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Below is a sample needs assessment survey, which shows examples of types of questions that may be included.

However, it is best if each school or district committee creates its own survey form based upon the school guidance and counseling program design and the unique characteristics of the school and community. SAMPLE School Counseling Program Survey (Reprinted from the New Hampshire Implementation Manual for Comprehensive School Guidance and Counseling) The members of the Comprehensive School Guidance and Counseling Program Steering Committee would like your help in planning the school counseling program. Please read the directions and give your honest feedback. Do not sign the survey; just circle whether you are a parent, teacher, community member or student. If you are a student, please indicate your grade in school.

Parent

Teacher

Community Member

Student

(Grade level______)

I. The following list names some topics that might be addressed in a comprehensive school guidance and counseling program. Even though all of these topics may sound interesting or valuable, we are trying to find out what students, parents, teachers, and community members consider are the most important topics. We would like you to indicate the top 10 topics that you feel would be most valuable in terms of your own needs or the needs of the whole school. First, read all of the topics. Then, go back and put the number 1 next to the topic that you feel would be the most important, the number 2 by the next most important, and so on down to the number 10. Do not list more than 10. If you have some suggestions that are not on the list, place them in the spaces that

have been provided and include your suggestion(s) in your top 10 ratings. Your lowest numbers will equal your highest priorities. ______Help with non-English-speaking students. _____Help with post-secondary options, admissions, applications, recommendations, and financial aid. _____Help with students with attention deficit hyperactivity disorder. _____Job-seeking and job-keeping skills. _____Orientation to guidance and counseling services and how to use them. _____Peer pressure. _____Peer relationships. _____Physical/sexual abuse or neglect concerns. _____Resolving conflicts and joint problem solving. _____School adjustment (making friends, getting along with people). _____School/classroom behavior. _____Self-awareness and self-concept. _____Sexual issues. _____Special enrichment programs (Boys/Girls State, Talent Search, Upward Bound, etc.). _____Study skills. _____Substance use/abuse. _____Suicide _________________________________________________________________________ _______________________________________________________________________

II. Program services. Below is a list of six major service areas of the guidance and counseling program. After reading the list, circle the number that shows what priority that service area should receive in the school counseling program. 4 Top Priority 4 4 3 3 3 Moderate Priority 2 2 1 1 2 1 Fairly Low Very Low Priority Priority Counseling Services (individual and group counseling, support groups, referral services) Appraisal Services (achievement tests, career interest inventories, special needs assessments, personality inventories, portfolios) Information Services (student records, handbook computerized data programs, postsecondary catalogs) Placement Services (enrichment programs, college admissions, course selection, career advising, referral to agencies) Consultation Services (conference with parents, teachers, and administrators; student assistance programs) Curricular Services (organization of materials for classroom teacher adoption, group and classroom presentation of guidance topics)

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Using the Results After the results are gathered, the work group will need to determine what procedure will be used for analyzing and interpreting the needs assessment results. The group will identify the issues and concerns of each of the target groups surveyed, take note of which results indicate differences between program objectives, including student attainment, and target groups expectations, and form conclusions about what these differences mean. Subsequent needs assessment surveys can be compared to previous ones to give information about progress toward desired goals.

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