Nama peserta :
Tanggal uji :
II RESPONDING
Dorongan Minimal
Refleksi
Empati
Paraphrase
Menyimpulkan sementara
Menyimpulkan
Memimpin
Fasilitating
Konfrontasi
Diam
Pertanyaan terbuka
Pertanyaan Tertutup
Klarifikasi
Respon sebab akibat
Respon mengurutkan
II PERSONALIZING
Personalisasi masalah
Personalisasi potensi
IV INITIATING
Merencanakan program
bersama konseli
Penjadwalan
Penguatan – Penolakan
Pengembangan komitmen
JUMLAH SKOR
V CATATAN PROSES KONSELING SKOR (1-5) CATATAN
Identifikasi masalah
Diagnosis
Prognosisi
Treatment
JUMLAH SKOR
Kesimpulan :
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SKOR TOTAL :
NILAI : TOTAL SKOR X 2
Predikat
Amat Baik :90 - 100
Baik Baik : 75 – 89
Cukup : 60 - 75
Kurang : 0 - 60