CE Certificate Form 2 | SPACE Treatment

CE Certificate Form

This is form has 30+ entry fields and is easier to fill out on a computer (compared to a phone).

First Name

Last Name

Degree

Address

City

Zip Code

(1) Very Little
(2) Some
(3) A fair amount
(4) Quite a bit
(5) A great deal

(1) Not useful
(2) Not very useful
(3) Somewhat useful
(4) Useful

(5) Very useful

(1) Not satisfied

(2) Not very satisfied
(3) Somewhat satisfied
(4) Satisfied
(5) Very Satisfied

For the next 6 questions, please use the following options to rate how much you agree that the following learning objectives were met:

(1) Strongly Disagree

(2) Disagree
(3) Neither Agree nor Disagree
(4) Agree
(5) Strongly Agree

Objective 1: The learner will be able to explain assessment strategies for ARFID.

Objective 2: The learner will be able to implement strategies to reduce eating-related stress in families of children with ARFID.

Objective 3: The learner will be able to Identify and describe the main components of SPACE-ARFID.

Objective 4: The learner will be able to formulate supportive parental responses to child restrictive eating.

Objective 5: The learner will be able to develop plans to reduce parental accommodation of highly dependent adult children (FTL).

Objective 6: The learner will be able to identify potential barriers to SPACE-FTL treatment and how to manage them.

For the next 6 questions, please again use the following options to rate the following statements:

(1) Strongly Disagree

(2) Disagree
(3) Neither Agree nor Disagree
(4) Agree
(5) Strongly Agree

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