WEBINAR EVALUATION FORM for CEs | DESTRUCTIVE RELATIONSHIPS AND REPAIR Webinar Presenter: Harmony Place Monterey Clinical Director, Mark Schwartz, Sc.D. Name* First Last Date* Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Website (if applicable) Your area of expertise, professional interests and focus:*A. Based on the content presented, I can respond to the following questions:1. Define FUSION in couple's relationships:*2. Why do individuals with disorganized attachment sometimes regress to childlike states?*3. What is a merger-seeker pattern in relationships*4. What is metacognitive therapy for couples*5. What is coherence in the therapy process?*B. Course Content and Learning Experience:1. Content was appropriate and beneficial for LMFT, LCSW LPCC, and LEP training:* Strongly Agree Agree Neutral Disagree Strongly Disagree 2. Information could be applied to my practice.* Strongly Agree Agree Neutral Disagree Strongly Disagree 3. Teaching methods were effective.* Strongly Agree Agree Neutral Disagree Strongly Disagree 4. Information was current and accurate.* Strongly Agree Agree Neutral Disagree Strongly Disagree 4. Overall this webinar was...* Awesome, beyond expectations Really good Adequate Not what I expected C. Instructor: Dr. Mark Schwartz1. The presenter knew the subject matter.* Strongly Agree Agree Neutral Disagree Strongly Disagree 2. The presenter explained the material well and answered questions effectively.* Strongly Agree Agree Neutral Disagree Strongly Disagree 3. The presenter was responsive to questions that were posted or that were to be addressed in this presentation.* Strongly Agree Agree Neutral Disagree Strongly Disagree 4. The presenter utilized course-appropriate technology to support learning.* Strongly Agree Agree Neutral Disagree Strongly Disagree D. Materials and Documents Provided1. Instructional materials were suitable and useful.* Strongly Agree Agree Neutral Disagree Strongly Disagree 2. The topic covered in this webinar was of value and useful for my work and/or personal learning.* Strongly Agree Agree Neutral Disagree Strongly Disagree 3. Overall Webinar rating: Awesome! Exceeded my expectations Good, as expected Not what I expected E. Open-ended Inputs Welcomed:E-1. What was your overall impression of the webinar? And, what went well in your opinion?*E-2. What could be improved? What suggestions might you have?*E-3. What topics and presenters would you like to see at future HPM presentations?*E-4. Additional comments or requests:
