Thank you for completing this questionnaire. CCS currently has been working with students from Drake University, Grandview University, and New York University (online program) to provide quality internship experiences form Masters Level Counselors. In addition to giving a meaningful experience, we are hoping this program will increase the number of providers that will stay in Story County. An essential component of this program is providing no cost outpatient mental health therapy services to individuals while they are waiting to connect with a long term therapist. Since the program started we have provided 289 FREE sessions!

It is our hope that we recruit interns that will meet the needs of our community. The purpose of this questionnaire is to get feedback about the populations and needs that you feel are underserved. This will help guide us in choosing our next round of interns.

Click here to learn more about the program.

Name *

First Name

Last Name

Email *

I agree to CCS using using feedback from this form (specifically comments) for purposes including, but not limited to, program development, advertising the program, recruiting board members, etc. Names will not be shared. *

Yes

Select populations that you see have fewer providers than needed *

Addiction

Trauma

Perinatal or Post Partum

LGBTQI+

Military Veterans

Preschool and younger children

Elementary Age Children

Middle School Age Children

High School Age Children

College/Young adult (18-24)

Adult (25-64)

Adults 65+

Couples/Marriage

Family

Individuals/Families who received a significant medial diagnosis

Criminal Justice Involvement

Housing insecure

Victims of Human Trafficking

Refugees

International Students

Other (please specify in the comment section)

Select the issues/diagnoses you see as needing more providers *

Depression

Anxiety

Trauma and/or PTSD

OCD

Bi-Polar Disorder

Borderline Personality

ADHD

PTSD

Grief

Autism Spectrum Disorder

Schizophrenia

Schizoaffective Disorer

Dissociative Identity Disorder

Dissociation

Children in child welfare system (abuse, neglect, drug affected children, etc.)

Caregivers involved child welfare system

Drug and Alcohol diagnosis

Stress

Other personality disorders

Other (please specify in the comment section)

What services/interventions would you like to see more of in Story County? *

Play therapy

Sand tray therapy

Cognitive Behavioral Therapy (CBT)

Dialectical Behavioral Therapy (DBT)

STEPPS Groups

Trauma informed Yoga

Internal Family Systems

Psychedelic Assisted Treatment

Medication Assisted Treatment (substance abuse)

Psychological Assessment/Evaluation

Psychiatric Medication provider

EMDR (eye movement desensitization and reprocessing)

Art Therapy

Music Therapy

Bi-Lingual Therapists (specify what language in comments)

Other (please specify in the comment section)

What do you think are the MOST needed outpatient mental health needs in Story County? *

Any other feedback, suggestions, etc.?

Are you interested in joining our Board of Directors? *

Yes

Thank you for your time in completing this evaluation. Your work an dedication to the counseling field is appreciated!

Are you ready to be a real life hero? You can make a difference through your financial contribution as well as donating your time.

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First Name

Last Name

Email Address

Thank you!

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Phone: 515-233-1699. Fax : 515-233-2957

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CCS is not a crisis center~ If you are experiencing thoughts of self harm or suicide dial 988

:::

CCS is not a crisis center~ If you are experiencing thoughts of self harm or suicide dial 988 :::

CCS does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, gender identity, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, visitors, volunteers, board members, subcontractors, vendors, and clients.