendations from the previous session.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

14. My family talked with the therapist about the success (or lack of success) of her/his recommendations from the previous session.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

15. We got much accomplished during the therapy session.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

16. My family was sure about the direction of treatment.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

17. The therapist’s recommendations made good use of our family’s strengths.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

18. My family accepted that part of the therapist’s job is to help us change certain things about our family.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

19. The therapist’s recommendations should help family members to become more responsible.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

20. The therapist talked to family members in a way we could understand.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

21. Our family agreed with the therapist about the goals of treatment.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

22. The therapist checked to see whether homework was completed from the last session.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

23. The therapist did whatever it took to help our family with tough situations.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

24. The therapist helped us to enforce rules for the child.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

25. The therapist helped family members talk with each other to solve problems.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

26. The therapist helped us keep our child from hanging around with troublesome friends.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

27. The therapist helped us improve our child’s behavior at school.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

28. The therapist helped us get our child to stay in school every day.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Comment Box

Thank you for sharing your confidential feedback!

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reach a live person,
or contact 911.

Main phone number
(for all departments):
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Answered 24x7 by a live person.

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MRC 711
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