Data Collection for Crisis Counseling Assistance and Training Programs
Access data collection forms and survey templates to evaluate your Crisis Counseling Assistance and Training Program (CCP), and learn how to use these forms and surveys.
Crisis counselors are required to document the services they provide. Collecting data on disaster survivors and the services they receive supports ongoing evaluation of your CCP.
Get answers to frequently asked questions (PDF | 209 KB) about data collection forms.
Data Collection Training
Prior to using the data collection forms, staff should complete the CCP Data Collection Training. The training takes about 50 minutes and contains four modules:
- Module 1 provides an overview of the Individual/Family Encounter Log and the Adult and Child/Youth Assessment and Referral Tool forms. It is about 20 minutes in length.
- Module 2 explains how to complete the Group Encounter Log to capture data on group counseling and public education sessions. It is about 10 minutes in length.
- Module 3 explains how to complete the Weekly Tally Sheet to capture brief encounters, material distribution, and media efforts. It is about 10 minutes in length.
- Module 4 provides an overview of the CCP data collection systems and reviews the data entry process. It is about 10 minutes in length.
Resources
There are three basic forms submitted to CCP team leaders after each encounter:
Service providers can use Assessment and Referral Tools to collect more in-depth information about service recipients:
- The Assessment and Referral Tool Guidance (PDF | 120 KB) explains when and how to administer the Adult and Child Assessment and Referral Tools.
- The Adult Assessment and Referral Tool (OMB 2025) (PDF | 219 KB) assesses a service recipient’s need for services beyond the scope of the CCP and helps determine what, if any, referrals can be provided (available in Spanish (PDF | 261 KB)).
- The Adult Assessment and Referral Tool Response Card (PDF | 159 KB) helps a service recipient assess disaster event reactions they may be experiencing (available in Spanish (PDF | 64 KB)).
- Use the Child/Youth Assessment and Referral Tool (OMB 2025) (PDF | 244 KB) with caregiver permission, to assess a child’s or youth’s need for services beyond the scope of the CCP and determine what, if any, referrals can be provided (available in Spanish (PDF | 265 KB)).
- The Child/Youth Assessment and Referral Tool Response Card (PDF | 74 KB) helps a child or youth identify disaster event reactions they may be experiencing (available in Spanish (PDF | 61 KB)).
Participant Feedback Survey
Feedback from disaster survivors gathered through the Participant Feedback Survey helps grantees assess service quality, learn more about the experiences of service recipients, and improve services over time. Following are resources to administer the Participant Feedback Survey:
- The Participant Feedback Survey (OMB 2025) (PDF | 320 KB) itself, which collects feedback from disaster survivors who have received CCP services (available in Spanish (PDF | 265 KB))
- Survey Guidelines for Trainers (PDF | 115 KB) and Survey Guidelines for Counselors (PDF | 97 KB) to prepare for administering the Participant Feedback Survey
- Optional Cover Letter (DOCX | 18 KB) which you can download and personalize to introduce the Participant Feedback Survey to disaster survivors
Service Provider Feedback Form
Feedback from service providers helps grantees understand the experiences and well-being of their staff members. Use the following resources to help you collect feedback from CCP service providers:
- The Service Provider Feedback Form (OMB 2025) (PDF | 380 KB) collects feedback from CCP crisis counselors and team leaders (available in Spanish (PDF | 231 KB)).
- Download and review the Task Timeline (PDF | 237 KB) for administering the CCP Service Provider Feedback survey.
- Download and personalize the optional announcement (DOCX | 20 KB) to introduce the CCP Service Provider Feedback survey to CCP crisis counselors and team leaders. (paper version (DOCX | 20 KB)
- Download and personalize the optional cover letter (DOCX | 21 KB) to introduce the CCP Service Provider Feedback survey to CCP crisis counselors and team leaders. (paper version (DOCX | 21 KB)
- Download and personalize the optional thank you and reminder letter (DOCX | 20 KB) to remind CCP crisis counselors and team leaders to provide their feedback.
There are three basic forms submitted to CCP team leaders after each encounter:
Service providers can use Assessment and Referral Tools to collect more in-depth information about service recipients:
- The Assessment and Referral Tool Guidance (PDF | 120 KB) explains when and how to administer the Adult and Child Assessment and Referral Tools.
- The Adult Assessment and Referral Tool (OMB 2025) (PDF | 219 KB) assesses a service recipient’s need for services beyond the scope of the CCP and helps determine what, if any, referrals can be provided (available in Spanish (PDF | 261 KB)).
- The Adult Assessment and Referral Tool Response Card (PDF | 159 KB) helps a service recipient assess disaster event reactions they may be experiencing (available in Spanish (PDF | 64 KB)).
- Use the Child/Youth Assessment and Referral Tool (OMB 2025) (PDF | 244 KB) with caregiver permission, to assess a child’s or youth’s need for services beyond the scope of the CCP and determine what, if any, referrals can be provided (available in Spanish (PDF | 265 KB)).
- The Child/Youth Assessment and Referral Tool Response Card (PDF | 74 KB) helps a child or youth identify disaster event reactions they may be experiencing (available in Spanish (PDF | 61 KB)).
Participant Feedback Survey
Feedback from disaster survivors gathered through the Participant Feedback Survey helps grantees assess service quality, learn more about the experiences of service recipients, and improve services over time. Following are resources to administer the Participant Feedback Survey:
- The Participant Feedback Survey (OMB 2025) (PDF | 320 KB) itself, which collects feedback from disaster survivors who have received CCP services (available in Spanish (PDF | 265 KB))
- Survey Guidelines for Trainers (PDF | 115 KB) and Survey Guidelines for Counselors (PDF | 97 KB) to prepare for administering the Participant Feedback Survey
- Optional Cover Letter (DOCX | 18 KB) which you can download and personalize to introduce the Participant Feedback Survey to disaster survivors
Service Provider Feedback Form
Feedback from service providers helps grantees understand the experiences and well-being of their staff members. Use the following resources to help you collect feedback from CCP service providers:
- The Service Provider Feedback Form (OMB 2025) (PDF | 380 KB) collects feedback from CCP crisis counselors and team leaders (available in Spanish (PDF | 231 KB)).
- Download and review the Task Timeline (PDF | 237 KB) for administering the CCP Service Provider Feedback survey.
- Download and personalize the optional announcement (DOCX | 20 KB) to introduce the CCP Service Provider Feedback survey to CCP crisis counselors and team leaders. (paper version (DOCX | 20 KB)
- Download and personalize the optional cover letter (DOCX | 21 KB) to introduce the CCP Service Provider Feedback survey to CCP crisis counselors and team leaders. (paper version (DOCX | 21 KB)
- Download and personalize the optional thank you and reminder letter (DOCX | 20 KB) to remind CCP crisis counselors and team leaders to provide their feedback.