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APPENDIX A Audiology Counseling Growth Checklist (ACGC)
The ACGC may be used as a self-assessment measure for those wishing to increase their
awareness of effective audiologist/patient dynamics or as a means to appraise the
effectiveness of others whose service delivery approach may serve as a springboard
toward growth in counseling. While observing another, or upon reflection of a concluding
patient visit that you have conducted, simply circle the most appropriate response
to the statements presented. All items are worded so that a yes response signifies
a positive behavior on the part of the audiologist. The word “patient” refers to the
individual seeking services during the session, whether this is the individual with
the hearing loss or that individual's parent, guardian, or spouse. If you are working
with a supervisor, comparison of your self-assessment on the ACGC with that of the
supervisor can be beneficial in developing a constructive dialogue toward growth.
GREETING AND OPENING
1. The audiologist introduced him/herself by name (or greeted the patient if formerly
met), with a handshake and direct eye contact.
Yes No NA
2. The audiologist seated him/herself at eye level with the patient.
Yes No NA
3. The audiologist began with an appropriate opening that invited the patient to express
his/her immediate concern and actively acknowledged and addressed this concern.
Yes Example: ____________________________________
No Example: ____________________________________
NA
DEMEANER AND DELIVERY
4. The audiologist maintained eye contact with the patient.
Yes Example: ____________________________________
No Example: ____________________________________
NA
5. The audiologist's facial expressions were appropriate to the context at hand.
Yes Example: ____________________________________
No Example: ____________________________________
NA
6. The audiologist maintained an attentive yet relaxed posture conveying a responsiveness
of undivided attention.
Yes Example: ____________________________________
No Example: ____________________________________
NA
7. The audiologist's nonverbal expressions were appropriate to the dialogue and not
distracting.
Yes Example: ____________________________________
No Example: ____________________________________
NA
8. The audiologist's voice was easily heard by the patient and maintained a tone of
interest.
Yes Example: ____________________________________
No Example: ____________________________________
NA
9. The audiologist spoke at an appropriate rate to enhance understanding.
Yes Example: ____________________________________
No Example: ____________________________________
NA
10. The audiologist avoided jargon within his/her comments making every effort to
ensure that meaning was understood.
Yes Example: ____________________________________
No Example: ____________________________________
NA
11. The audiologist avoided both verbal statements and nonverbal expressions that
might appear judgmental.
Yes Example: ____________________________________
No Example: ____________________________________
NA
12. The audiologist seemed aware of potential conflicts between his/her social style
and that of the patient.
Yes Example: ____________________________________
No Example: ____________________________________
NA
PATIENT AFFIRMATION
13. The audiologist appeared conscious of multicultural issues that might influence
the dynamics of the interaction.
Yes Example: ____________________________________
No Example: ____________________________________
NA
14. The audiologist employed reflective listening responses to ensure patient's meanings
were understood correctly and to display a desire to attain that understanding.
Yes Example: ____________________________________
No Example: ____________________________________
NA
15. The audiologist made affirmative statements regarding perceived patient strengths.
Yes Example: ____________________________________
No Example: ____________________________________
NA
16. The audiologist seemed aware of and responded to the feelings underlying the patient's
statements.
Yes Example: ____________________________________
No Example: ____________________________________
NA
17. The audiologist used statements that affirmed something expressed by the patient.
Yes Example: ____________________________________
No Example: ____________________________________
NA
PATIENT ENCOURAGEMENT
18. The audiologist avoided closed questions that might elicit simple yes/no responses.
Yes Example: ____________________________________
No Example: ____________________________________
NA
19. The audiologist made appropriate use of silence to encourage further comment from
the patient on a current topic before changing the direction of discussion.
Yes Example: ____________________________________
No Example: ____________________________________
NA
20. The audiologist's nonverbal expressions were encouraging to the continuation of
dialogue.
Yes Example: ____________________________________
No Example: ____________________________________
NA
21. The audiologist interjected positive affirmations (yes, mm-mm, etc.) to encourage
continuation or expansion of the patient's comments.
Yes Example: ____________________________________
No Example: ____________________________________
NA
22. The audiologist encouraged the patient to express his/her feelings.
Yes Example: ____________________________________
No Example: ____________________________________
NA
23. The audiologist avoided signs of defensiveness of expressed feelings of anger,
frustration, etc., that may have appeared directed at the audiologist.
Yes Example: ____________________________________
No Example: ____________________________________
NA
EXPLORATION
24. The audiologist appropriately challenged statements made by the patient that might
impede the positive actions taken by the patient and helped him/her to identify more
positive views.
Yes Example: ____________________________________
No Example: ____________________________________
NA
25. If exploring solutions for specific communication breakdowns, the audiologist
asked the patient to identify at least one action that might be taken to address the
problem.
Yes Example: ____________________________________
No Example: ____________________________________
NA
26. The audiologist suggested alternative actions that might be useful.
Yes Example: ____________________________________
No Example: ____________________________________
NA
27. The audiologist helped the patient to develop actions that might facilitate an
identified goal.
Yes Example: ____________________________________
No Example: ____________________________________
NA
28. The audiologist provided an opportunity to practice identified actions.
Yes Example: ____________________________________
No Example: ____________________________________
NA
29. The audiologist encouraged the patient to critique the effectiveness of actions
taken to address the identified goal when attempted at home, work, or during social
activities.
Yes Example: ____________________________________
No Example: ____________________________________
NA
30. The audiologist recognized when a topic could not be fully explored during current
time constraints and offered an opportunity to return for further exploration.
Yes Example: ____________________________________
No Example: ____________________________________
NA
Reproduced from Clark and English.[2] Reprinted by permission of the publisher.
John Greer ClarkPh.D.
3636 Middleton Ave., Cincinnati, OH 45220
Email: jg.clark@uc.edu
