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© 2007 by the American Counseling Association. All rights reserved.
Program evaluation in counseling has been a consistent topic of discourse in the profession over the past 20 years (Gysbers, Hughey, Starr, & Lapan, 1992; Hadley & Mitchell, 1995; Loesch, 2001; Wheeler & Loesch, 1981). Considered an applied research discipline, program evaluation refers to a systematic process of collecting and analyzing information about the efficiency, the ef- fectiveness, and the impact of programs and services (Boulmetis & Dutwin, 2000). The field of program evaluation has grown rapidly since the 1950s as public and private sector organizations have sought quality, efficiency, and equity in the delivery of services (Stufflebeam, 2000b). Today, professional program evaluators are recognized as highly skilled specialists with advanced training in statistics, research methodology, and evaluation procedures (Hosie, 1994). Although program evaluation has developed as a distinct academic and professional discipline, human services professionals have frequently adopted program evaluation principles in order to conduct micro-evaluations of local services. From this perspective, program evaluation can be considered as a type of action research geared toward monitoring and improving a particular program or service. Because micro-evaluations are conducted on a smaller scale, they may be planned and implemented by practitioners. Therefore, for the purposes of this article, we consider counseling program evaluation to be the ongoing use of evaluation principles by counselors to assess and improve the effectiveness and impact of their programs and services.
Challenges to Counseling Program Evaluation Counseling program evaluation has not always been conceptual- ized from the perspective of practicing counselors. For instance, Benkofski and Heppner (1999) presented guidelines for counsel-
ing program evaluation that emphasized the use of independent evaluators rather than counseling practitioners. Furthermore, program evaluation literature has often emphasized evaluation models and principles that were developed for use in large-scale organizational evaluations by professional program evaluators (e.g., Kellaghan & Madaus, 2000; Kettner, Moroney, & Martin, 1999). Such models and practices are not easily implemented by counseling practitioners and may have contributed to the hesi- tance of counselors to use program evaluation methods. Loesch (2001) argued that the lack of counselor-specific evaluation models has substantially contributed to the dichotomy between research and practice in counseling. Therefore, new paradigms of counseling program evaluation are needed to increase the frequency of practitioner-implemented evaluations.
Much of the literature related to counseling program evaluation has cited the lack of both counselors’ ability to systematically evaluate counseling services and of their interest in doing so (e.g., Fairchild, 1993; Whiston, 1996). Many reasons have been suggested for counselors’ failure to conduct evaluations. An important reason is that conducting an evaluation requires some degree of expertise in research methods, particularly in formulating research questions, col- lecting relevant data, and selecting appropriate analyses. Yet counselors typically receive little training to prepare them for demonstrating outcomes (Whiston, 1996) and evaluating their services (Hosie, 1994). Consequently, counselor education programs have been criticized for failing to provide appropri- ate evaluation and research training to new counselors (Bor- ders, 2002; Heppner, Kivlighan, & Wampold, 1999; Sexton, 1999; Sexton, Whiston, Bleuer, & Walz, 1997). Counselors may, therefore, refrain from program evaluation because of
Randall L. Astramovich, Department of Counselor Education, University of Nevada, Las Vegas; J. Kelly Coker, Harbin and As- sociates Psychotherapy, Fayetteville, North Carolina. J. Kelly Coker is now at the Department of Counselor Education, Capella University. Correspondence concerning this article should be addressed to Randall L. Astramovich, Department of Counselor Education, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 453066, Las Vegas, NV 89154-3066 (e-mail: Randy. Astramovich@unlv.edu).
Program Evaluation: The Accountability Bridge Model for Counselors Randall L. Astramovich and J. Kelly Coker
The accountability and reform movements in education and the human services professions have pressured coun- selors to demonstrate outcomes of counseling programs and services. Evaluation models developed for large-scale evaluations are generally impractical for counselors to implement. Counselors require practical models to guide them in planning and conducting counseling program evaluations. The authors present the Accountability Bridge Counseling Program Evaluation Model and discuss its use in evaluating counseling services and programs
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a lack of confidence in their ability to effectively collect and analyze data and apply findings to their professional practice (Isaacs, 2003). However, for those counselors with the req- uisite skills to conduct evaluations, their hesitance may be related to the fear of finding that their services are ineffective (Lusky & Hayes, 2001; Wheeler & Loesch, 1981).
Despite calls for counselors and counseling programs to em- brace research and evaluation as an integral part of the provision of counseling services (e.g., Borders & Drury, 1992; Fairchild, 1994; Whiston, 1996), there is virtually no information that documents counselors’ interest in and use of counseling program evaluation. Although counselors may place minimal value on research and evaluation activities (Loesch, 2001), strong sociopolitical forces, including the emphasis on managed care in mental health and the school reform movement in public education, often require today’s counselors to use evaluation methods to demonstrate the effectiveness and impact of their counseling services.
Program Evaluation and Accountability Distinguishing between program evaluation and accountability is essential because many professionals use the terms inter- changeably and, occasionally, as categories of each other. For instance, Isaacs (2003) viewed program evaluation as a type of accountability that focuses primarily on program effectiveness and improvement. However, from our perspective, counseling program evaluation precedes accountability. As defined by Loesch (2001), counseling program evaluations help practi- tioners “maximize the efficiency and effectiveness of service delivery through careful and systematic examination of program components, methodologies, and outcomes” (p. 513). Counsel- ing program evaluations, thus, have inherent value in helping practitioners plan, implement, and refine counseling practice regardless of the need to demonstrate accountability. However, when called on to provide evidence of program effectiveness and impact, counselors can effectively draw on information gathered from their own program evaluations.
We, thus, conceptualize counseling accountability as provid- ing specific information to stakeholders and other supervising authorities about the effectiveness and efficiency of counseling services (Studer & Sommers, 2000). In our view, demonstrat- ing accountability forms a bridge between counseling practice and the broader context of the service impact on stakeholders. However, accountability should not be the sole motivation for counseling program evaluation. As emphasized by Loesch (2001), counseling program evaluations should be undertaken to improve counseling services rather than merely to provide a justification for existing programming.
The Need for New Models of Counseling Program Evaluation
We believe that a significant contributor to counselors’ dis- interest in evaluation involves the lack of practical program
evaluation models available to them for this purpose. Fur- thermore, confusion about the differences between program evaluation and accountability appear to deter counselors from engaging in ongoing program evaluations (Loesch, 2001). Therefore, the development of new, counselor-specific models that clearly conceptualize program evaluation and account- ability may provide the necessary impetus to establish program evaluation as a standard of practice in counseling.
Recent examples of counselor-focused evaluation ap- proaches include Lusky and Hayes’s (2001) consultation model of counseling program evaluation and Lapan’s (2001) framework for planning and evaluating school counseling programs. Gysbers and Henderson (2000) also discussed the role of evaluation in school counseling programs and offered practical strategies and tools that counselors could imple- ment. These approaches have helped maintain a focus on the importance of counseling program evaluation.
The purpose of this article was to build on the emerg- ing counselor-focused literature on program evaluation by providing counselors with a practical model for developing and implementing evaluation-based counseling services. As Whiston (1996) emphasized, counseling practice and research form a continuum rather than being mutually exclusive activi- ties. Although some counselors may identify more strongly with research and others more strongly with practice, both perspectives provide valuable feedback about the impact of counseling on clients served. Indeed, evaluation and feedback are integral parts of the counseling process, and most coun- selors will identify with the idea of refining their practice by using feedback from numerous sources as a basis.
This article is geared both to practitioners who may have had little prior training in or experience with counseling program evaluations and to counselor educators interested in training students in counseling program evaluation methods. We begin by discussing accountability in counseling and the uses of counseling program evaluation. Next, we present the Accountability Bridge Counseling Program Evaluation Model and discuss the steps involved in its implementation. Finally, we discuss implications and make recommendations for training counselors in evaluation skills.
Accountability in Counseling Accountability has become a catchword in today’s sociopoliti- cal climate. Since the 1960s, local, state, and federal govern- ment spending has been more closely scrutinized and the effectiveness of social programs and initiatives more carefully questioned (Houser, 1998; Kirst, 2000). As professionals in the social services field, counselors have not been shielded from the demands to demonstrate successful and cost-effective outcomes, nor have counseling programs. Despite increas- ing pressure to document effectiveness, some counselors maintain that counseling programs are generally immeasur- able (Loesch, 2001). However, given the rising demands for
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accountability in education and social programs, such an attitude is undoubtedly naïve. In fact, funding of educational programs and social services often hinges on the ability to demonstrate successful outcomes to stakeholders. Because counselors often rely on third-party and government funding, the future of the counseling profession may indeed rest on the ability of practitioners to answer the calls for documentation of effectiveness (Houser, 1998).
School Counseling Accountability
Today’s school counselors face increased demands to demon- strate program effectiveness (Adelman, 2002; Borders, 2002; Herr, 2002; House & Hayes, 2002; Lusky & Hayes, 2001). Primarily rooted in the school reform movement, demonstrat- ing accountability is becoming a standard practice among school counselors (Dahir & Stone, 2003; Fairchild & Seeley, 1995; Hughes & James, 2001; Myrick, 2003; Otwell & Mullis, 1997; Vacc & Rhyne-Winkler, 1993). Standards-based educa- tion reforms, including the No Child Left Behind (NCLB) Act of 2001, have fueled pressures on local school systems to demonstrate effective educational practices (Albrecht & Joles, 2003; Finn, 2002; Gandal & Vranek, 2001). The NCLB Act of 2001 emphasizes student testing and teacher effective- ness; however, school counselors have also recognized that in the current educational environment, actively evaluating the effectiveness of their school counseling programs is crucial. Although the pressures for accountability have seemingly increased in recent years, Lapan (2001) noted that school counselors have developed results-based systems and used student outcome data for many years. Furthermore, school counselors have historically been connected with school re- form, and their roles have often been shaped by educational legislation (Herr, 2002).
Although accountability demands are numerous, school counselors may fail to evaluate their programs because of time constraints, elusiveness of measuring school counseling out- comes, lack of training in research and evaluation methods, and the fear that evaluation results may discredit school counseling programs (Schmidt, 1995). Because of these factors, when school counselors attempted to provide accountability, they may have relied on simple tallies of services and programs offered to students. However, as discussed by Fairchild and Seeley (1995), merely documenting the frequency of school counseling services no longer meets the criteria for demonstrating program effective- ness. Although data about service provision may be important, school counselors must engage in ongoing evaluations of their counseling programs in order to assess the outcomes and the impact of their services.
Trevisan (2000) emphasized that school counseling pro- gram evaluation may help the school counseling profession by providing accountability data to stakeholders, generating feedback about program effectiveness and program needs, and clarifying the roles and functions of school counselors. As the
profession of school counseling evolves, increasing emphasis on leadership and advocacy (Erford, House, & Martin, 2003; House & Sears, 2002) and on comprehensive school coun- seling programs (American School Counselor Association [ASCA], 2003; Sink & MacDonald, 1998; Trevisan, 2002b) will coincide with ongoing research and program evaluation efforts (Paisley & Borders, 1995; Whiston, 2002; Whiston & Sexton, 1998). ASCA’s (2003) revised national standards for school counseling reflect the importance of school coun- seling accountability and provide direction for practicing school counselors in the evaluation of their comprehensive school counseling programs (Isaacs, 2003). Considering the accountability and outcomes-focused initiatives in today’s education environment, school counselors need skills and tools for systematically evaluating the impact of the services they provide (Trevisan, 2001).
Mental Health Counseling Accountability
Like professional school counselors, today’s mental health counselors have experienced significant pressures to dem- onstrate the effectiveness and the efficiency of their counsel- ing services. To secure managed care contracts and receive third-party reimbursements, mental health counselors are increasingly required to keep detailed records about specific interventions and outcomes of counseling sessions (Granello & Hill, 2003; Krousel-Wood, 2000; Sexton, 1996). Despite the financial implications of avoiding such accountability measures, many mental health counselors have fought for autonomy from third-party payers in the provision of coun- seling services. Mental health counselors often indicate that their ability to provide quality mental health care to clients is hampered by managed care’s demands to demonstrate tech- nical proficiency and cost-effective service delivery (Scheid, 2003). Furthermore, mental health counselors often express concerns about their therapeutic decision-making capacity being curtailed by managed care (Granello & Hill, 2003).
Managed care’s mandate for accountability in the field of mental health counseling may have resulted, in part, from counselors’ failure to initiate their own outcomes assessments (Loesch, 2001). However, the emergence of empirically sup- ported treatments (ESTs) has helped counselors respond to the call for accountability from managed care (Herbert, 2003). Specifically, ESTs draw on evidence-based practices from empirical counseling research to provide counselors with intervention guidelines and treatment manuals for specific client problems. Yet, mental health counselors may resist the use of such approaches, insisting that counseling procedures and outcomes cannot be formally measured and that attempt- ing such evaluations merely reduces time spent providing counseling services (Sanderson, 2003). Today’s managed care companies, however, may require counselors to base their practice on specific ESTs in order to receive payment for services. Further complicating the issue is the fact that,
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as previously noted with other areas of counseling, mental health counselors often receive no training in evaluating the outcomes and impact of their services (Granello & Hill, 2003; Sexton et al., 1997). Ultimately, resistance from mental health counselors to document counseling outcomes may be due to insufficient counselor training in evaluation methods.
Despite the tumultuous history of the pressures brought to bear on mental health practitioners by managed care for accountability, there is a major impetus for shifting toward examining program effectiveness and outcomes in mental health counseling—the benefit of forging a professional identity. Kelly (1996) underscored the need for mental health counselors to be accepted as legitimate mental health provid- ers who are on the same professional level as social workers, psychologists, and psychiatrists. The ability to document outcomes and identify effective treatments is, therefore, criti- cal in furthering the professional identity of mental health counselors within the mental health professions.
Accountability in Other Counseling Specialties
Although most literature on counseling accountability empha- sizes school and mental health settings, calls for accountability have also been directed to other counseling specialties. Bishop and Trembley (1987) discussed the accountability pressures faced in college counseling centers. Similar to school coun- selors and mental health counselors, college counselors and those in authority in college counseling centers have resisted accountability demands placed on them by authorities in higher education. Bishop and Trembley also noted that some counselors have maintained that counseling centers are de- signed for practice rather than research.
Ultimately, all counseling practitioners, despite their spe- cialty area, are faced with the need to demonstrate program effectiveness. Although counselors may be hesitant or unwill- ing to evaluate the effectiveness of their services because they see little relevance to their individual practice, the future of the counseling profession may well be shaped by the way practitioners respond to accountability demands.
Program Evaluation in Counseling In recent years, the terms program evaluation and ac- countability have often been used synonymously in dis- cussions of counseling research and outcomes. However, accountability efforts in counseling generally result from external pressures to demonstrate eff iciency and effec- tiveness. On the other hand, counselor-initiated program evaluations can be used to better inform practice and improve counseling services. We believe that a key shift in the profession would be to have counselors continu- ally evaluate their programs and outcomes not because of external pressures, but from a desire to enhance client services and to advocate for clients and the counseling
profession. New perspectives on the role of evaluation of counseling practices may ultimately help program evalu- ation become a standard of practice in counseling.
Program evaluation models have proliferated in the fields of economics, political science, sociology, psychology, and education (Hosie, 1994) and have been used for improving quality (Ernst & Hiebert, 2002), assessing goal achieve- ment, decision making, determining consumer impact, and examining cost-effectiveness (Madaus & Kellaghan, 2000). Many program evaluation models were developed for use in large-scale organizational evaluations and are, thus, impracti- cal for use by counselors. Furthermore, large-scale program evaluation models are generally based on the assumption that a staff of independent evaluation experts or an assessment team will plan and implement the evaluation. Within the counsel- ing professions, however, financial constraints generally make such independent evaluations of programs unfeasible. Consequently, counselors usually rely on limited resources and their own research skills to carry out an evaluation of program effectiveness. Fortunately, many of the principles and practices of large-scale evaluation models can be adapted for use by counselors.
Given the wide range of program evaluation definitions and approaches, models from human services professions and edu- cation appear most relevant for the needs of counselors because these models generally emphasize ongoing evaluation for pro- gram improvement (e.g., Stufflebeam, 2000a). Counseling pro- gram evaluation may be defined as the ongoing use of evaluation principles by counselors to assess and improve the effectiveness and impact of counseling programs and services. Ongoing coun- seling program evaluations can provide crucial feedback about the direction and the growth of counseling services and can also meet the accountability required by stakeholders (Boulmetis & Dutwin, 2000; Loesch, 2001; Stufflebeam, 2000b).
Reasons for Evaluating Counseling Programs
Program evaluations may be initiated for various reasons; however, evaluations are intended to generate practical in- formation rather than to be mere academic exercises (Royse, Thyer, Padgett, & Logan, 2001). Counseling program evalu- ations should, therefore, provide concrete information about the effectiveness, the efficiency, and the impact of services (Boulmetis & Dutwin, 2000). Specifically, counseling pro- gram evaluations can yield information that will demonstrate the degree to which clients are being helped. Evaluations may also provide feedback about client satisfaction and can help to distinguish between effective and ineffective approaches for the populations being served (Isaacs, 2003). On a broader scope, program evaluations can help to determine if services are having an influence on larger social problems (Royse et al., 2001). On the contextual level, evaluations can provide information about the use of staff and program resources in the provision of services (Stufflebeam, 2000a).
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Accountability to stakeholders has often been a consideration in formulating approaches to counseling program evaluation. For example, Lapan (2001) indicated that program evaluations help counselors to identify effective services that are valued by stake- holders. Thus, by using stakeholder feedback in program planning and then providing valued services, counselors are better prepared to demonstrate the accountability of their programs and practice. Internal accountability may be requested by administrators of local programs to determine if program staff and resources are being used effectively. On the other hand, external accountability may be requested by policy makers and stakeholders with an interest in the effectiveness of provided services (Priest, 2001).
Counseling program evaluations are generally implemented to provide information about local needs; however, in some instances information from local evaluations may have significant implica- tions for the entire counseling profession. As discussed by Whiston (1996), the professional identity of counselors can be enhanced through action research that demonstrates the effectiveness of ser- vices. By conceptualizing program evaluations as a type of action research, counselors have the potential to consider this effort as a contribution to the growing research-base in counseling.
Questions That Evaluations May Answer
Counseling program evaluations, like all forms of evalua- tions, are undertaken to answer questions about the effective- ness of programs and services in meeting specific goals (Berk & Rossi, 1999). Questions about the overall effectiveness and impact of services may be answered, as well as more discrete, problem-specific concerns. Furthermore, questions posed in evaluations help guide the collection and analysis of outcome information and the subsequent reporting of outcomes to stakeholders.
Numerous questions may be explored with evaluations. Powell, Steele, and Douglah (1996) indicated that evalu- ation questions generally fall into four broad categories: outcomes and impacts, program need, program context, and program operations. The following are some examples of the types of questions that counseling program evaluations may answer:
• Are clients being helped? • What methods, interventions, and programs are most
helpful for clients? • How satisfied are clients with services received? • What are the long-term effects of counseling programs
and services? • What impact do the services and programs have on
the larger social system? • What are the most effective uses of program staff? • How well are program objectives being met?
Program evaluations are generally guided by specific questions related to program objectives. Guiding questions
help counselors to plan services and gather data specific to the problems under investigation. Depending on program and stakeholder needs, counseling evaluations may be designed to answer many questions simultaneously or they may be focused on specific objectives and outcomes. As part of an ongoing process, the initial cycle of a counseling program evaluation may yield information that can help to define or refine further problems and questions for exploration in the next evaluation cycle.
Ultimately, counseling program evaluations may serve many purposes and may provide answers to a variety of questions. However, if counselors are to implement evaluations, a practical framework for conceptualizing the evaluation process seems essential. Counselors, thus, need a conceptual foundation for guiding the evaluation of their programs and services.
The Accountability Bridge Counseling Program Evaluation Model for Counselors
The Accountability Bridge Counseling Program Evaluation Model (see Figure 1) provides a framework to be used by individual counselors and within counseling programs and counseling agencies to plan and deliver counseling services and to assess their effectiveness and impact. Drawing on concepts from the business evaluation model proposed by Ernst and Hiebert (2002) and the Context, Input, Process, Product Model (CIPP) developed by Stufflebeam (2000a), the Accountability Bridge Counseling Program Evaluation Model organizes counseling evaluation into two reoccur- ring cycles that represent a continual refinement of services based on outcomes, stakeholder feedback, and the needs of the populations served. The counseling program evaluation cycle focuses on the provision and outcomes of counseling services, whereas the counseling context evaluation cycle ex- amines the impact of counseling services on stakeholders and uses their feedback, along with the results yielded by needs assessments, to establish and refine the goals of counseling programs. The two cycles are connected by an “accountability” bridge, whereby results from counseling practices are com- municated to stakeholders within the context of the larger service system. Providing accountability to stakeholders is, therefore, an integral part of the model. Although it is beyond the scope of this article to discuss each component in depth, a basic review of the framework and principles of the model will help counselors begin to conceptualize the process of planning and implementing counseling program evaluations.
Counseling Program Evaluation Cycle
The counseling program evaluation cycle involves the planning and implementation of counseling practice and culminates with assessing the outcomes of individual and group counseling, guidance services, and counseling programs. Four stages are involved in the counseling program evaluation cycle.
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1. Program planning. Although we enter the discussion of the model at the program planning stage, information obtained from the counseling context evaluation cycle is critical in the planning process. Thus, on the basis of input obtained from needs assessments and the subsequent formation of service objectives, counseling programs and services are planned and developed to address the needs of the populations served. Program planning involves identifying specific counsel- ing methods and activities that are appropriate for certain populations as well as determining the availability of needed resources, including staff, facilities, and special materials (Royse et al., 2001).
Lapan (2001) stressed that effective school counseling programs meet objectives by planning results-based inter- ventions that can be measured. Therefore, a key component of the program planning process involves the simultaneous planning of methods for measuring outcomes (Boulmetis & Dutwin, 2000). For instance, during the program planning phase, a community counseling agency that is planning a new substance abuse aftercare program should determine the means of assessing client progress through the program. Furthermore, developing multiple outcome measures can help increase the validity of findings. Gysbers and Hender- son (2000) discussed several means for assessing school counseling outcomes, including pretest–posttest instruments, performance indicators, and checklists. Studer and Sommers (2000) indicated that multiple measures, such as assessment instruments, observable data, available school-based data, and client/parent/teacher interviews, could be used in school counseling program evaluation. In mental health and college counseling specialties, similar measures of client and program progress can be used, including standardized assessment tools such as depression and anxiety inventories. Other means of collecting outcome data include surveys, individual and
group interviews, observation methods, and document review (Powell et al., 1996). Furthermore, data can be collected over a 1- to 3-year period to determine program effectiveness over longer periods of time (Studer & Sommers, 2000).
A f inal consideration in the program planning stage involves determining when clients will complete selected measures and assessments . Individuals who will be respon- sible for gathering and processing the information should be identified as well. For example, in a community agency setting, counselors may take responsibility for collecting data about their own client caseload, whereas a counselor supervisor may collect data from community sources.
2. Program implementation. After programs and services have been planned and outcome measures have been selected, programs and services are initiated. Sometimes referred to as “formative evaluation,” the program implementation phase actualizes the delivery of services shaped by input from the counseling context evaluation cycle. During program imple- mentation, counselors may identify differences between the planned programs and the realities of providing the services. Therefore, at this point, decisions may be made to change programs before they are fully operational or to make refine- ments in programs and services as the need arises.
3. Program monitoring and refinement. Once programs and services have been initiated and are fully operational, coun- selors may need to make adjustments to their practice based on preliminary results and feedback from clients and other interested parties. Programs and services may, therefore, need to be refined and altered to successfully meet the needs of the clientele served. Monitoring program success helps to ensure the quality of counseling services and maximizes the likelihood of finding positive results during outcomes assessments.
4. Outcomes assessment. As programs and services are completed, outcomes assessments help to determine if objec-
FIGURE 1
Accountability Bridge Counseling Program Evaluation Model
Program Monitoring and Refinement
Feedback From Stakeholders
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tives have been met. Therefore, during the outcomes assessment phase, final data are collected, and all program data are analyzed to determine the outcomes of interventions and programs. Counseling outcome data should be analyzed and interpreted as soon as possible after being collected (Gysbers & Henderson, 2000). Data analysis approaches differ for quantitative and qualitative data, and counselors with limited research back- ground may need to seek assistance from peers and supervisors with knowledge of analyzing a variety of data sets. Available data analysis computer software can also expedite the analysis and interpretation of data. Such software programs also allow for easy creation of charts and graphs that can play a key role in the dissemination of evaluation results.