DVP Updated TPR #1
Name
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First Name
Last Name
Date
*
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Month
-
Day
Year
Date
Email
*
example@example.com
1. How did your actions impact others related with the offense and similar behaviors leading up to it?
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2. What patterns and behaviors are you taking accountability/responsibility for leading up your arrest (describe specific behaviors)?
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3. What have you learned about your behaviors as it relates to the offense? What are your attitudes and thoughts about your behavior now compared to when you started therapy?
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4. What changes do you need to continue to make when you feel frustrated and/or upset?
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5. How are you establishing and respecting boundaries in your relationships?
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6. How has alcohol/drug use impacted your relationships? What steps are you taking to address these issues?
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Therapist Comments (for NIC therapist to complete):
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Should be Empty: