1

Revised February 22, 2013

Crisis Counseling Assistance and Training Program (CCP)

2012 Data Collection Forms

Frequently Asked Questions

General Questions

1. Since crisis counselors cannot fill out the Individual/Family Crisis Counseling Services Encounter

Log until after the encounter, how do they remember the information?  

 While crisis counselors should not fill the form out in front of the survivors, they should

feel free to carry a small notebook in which they can jot down notes.  Crisis counselors

may want to ask survivors if they mind if they take a couple of notes, but they should

reassure survivors that this information does not include their name or address.  Also,

because crisis counselors should be out in teams, one crisis counselor may keep notes,

while the other is the lead in the engagement.

2. If a crisis counselor visits a group of unrelated people living in the same household, should that

interaction be logged on the Individual/Family Crisis Counseling Services Encounter Log?   

 Yes, the Individual/Family Crisis Counseling Services Encounter Log is meant to capture

interactions with those who live together as a household, even if those people are not

related.

3. If a crisis counselor is visiting with a family or household and a neighbor comes by, does the

crisis counselor include the neighbor in the same Individual/Family Crisis Counseling Services

Encounter Log, or would s/he complete a separate form?   

 The Individual/Family Crisis Counseling Services Encounter Log would not capture

interactions with a neighbor.  The crisis counselor should complete a separate

Individual/Family Crisis Counseling Services Encounter Log for the neighbor if the

encounter lasts for 15 minutes or more.  If the encounter with the neighbor is shorter

than 15 minutes, the crisis counselor should log it on the Weekly Tally Sheet.

4. When a crisis counselor meets with an individual for 15 minutes or more following a group

counseling or public education session, does the crisis counselor include the encounter on the

Group Encounter Log form for the group session that already took place, or does the crisis

counselor complete a separate Individual/Family Crisis Counseling Services Encounter Log?  

 The crisis counselor should complete a separate Individual/Family Crisis Counseling

Services Encounter Log for the individual that he or she encountered after the group

session.

5. If a crisis counselor meets with someone for over 15 minutes, and then a second family

member enters (as the first person leaves) and starts a new conversation for another 15

minutes, how many forms need to be filled out?

 The crisis counselor should document both conversations on the same Individual/Family

Crisis Counseling Services Encounter Log.   

6. If a group session is finished in LESS than 15 minutes, should the crisis counselor still complete

the Group Encounter Log form?  

 No, the crisis counselor should log the contacts on the Weekly Tally Sheet.

   
2

Revised February 22, 2013

7. If the crisis counselor completes the Child/Youth or the Adult Assessment and Referral Tool,

does he or she still have to complete the Individual/Family Crisis Counseling Services Encounter

Log?

 If the use of the Child/Youth or Adult Assessment and Referral Tool is precipitated by an

individual/family crisis counseling services encounter lasting more than 15 minutes,

then both forms should be completed.  However, if the visit is only to administer the

Child/Youth or Adult Assessment and Referral Tool, presumably the Individual/Family

Crisis Counseling Services Encounter Log was completed prior to the visit, and only the

Child/Youth or Adult Assessment and Referral Tool would be completed for the followup

visit.

8. How are phone calls logged?  

 Phone calls are documented like any other individual interaction.  If a phone call (not

received via the hotline) lasts 15 minutes or longer, it should be logged using the

Individual/Family Crisis Counseling Services Encounter Log (with “phone counseling”

checked under Location of Service).  If the phone call lasts less than 15 minutes, it is

tallied on the Weekly Tally Sheet, under “Telephone contact by crisis counselor.”

9. How are calls received via the CCP hotline recorded?

 If a call received on the helpline/hotline/crisis line lasts longer than 15 minutes, then the

encounter should be captured on the Individual/Family Crisis Counseling Services

Encounter Log.  Under Location of Service, the “phone counseling” and “If hotline,

helpline, or crisis line” items should also be checked.  If the encounter is less than 15

minutes, it is tallied on the Weekly Tally Sheet, under “Hotline/helpline/lifeline contact.”

10. My CCP uses texting and chatting to provide outreach and crisis counseling. How are these

interactions recorded?

 While face‐to‐face crisis counseling is preferred, alternative methods of outreach can be

recorded, as well.  Brief contacts by chat or text can be recorded under “email contacts”

on the Weekly Tally Sheet. If the chat or text becomes more in‐depth, and lasts longer

than 15 minutes, then an Individual/Family Crisis Counseling Services Encounter Log

should be completed, noting “phone counseling” as the Location of Service.

Individual / Family Crisis Counseling Services Encounter Log

1. Do both crisis counselors have to add their employee numbers to the Individual/Family Crisis

Counseling Services Encounter Log?  

 The second employee number is not required, but it is provided for situations when

crisis counseling is done in pairs.  For safety reasons, door‐to‐door canvassing should

always be conducted in teams.  There are certainly other situations when crisis

counseling encounters are conducted by a single crisis counselor, such as when a

survivor approaches a staff member following a group presentation.  It is suggested that

the team decide who will “lead” the discussion, while the other crisis counselor can take

notes to complete the form.

2. What should the crisis counselor select if the race of the participant(s) in an encounter is/are

unknown?  

 The crisis counselor should use his or her best judgment in identifying the race of the

participant(s) in the encounter.  If the crisis counselor cannot make a guess, then s/he

should leave the question blank.

   
3

Revised February 22, 2013

3. When a crisis counselor is providing services in a location that is not listed, what should be

selected?  

 The crisis counselor should select “Other” and specify the type of location in the

response box.  Whenever possible, the crisis counselor should provide a general

descriptive term, rather than the proper name or address of the location (e.g., list

“museum” and not the “American Museum of Modern Art” or list, “disaster supply

distribution center”, not the actual address of the distribution center).

4. When a crisis counselor is providing services to survivors at a hotel or motel in which the

survivors are staying, what location should be selected?  

 The crisis counselor should select “temporary home” for these encounters.

5. What should the crisis counselor select if the focus of the encounter is a topic/category not

listed on the Individual/Family Crisis Counseling Services Encounter Log?

 The crisis counselor should select “Other” and specify the focus in the response box

(e.g., disaster recovery).

6. What should the crisis counselor select if the type of referral provided during the encounter is

not listed on the Individual/Family Crisis Counseling Services Encounter Log?  

 The crisis counselor should specify what it is in the “other” response box.  The referral

should be described as the type of agency, not the specific agency name (e.g., basic

needs provider).

7. What kinds of factors should be documented under Risk Categories?  

 The Risk Category items should describe what the individual(s) was/were dealing with at

the time (onset) of the disaster event.  Most of these risk categories are expected to be

the result of the disaster experience, but a few of them (e.g., past substance use/mental

health problem, preexisting physical disability, or past trauma) could have been present

prior to the disaster.  If a risk factor presented itself after the disaster, it would not be

documented here.

8. In the Event Reactions section, should the crisis counselor note reactions that have been

resolved?  For example, if a survivor had initially been experiencing headaches immediately

following the disaster event, but during the encounter, the survivor stated those were no

longer occurring, should the headaches be documented as an event reaction?

 The Event Reactions section should indicate reactions present at the time of the crisis

counseling encounter, or those that the survivor indicates that they are presently

experiencing.  If a survivor indicates that they are no longer experiencing any

behavioral, emotional, physical, or cognitive reactions, then “Coping Well” should be

checked on the form.  

9. Should the questions (such as demographics and risk factors) be read to the survivor(s), in

order to ensure the answers are correct?

 No, the crisis counselors should never use the form during the encounter or read the

questions aloud.  However, the crisis counselor should be familiar enough with the

items requested on the forms that he or she can ask probing questions to elicit

information.  The crisis counselor should complete the form after the encounter is over

and should use his/her best judgment to answer the questions based on the information

that was voluntarily shared and any observations s/he had during the encounter.  It is

good practice for one crisis counselor to be the “lead” in the interaction, and the other

to listen to remember details, or take a few notes to ensure proper documentation after

the visit.

   
4

Revised February 22, 2013

10. Are crisis counselors required to provide referrals or handouts if risk factors or event reactions

are identified?   

 No, a crisis counselor is not required to provide referrals or handouts, but the team

should keep resource lists and printed education materials (e.g., brochures about the

CCP, or tip sheets on coping with disaster reactions) on hand and available for when

they are needed.

11. Is it possible for crisis counselors to give out printed materials, but not give a referral?  And is

it acceptable for a crisis counselor to give a referral without providing any handouts or

brochures?   

 Yes, crisis counselors may give out printed materials (e.g., tip sheets on coping with

disasters) without giving a referral, when this seems appropriate to the team.  And yes,

a crisis counselor may alternatively give a referral without providing printed materials,

but it is advisable that the team keep a referral resource list handy and to verify the

accuracy of the referrals (i.e., contact information, location, and services provided) as

needed.

12. If the crisis counselor has an encounter where the participant(s) have a family member

translating to another language (i.e., the crisis counselor speaks English, and a family member

translates for the participants), what does the crisis counselor note for the “primary language”

question?

 If an interpreter was used to provide counseling services to someone who did not speak

English, then that other language of the survivor should be noted.  But if the other

language is spoken only among family members, and yet the crisis counseling occurred

in English, then English should be noted.   

13. On the third visit to a particular individual (or family), should the crisis counselor complete an

Individual/Family Crisis Counseling Services Encounter Log or the appropriate Assessment and

Referral Tool?  

 If the portion of the encounter prior to the administration of the Adult or Child/Youth

Assessment and Referral Tool lasts longer than 15 minutes, then the crisis counselor

should complete the appropriate Assessment and Referral Tool as well as the

Individual/Family Crisis Counseling Services Encounter Log.  However, if the

Individual/Family Crisis Counseling Services Encounter Log is completed and a separate

appointment is made for the administration of the appropriate Assessment and Referral

Tool, then at the second visit only the Adult or Child/Youth Assessment and Referral

Tool is used.

14. A crisis counselor has a 13‐minute encounter with an individual, in which the counselor offers

some tips for coping, but the individual stops short, becoming emotional, and asks the crisis

counselor to come back to the home.  Should the crisis counselor fill out the Individual/Family

Crisis Counseling Services Encounter Log?

 Yes.  Although the general rule for individual/family encounters is that they should be at

least 15 minutes, if a significant interaction is only a minute or 2 short, the encounter

can still be recorded on the Individual/Family Crisis Counseling Services Encounter Log.  

However, it is recommended that the crisis counselor be equipped with many skills to

engage an emotional individual so that this type of encounter would typically last longer

than 15 minutes.

   
5

Revised February 22, 2013

15. If a crisis counseling encounter occurs in a home in which other family members are present,

but those others do not speak to the counselor (e.g., they are watching television, playing

games, etc.), should those family members be counted in the Individual/Family Crisis

Counseling Services Encounter Log?  

 No, the crisis counselor should only count those who were fully engaged during the

encounter for 15 minutes (i.e., those who are actively listening and/or talking).   

16. What if there is a baby present during the encounter?  Do you log the baby on the

Individual/Family Crisis Counseling Services Encounter Log?

 If the child is too young to engage in meaningful dialogue, then they should not be

recorded on the Individual/Family Crisis Counseling Services Encounter Log.

Group Encounter Log

1. Is it required to list two crisis counselor numbers on this form?  

 It is always recommended that crisis counselors perform services in pairs.  However, the

second crisis counselor is not a required field on this form.  If more than one staff

member is present during a group encounter, those staff should coordinate to make

sure that only one Group Encounter Log is completed.

2. If a crisis counselor is invited to provide a presentation/ public education session, yet during

the session the participants do most of the talking, what type of service should be selected on

the Group Encounter Log form?

 The crisis counselor should select group counseling.

3. If a crisis counselor is invited to facilitate a group counseling session, yet during the session,

the counselor ends up doing the majority of the talking, what type of service should be

selected on the Group Encounter Log form?  

 The crisis counselor should select public education session.

4. What should the crisis counselor select if the race or races of one or more participants in an

encounter is/are unknown?  

 The crisis counselor should use his or her best judgment in identifying the race(s) of the

participants in the group encounter.

5. If a crisis counselor meets a group for 15 minutes or more, and for half of the time the

participants do the talking, and for the other half the crisis counselor does the talking, should

the crisis counselor select both group counseling and public education for “Type of Service”?  

 No, only one can be selected.  The crisis counselor should use his/her best judgment to

choose what s/he feels was the majority of the focus of the session—either group

counseling or public education, but not both.

Weekly Tally Sheet

1. When is the Weekly Tally Sheet completed?  

 The data collection form is filled out at the end of each day, and submitted on a weekly

basis.

2. How many staff members should tally their data on the same Weekly Tally Sheet?  

 Only one staff member should use each Weekly Tally Sheet, as only one field is provided

for his/her employee number.

   
6

Revised February 22, 2013

3. When a staff member disseminates an e‐mail message to a large listserv and everyone gets

the same message, is this logged on the Weekly Tally Sheet as one e‐mail, or as the total

number of people who were sent the e‐mail?

 Since a listserv is used, this would be logged as one under mass media.  If the e‐mail is

sent to a smaller group, which is not managed by a listserv (such as a group of eight

people who signed up for your CCP’s support group), then it could be logged as an e‐

mail contact, and the number of recipients noted.

4. If a staff member gives a 5‐minute presentation to a group of 50 people, is this logged as 50

in‐person brief contacts or 1 social networking message?   

 This would be logged as 50 in‐person brief contacts.

5. If a staff member attends a local town hall meeting, but does not speak personally to anyone

or introduce him‐ or herself to the group, how is it logged on the Weekly Tally Sheet?  

 This would not be logged on the Weekly Tally Sheet because the staff member did not

speak to anyone.

6. When a CCP staff member provides or distributes a packet of materials with more than one

item in the packet, should this be logged as one material item distributed, or should it be

logged with the number of material items in the packet?

 The staff member should log this as one material item distributed, not the number of

material items in the packet.

7. When a CCP staff member posts an update to Facebook, should he or she also count the

number of likes and shares to the Weekly Tally Sheet?  

 No, the staff member should only log the number of Facebook posts made.  Likes and

shares can be captured in a CCP report narrative.

8. When a CCP staff member posts an update to Twitter (a tweet), should he or she also add the

number of re‐tweets to the Weekly Tally Sheet?  

 No, the crisis counselor should only log the number of tweets.  Re‐tweets and favorites

can be captured in a CCP report narrative.

9. If a CCP staff member sets up a recurring message or advertisement to be posted (via a social

media management dashboard, newspaper, or radio station), how many messages should this

be logged as?  

 The staff member should log each consecutive message that is posted, even if it is the

same message being posted.

10. If a CCP arranges to broadcast a public service announcement (PSA) on the radio or television,

can the Weekly Tally Sheet document the listenership/viewership of the station?

 No, the Weekly Tally Sheet should document the number of times the PSA airs, but it

should not include any listenership/viewership data.  This information can be captured

in a CCP report narrative.   

11. If a CCP has a partnership with a restaurant, and the restaurant is printing the CCP support

message and phone number on every customer receipt, can the CCP log it on the Weekly Tally

Sheet?

 Since the receipts show the message and phone number, they can be counted as

“materials handed to people with little or no interaction.”  Since this distribution is not

being done by crisis counselors, the program should dedicate another person to

complete the Weekly Tally Sheet.

12. If a CCP has a partnership with a local store that is posting the CCP support message and

phone number on their electronic marquee, where do CCPs count that on the Weekly Tally

Sheet?

 The message board should be counted as one mass media message.
7

Revised February 22, 2013

13. If a CCP has a partnership with local realtors as they help find housing for displaced survivors,

and the CCP message and phone number are printed on their lawn signs, can CCPs count this

on the Weekly Tally Sheet?

 If the number of signs put up in lawns is being counted, then each sign could be counted

as materials distributed.  If the program prints a large number of signs, but doesn't track

how many get put out, then they should count one “mass media” message, and then

report the number printed in the CCP reporting narrative.  

Adult Assessment and Referral Tool

1. What if the survivor refuses to answer questions for the Adult Assessment and Referral Tool?

 All services and interactions within the CCP are voluntary and anonymous.  If you

believe someone is a danger to him‐ or herself or others, contact your team leader for

further assistance.

2. When is the tool administered?

 It is recommended on the third and fifth encounter or if the survivor is experiencing

severe reactions to the disaster.

3. If you are visiting someone for the first time and you think you are witnessing intense

reactions, can you complete the Adult Assessment and Referral Tool even though it’s not the

third visit?  

 Yes, you may use the Adult Assessment and Referral Tool anytime you are meeting with

someone who seems to be experiencing intense reactions.  The tool is there to help you

whether or not a problem is serious enough to warrant a referral to more intensive

services.   

4. If you know you are doing more intensive work with the survivor, such as Skills for

Psychological Recovery, do you still need to administer the tool on the third and fifth visits?

 No, because you already have a plan for recovery with the survivor.  

5. Should the questions be read aloud to the survivor, or completed afterwards, like the items on

the Individual/Family Crisis Counseling Services Encounter Log?

 Unlike the Individual/Family Crisis Counseling Services Encounter Log, the Adult

Assessment and Referral Tool is supposed to be read aloud to the adult survivor during

the encounter.  There are instructions on the form on how to do this.

Child/Youth Assessment and Referral Tool

1. Does a parent have to be present when the tool is administered?

 A parent or school staff member needs to be aware that the child is being assessed and

present if necessary.

2. If the assessment is administered at school with school staff present, do you still need parental

consent?

 It is strongly recommended that notice been given to parents, and parental consent be

obtained, prior to CCP staff members interacting with children at the school.  

3. What if the child is too young to understand and answer the assessment questions?

 The crisis counselor should work with the child’s parent to discuss the questions, or the

parent can answer on behalf of the child (ages 0‐7).  

   
8

Revised February 22, 2013

4. Should the questions be read aloud to the survivor or completed afterwards like the items on

the Individual/Family Crisis Counseling Services Encounter Log?

 Unlike the Individual/Family Crisis Counseling Services Encounter Log, the Child/Youth

Assessment and Referral Tool is supposed to be read aloud to the child or the parent

during the encounter.  There are instructions on the form on how to do this.

5. I’m uncomfortable about asking if someone is thinking of hurting him‐ or herself or others.  

What should I do if someone says yes?  And won’t asking about it just give the person ideas?

 It’s a common fear that asking about suicidal thoughts might cause people to think

about killing themselves, but it doesn’t; it simply shows that you care and that you are

listening with acceptance and an open mind.  Before you administer this tool, be sure

you have a plan in place for what to do if someone does say yes to this question;

protocols will vary, so talk to your supervisor ahead of time.  You should also always

have a list of referrals on hand, in case a survivor needs more intensive services.   

Participant Feedback Survey

1. When should the surveys be disseminated?

 The survey can be disseminated twice during the Regular Services Program (RSP).  The

first set of surveys should be administered approximately 6 months after the disaster,

usually just before, or just after the First Quarterly Report (depending on the length of

the ISP).  The second administration occurs 12 months following the disaster and before

the end of the program.

2. What is the best way to ensure participation in the survey?

 Programs should disseminate the surveys in a self‐addressed, stamped envelope with a

pen, and their staff should even offer to wait and take the sealed survey with them.   

3. Whom should the survey be given to?

 It should be given to any survivor receiving primary services in the identified week of

dissemination.   

4. Why is this survey important?

 Any feedback from survivors will help guide the program and help to improve services

given to survivors.

5. Is this survey used to evaluate the performance of particular crisis counselors?

 No.  Although the questions refer to the crisis counselor, the survey does not name

him/her in any way, and this information is not used to single out crisis counselor

performance.

Service Provider Feedback Survey

1. Why should I fill this survey out?

 Any feedback provided by program crisis counseling staff can help to improve the

program and to improve the CCP for future programs.

2. What if the program management doesn’t like what I have to say in the survey?

 The survey is anonymous and confidential and done online.  An outside party

summarizes the comments and scores, so no identifying information is available to

program management.

3. Why is the survey given twice throughout the life of an RSP?

 The survey is given twice to measure the usefulness of the required trainings, the levels

of staff stress, and the experiences of staff throughout the life of the program.