Scenario 1: Belinda Belinda is six months pregnant, and she volunteers as a telephone counsellor. After a onehour call assisting a person to manage suicide ideations, Belinda seeks supervision. She tells the supervisor she found the call extremely taxing and is not sure if she was able to help the caller. Event Debrief and Evaluation Form Part A Debrief details Reason for debrief [Reason for debrief] Debrief facilitator Date of debrief Time of debrief [Debrief facilitator name] [Clickitap to select date] [00.00 amfpm] Location of debrief [Location of debrief] Persons involved [List persons involved] Desired outcomes of the debrief [Click here to enter your comments] Debriefing techniques to be used [Click here to enter your comments] Debriefing risk assessment Potential risk Indicators Solution [Describe the risk] [List the signs] [Propose solution/s] [Describe the risk] [List the signs] [Propose solution/s] Part B - Debrief evaluation Key points of discussion. [Click here to enter your comments] List or describe what you thought was SUCCESSFUL or worked well in discussion or for what you were involved in. [Click here to enter your comments] List or describe what you thought was NOT SUCCESSFUL or did not work well in discussion or for what you were involved in. [Click here to enter your comments] List or describe what you thought was NOT SUCCESSFUL or did not work well in discussion or for what you were involved in. [Click here to enter your comments] List your actions/recommendations for improvement for future occurrenceot to happen again for the area of discussion or for what you were involved in. [Click here to enter your comments] List or describe what impact you think the reason for debriefing had on you and others. [Click here to enter your comments] Any further comments or suggestions for improvement for future events. [Click here to enter your comments] In your opinion was the debrief helpful. [Click here to enter your comments] Actions List of actions/recommendations Responsibility belongs to [Enter your actions/recommendations] [Full name] [Enter your actions/recommendations] [Full name]