The Cortland County Youth Services Development Director is conducting a survey to identify the current professional development needs of human service professionals.  Information from this survey will be utilized in:   Identifying unmet training needs Identifying potential training resources Developing a training calendar open to all human service professionals in Cortland County

	1. In what human services division do you currently work?
	Mental Health Children and Youth Services Mental Retardation / Developmental Disabilities Alcohol/Substance Abuse Adult Services Social Services Probation Education Law Enforcement Other, please specify

	2. Does your employer provide time for you to attend trainings?
	Yes, always Yes, only if it is relevant to my position Sometimes Never

	3. Is your employer able to cover training expenses, i.e., mileage, attendance fees, work time?
	Yes Sometimes Never

	4. What day(s) of the week is best for you to attend a training?
	Monday Preferred Indifferent Not Available 1 2 3 Tuesday  Preferred Indifferent Not Available 1 2 3 Wednesday  Preferred Indifferent Not Available 1 2 3 Thursday Preferred Indifferent Not Available 1 2 3 Friday  Preferred Indifferent Not Available 1 2 3 Saturday Preferred Indifferent Not Available 1 2 3 Sunday         Preferred Indifferent Not Available 1 2 3

	5. What time of day is most convenient for you to attend a training?
	8 AM - 10 AM Preferred Indifferent Not Available 1 2 3 10 AM - Noon Preferred Indifferent Not Available 1 2 3 Noon - 2 PM Preferred Indifferent Not Available 1 2 3 2 PM - 4 PM Preferred Indifferent Not Available 1 2 3 4 PM - 6 PM Preferred Indifferent Not Available 1 2 3 6 PM - 8 PM Preferred Indifferent Not Available 1 2 3

	6. What type of training style is most effective for you?  Check all that apply:
	Lecture Group Work/Exercises Discussion/Round Table Audiovisual (i.e. videos, power point) Combination of any of the above Other, please explain

	7. Please explain any training currently provided by you or anyone in your agency?

	8. Do you require certificate(s) for proof of course completion?
	YesNo

	9. Do you have any special training requirements? (Evidence based training for example.)
	YesNo If so, please explain:

	10. Please rate your level of need of the following mental hygiene training topics.  Mental Hygiene pertains to mental health, addictions and/or developmental disabilities.
	Working w/Clients w/ Personality Disorders High Need Moderate Need Low Need No Need   1 2 3 4 N/A Handling Telephone Calls from Suicidal Clients High Need Moderate Need Low Need No Need   1 2 3 4 N/A Direct Contact w/Suicidal Clients High Need Moderate Need Low Need No Need   1 2 3 4 N/A School Based Behavior Interventions High Need Moderate Need Low Need No Need   1 2 3 4 N/A Supporting Parents w/ Mental Hygiene Challenges High Need Moderate Need Low Need No Need   1 2 3 4 N/A Engaging Reluctant Families High Need Moderate Need Low Need No Need   1 2 3 4 N/A Helping Clients to Develop Circles of Support High Need Moderate Need Low Need No Need   1 2 3 4 N/A Education Advocacy High Need Moderate Need Low Need No Need   1 2 3 4 N/A Update on Mandated Reporter Regulations High Need Moderate Need Low Need No Need   1 2 3 4 N/A Update on State/Federal Initiative High Need Moderate Need Low Need No Need   1 2 3 4 N/A Empowering Clients/Self-Determination High Need Moderate Need Low Need No Need   1 2 3 4 N/A Wellness/Recovery Focused Treatment High Need Moderate Need Low Need No Need   1 2 3 4 N/A Addressing Quality of Life Issues w/ Clients High Need Moderate Need Low Need No Need   1 2 3 4 N/A Bridges Out of Poverty High Need Moderate Need Low Need No Need   1 2 3 4 N/A Working w/ Military Families High Need Moderate Need Low Need No Need   1 2 3 4 N/A Working w/ Peer Professionals and/or Family Partners High Need Moderate Need Low Need No Need   1 2 3 4 N/A Educating Clients/Families on Computer Safety High Need Moderate Need Low Need No Need   1 2 3 4 N/A Working w/ Learning Disabled Adults High Need Moderate Need Low Need No Need   1 2 3 4 N/A Supporting Families w/ Addictions High Need Moderate Need Low Need No Need   1 2 3 4 N/A Substance Abuse Prevention: Children - OTC/Prescription High Need Moderate Need Low Need No Need   1 2 3 4 N/A Facilitation Skills  High Need Moderate Need Low Need No Need   1 2 3 4 N/A Cultural Competency High Need Moderate Need Low Need No Need   1 2 3 4 N/A

	11. These trainings would provide instruction on how to work with clients who already receive or need multiple services; such as mental health, alcohol/substance abuse, mental retardation/developmental disabilities, child welfare, community /recovery services and/or criminal justice.  In reference to the following training topics, Clinical Treatment may include individual, family or group therapeutic interventions in a home-based, or in outpatient clinic setting; whereas Supportive/Community Work includes services which may address basic social skills, activities of daily living skills and/or community integration. Please rate your level of need of the following cross-system trainings:
	Clinical Treatment for Individuals w/ Co-occurring Disorders (Mental Health & Substance Abuse) High Need Moderate Need Low Need No Need   1 2 3 4 N/A Clinical Treatment of Individuals w/ Dual Diagnosis (Developmental Disability & Mental Health) High Need Moderate Need Low Need No Need   1 2 3 4 N/A Clinical Treatment for Individuals w/ Developmental Disability & Substance Abuse High Need Moderate Need Low Need No Need   1 2 3 4 N/A Supportive/Community Work w/ Individuals w/ Co-Occurring Disorders (Mental Health & Substance Abuse) High Need Moderate Need Low Need No Need   1 2 3 4 N/A Supportive/Community Work w/ Individuals w/ (Developmental Disability & Mental Health) High Need Moderate Need Low Need No Need   1 2 3 4 N/A Supportive/Community Work w/ Individuals w/ Developmental Disability & Substance Abuse High Need Moderate Need Low Need No Need   1 2 3 4 N/A Working w/ JD/PINS Involved Children & Families High Need Moderate Need Low Need No Need   1 2 3 4 N/A Chronic Health Problems in Individuals w/ Disabilities High Need Moderate Need Low Need No Need   1 2 3 4 N/A Individuals w/ Disabilities & the Criminal Justice System High Need Moderate Need Low Need No Need   1 2 3 4 N/A Transition Age youth High Need Moderate Need Low Need No Need   1 2 3 4 N/A Autism vs. Bipolar vs. ADHD High Need Moderate Need Low Need No Need   1 2 3 4 N/A Medications Update High Need Moderate Need Low Need No Need   1 2 3 4 N/A Overview of Mental Hygiene Services in Cortland County (MH/ASA/MR-DD) High Need Moderate Need Low Need No Need   1 2 3 4 N/A

	12. Please list or describe any other Mental Hygiene related trainings that would be useful to your profession or would be of interest to you personally: