Integrated Behavioral Health Evaluation

Activity Rating *

	5	4	3	2	1
How would you rate this activity? (5=Excellent, 1=Poor)	How would you rate this activity? (5=Excellent, 1=Poor) - 5	How would you rate this activity? (5=Excellent, 1=Poor) - 4	How would you rate this activity? (5=Excellent, 1=Poor) - 3	How would you rate this activity? (5=Excellent, 1=Poor) - 2	How would you rate this activity? (5=Excellent, 1=Poor) - 1
Commercial Bias	Commercial Bias - 5	Commercial Bias - 4	Commercial Bias -	Commercial Bias -	Commercial Bias -
Best Evidence Available	Best Evidence Available - 5	Best Evidence Available - 4	Best Evidence Available - 3	Best Evidence Available -	Best Evidence Available -
Relevant to your practice	Relevant to your practice - 5	Relevant to your practice - 4	Relevant to your practice - 3	Relevant to your practice -	Relevant to your practice -
Make any changes	Make any changes - 5	Make any changes - 4	Make any changes -	Make any changes -	Make any changes -
Work effectively with interprofessional team members to enhance care	Work effectively with interprofessional team members to enhance care - 5	Work effectively with interprofessional team members to enhance care - 4	Work effectively with interprofessional team members to enhance care - 3	Work effectively with interprofessional team members to enhance care - 2	Work effectively with interprofessional team members to enhance care - 1
Understand the abilities and contributions of interprofessional team members	Understand the abilities and contributions of interprofessional team members - 5	Understand the abilities and contributions of interprofessional team members - 4	Understand the abilities and contributions of interprofessional team members - 3	Understand the abilities and contributions of interprofessional team members - 2	Understand the abilities and contributions of interprofessional team members - 1
If no, provide detail
If you said yes above, please describe at least one change that you plan to make as a result of this activity:

Learning Objectives *

As a result of this activity, do you feel you are better able to: Summarize key principles of Focused Acceptance and Commitment Therapy (FACT)?

Yes

No

Partial

Learning Objectives *

As a result of this activity, do you feel you are better able to: Describe case conceptualization from a FACT perspective?

Yes

No

Partial

Learning Objectives *

As a result of this activity, do you feel you are better able to: Describe clinical interventions for a FACT framework in an integrated behavioral health setting?

Yes

No

Partial

How will this session be useful to your practice?

Which of the following aided in your engagement with this activity *

a|Please rate the following presentation: Dialectical Behavior Therapy: Practical Applications for the IBH Setting (5=excellent; 1=poor)

degree *

Degree:

Number of years in practice *

Number of years in practice:

Most important factor *

What was the most important factor in your decision to attend this live activity?

Feedback *

Please list topics of interest for future didactics and/or additional comments regarding today's clinic.

How did you find out about this activity? *

How did you find out about this activity?

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