Form Survey ECS Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

ECS DOS Survey for March 2024 saved MAR 12 2024 1134 PM

ECS Survey

OMB: 1405-0193

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Employee Consultation Services (ECS): Here
to Support You!
Thank you for participating in our (10) question inquiry. Your feedback is
valuable to us as we strive to improve our services.
1. Prior to today, did you know about ECS/EAP (the Department of State’s
Employee Assistance Program)?
Yes
No
Additional Comments:
2. ECS offers confidential short- term counseling, crisis intervention, presentations,
group support, management consultations, substance use counseling, and referral
services. Have you ever used ECS services?
Yes
No
Additional Comments:
3. Did you know that you may be granted excused absence from official duty to
receive services from ECS?
Yes
No
Additional Comments:
4. Did you know that ECS services are confidential? This means that our staff is
prohibited from disclosing your identity and communication content to anyone
else in the Department.
Yes
No
Additional Comments

SENSITIVE BUT UNCLASSIFIED

5.Below is a list of proposed topics for ECS workshops. Please indicate which
workshops you would be interested in attending now or in the future.
Activating Happiness
Bullying in the Workplace
Changing Habits regarding
Substance Use
Divorce and Separation
Domestic Violence
Eldercare
Forgiveness
Financial Counseling
Healthy Marriage
Communication
Increasing Self-Esteem
Increasing Assertiveness
Infidelity
Increasing Emotional Intelligence
Life Transitions
Living with a Family Member
with a Mental Health Challenge
Managing Anger
Managing Anxiety
Managing Conflict in the
Workplace

Managing Depression
Managing Parental Stress
Managing Stress in the
(Personal /Workplace)
Managing Difficult Relationships
Meaningful Living
Mindful Eating
Mindfulness
Parenting Children (0-17)
Problematic Pornography Use
Single Again
Sleep Difficulties
Strengthening Personal
Relationships
Suicide Prevention
Tools to Prevent Workplace
Burnout
Understanding Grief and Loss
Understanding Trauma
Understanding Depression
Understanding the LBGTQ+
Community

6. Please identify topics not listed above that may benefit you or other
personnel.

SENSITIVE BUT UNCLASSIFIED

7. If your life is impacted by caregiving responsibilities, identify the area where
support is required. Check all that apply:
Elder Care
Childcare
Caring for a person with a disability
Other:
My life is not impacted by caregiving responsibilities.
Additional Comments
8. Do you have concerns related to sexual orientation or gender (LBGTQ+)? If
yes, what services can DOS offer that may support you & your family?
Yes
No
Additional Comments
9. Which option below best describes your employment type with the
Department of State?
Foreign Service

Civil Service

EFM

Other

10. What is the length of time you have been employed by DOS?
1-5 years
6-11 years
12-17 years
18+ years
11. What is the ideal time for you to schedule an appointment with ECS?
7:00AM - 4:00PM ET
4:00PM - 11:00PM ET
11:00PM- 7:00AM ET

SENSITIVE BUT UNCLASSIFIED


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