Track-A Information and Application The Fast Track to Becoming a Registered Play Therapist!
|
|
- Dulcie Lindsey
- 5 years ago
- Views:
Transcription
1 Chesapeake Beach Professional Seminars 3555 Ponds Wood Drive Chesapeake Beach, MD Cbpseminars.org Phone: Fax Track-A Information and Application The Fast Track to Becoming a Registered Play Therapist! What is Play Therapy? Play is described as the child s world of make-believe. Play therapy is a safe place to work through inner conflicts, where toys are used as tools. For therapists, play therapy is the best tool to learn about a child s inner thoughts, personality, worries and wishes (Irwin). Giants in the field such as Virginia Axline, Clark Moustakas, Carl Rogers and Haim Ginon have contributed much to the early development of play therapy. Later on, Garry Landreth, Louise Guerney, Violet Oaklander, Eliana Gil and many others have also made significant contributions. Why Become a Registered Play Therapist? Mental health services in the form of play therapy for children ages 3-10, require specialized training. Play therapy is a skill that is rarely taught in graduate school. Our play therapy institute provides 150 hours of intensive training in play therapy and child psychotherapy. Our training helps clinicians bring healing to children who present with trauma, behavioral issues, emotional dysregulation, anger, rage, grief and loss, anxiety, and many other symptoms. With extensive research through the efforts of the Association for Play Therapy (APT), play therapy is regarded as evidenced-based. How to Become a Registered Play Therapist: To become a Registered Play Therapist (RPT), one must go through the credentialing process set forth by the Association for Play Therapy (APT), a nation-wide organization located in California. After completing 150 hours of training and clinical supervision in play therapy, an application is submitted to the APT. There is also an opportunity to become an RPT-S (Registered Play Therapist-Supervisor). Please contact the APT directly to learn about the pre-requisites and all other pertinent information. CBPS provides over 150 hours of training through our Track A program. Our APT approved provider number is # You must be a licensed mental health provider and meet other requirements specified by the APT in order to obtain the credentials. Content of the training we offer includes history, theory, techniques/methods, and the application of play therapy to special populations and in special settings as recommended by APT. The credentials provided through APT is not a mental health license. Visit APT website: or call Cost: The cost for most individual workshops is $ $ per day. Two days is $ $ Some workshops have special fees. The cost includes a CE certificate, unless otherwise noted. The cost for Track A is $ , which represents an $825+ savings. This cost includes 150 hours of training, a resource packet, and 150 CE/Clock Hours approved through the APT. The cost for Track-A does not 1
2 include cost for clinical supervision. You may choose to pay the entire fee or use our payment plan. If you would like to use our payment plan, you will be required to add an additional $ We accept credit card payments, checks, and PayPal payments. Please make checks payable to Chesapeake Beach Professional Seminars. For those who wish to participate in a payment plan, a down payment of $ is required as the first payment, follow by 10 consecutive monthly payments of $ The cost for returned checks and late payments is $25.00 each. Please consult your employer regarding funding. Several past participants have been successful in obtaining funding from their employers. If you are active in a religious organization, consult your clergy about funding opportunities. You may be able to offer FREE clinical services in exchange for funding. Another creative way is to sponsor a workshop and invite other agencies to participate. Grant funding may also be pursued. Military veterans should inquire to the appropriate agencies about funding. Training Categories: For Track-A, CBPS offers a variety of courses that address all of the important aspects of play therapy. We add new workshops each year, but we provide the same core training to ensure that all members of Track-A are afforded the opportunity to attend the training they want at a time that is convenient. The following is a calendar with most of the workshops we offer. CBPS also offers workshops on specific topics that are not listed as part of our core training. Be sure to visit our website for updated training information. Play Therapy History (4 5 hours recommended): History, Theory & Foundation of Play Therapy: 6 hours Total Hours: 6 Play Therapy Theories (40 50 hours recommended): Child-Centered Play Therapy (Experiential with Children during Boot Camp only), Day 1 & 2: 12 hours Gestalt Play Therapy, What I Learned from the Master, 2 days: 12 hours Introduction to Sandtray Play Therapy, Day 1: 6 hours Adlerian Play Therapy, 2 days: 12 hours Filial Play Therapy, 2 days: 12 hours Total Hours: 48 Play Therapy Techniques and Methods (40 50 hours recommended): Kaleidoscope of Play Therapy Techniques: 6 hours Use of Art in Play Therapy to Understand Child Development: 6 hours Teaching Social Skills Using CBT & Play Therapy: 6 hours Innovative Healing Play Therapy Techniques: 6 hours Use of Expressive Arts in Play Therapy: 6 hours Art as a Neurosequential Approach to Treating Developmental Trauma in Children in Play Therapy- Day 1: 6 hours Play Therapy Based Applications for Trauma-Focused CBT with Children: 6 hours Use of Games in Play Therapy: 6 hours Sandtray Play Therapy with Children & Adolescents: 6 hours Total Hours: 54 2
3 Play Therapy Applications (special settings or populations, hours recommended): Effective Parenting Strategies for Play Therapists & Child Psychotherapists: 6 hours Traumatic Grief in Play Therapy: 6 hours Groups for Adolescents Using Drama & Play Therapy: 6 hours Managing the Angry Child Using Play Therapy & CBT: 6 hours Play Therapy with Children on the Autism Spectrum: 6 hours Sandtray with Adults Understanding & Treating Trauma in Children Using Drama & Play Therapy: 6 hours Who Let the ANTs Out! CBT and Play Therapy for Children with Anxiety: 6 hours Creative Play Therapy Interventions for Bereavement and Divorce: 6 hours Guiding Parents and Teachers in Supporting Young Children's Development Through Play Therapy: 6 hours Play Therapy for Sexually Traumatized Children: 6 hours Ethical Dilemmas in Play Therapy: 6 hours Multicultural Issues in Play Therapy: 6 hours Helping Foster Children & Teens Heal Broken Attachments through Play Therapy Techniques: 6 hours Play Therapy Skills Lab Directive & Non-Directive: 6 hours Play Therapy Skills Lab Use of Art: 6 hours School-Based Play Therapy: 6 hours Effective Use of Puppets in Play Therapy: 3 hours Putting it All Together Comprehensive Self-Evaluation of the Play Therapy Process: 6 hours Total Hours: 105 Certificate of completion: We award certificates of completion for each workshop. These certificates will be provided at the end of each workshop, after course evaluation is completed and sign in-sheets verified. For Track A participants, a second certificate will be given to reflect completion of 150 hours of training. 3
4 Track-A: Cost The Fast Track to Becoming a Registered Play Therapist! Payment: Track-A payment in full is $2,600 without the use of a payment plan. Participating using our payment includes an additional charge of $ A down payment of $ is required, followed by 10 months of payments, totaling $ each month. There is a fee of $25.00 for returned checks or late payments when applicable. Cost Includes: 150 Hours of play therapy training (to be completed within 2 years of beginning the program) 150 CEU/CE/Clock Hours Certificate of Completion of 150 hours of play therapy training from CBPS Resource Pack Why Become a Registered Play Therapist: Increase knowledge and expertise working with children and adolescents Increase confidence and comfort level Improve credibility with parents and behavioral health insurance companies Potential increase in revenue and referrals to your practice Add RPT to existing credentials Cancellation Policy: Written cancellation notice must be received in our office at least ten business days prior to the training in order to receive a refund. A $25.00 processing fee will be deducted from your refund. If written cancellation notice is received less than ten business days, a voucher will be given to attend another training, and $25 will be subtracted from the amount on the voucher. If you do not notify us of your intent to cancel, you will not receive a refund or credit. Chesapeake Beach Professional Seminars reserves the right to cancel a workshop due to inclement weather or insufficient registrants. If this occurs, you will be provided with a full refund. In the event of inclement weather, please check your , text messages or voice mail for CBPS notifications/instructions. Canceling participation in Track-A: If you wish to cancel your participation in Track-A, you must contact CBPS in writing no later than 30 days from date of the first Track A training you attended. After 30 days, no refunds will be provided. 4
5 Track-A Application Form The Fast Track to Becoming a Registered Play Therapist! Please complete this section Name: Discipline: Title: Type of License: Credentials: License #: Home Address: City: State: Zip: Home Phone: Cell Phone: Employer Address: City: State: Zip: Work Phone: Please check all of the following that apply: The following information is required for all Track-A participants. if you have any questions about the information, please contact CBPS by (cbps2006@gmail.com) or by phone ( ). Please provide your initials in the box to the left as indication that you agree to each standard: Initials: I agree to complete the Track-A curriculum within 2 years of the first training taken I agree to keep track of workshops I have attended in order to give an account of my hours if needed I agree to submit a full payment of $2,600 to CBPS for my Track-A training, OR I agree to an individual payment plan ($2,600 + $125.00) totaling $2, The payment plan consists of a $ down payment followed by 10 consecutive monthly payments of $ $220 begins the month after paying the down payment. I agree to pay the late payment fee of $25.00 if I do not pay on the due date (end of each month) I agree to pay the returned check fee of $25.00 should the payment not go through I understand that there is no refund for the total cost paid to CBPS s Track-A program after 30- days from the first training I attended 5
6 Payment Options: Initials: I will submit my monthly payment by: PayPal: Please provide address linked to PayPal account: Credit Card: CBPS will send you a copy of our Credit Card Authorization Form to complete either electronically or hard-copy. Check: Submitted to: Chesapeake Beach Professional Seminars 3555 Ponds Wood Drive, Chesapeake Beach, MD Please make the check payable to Chesapeake Beach Professional Seminars Please sign, indicating that you have read this entire document and agree to the above. Signature: Date: 6
Credentialing Guide:
Credentialing Guide: Registered Play Therapist (RPT) & Supervisor (RPT-S) Applicants The Association for Play Therapy (APT) is a national professional society formed in 1982 to advance the play therapy
More informationTune In: Engaging Teens in the Play Therapy Process Jodi Smith, MSW, LCSW, RPT-S Brief Description of Training
Tune In: Engaging Teens in the Play Therapy Process Jodi Smith, MSW, LCSW, RPT-S The Georgia State University Student Center Friday, June 4, 2010 8:30 AM 4 PM Brief Description of Training Therapists working
More informationOrlando, Florida Friday, February 27 and Saturday, February 28, 2004 featuring. Eliana Gil, PhD, LMFT, RPT-S
The Florida Association for Play Therapy and The University of Central Florida Present The 2004 FAPT Conference Orlando, Florida Friday, February 27 and Saturday, February 28, 2004 featuring Eliana Gil,
More informationSensorimotor Psychotherapy Level I
2016 Professional Development Courses childhood.org.au/training Sensorimotor Psychotherapy Level I Applying somatic sequencing and body based approaches to trauma interventions Course information Sydney
More informationBASIC TRAINING COURSE OVERVIEW
Basic Training In EMDR Therapy A Developmentally Grounded Training for Treating Clients from Infants to Adults Courses offer 40 CE Credits Basic Training Overview Presented by Tapia Counseling and Psychological
More informationWestcoast Children s Clinic POSTDOCTORAL RESIDENCY PROGRAM. in Child and Adolescent Psychology
Westcoast Children s Clinic 2017-2018 POSTDOCTORAL RESIDENCY PROGRAM in Child and Adolescent Psychology TABLE OF CONTENTS INSIDE POSTDOCTORAL RESIDENCY PROGRAM Pages 1-3 TRAINING ACTIVITIES Page 4-5 POSTDOCTORAL
More informationCanadian Association for Child and Play Therapy (CACPT) October 2015 CACPT E-Newsletter
Canadian Association for Child and Play Therapy (CACPT) October 2015 CACPT E-Newsletter Welcome to the Canadian Association for Child and Play Therapy E-Newsletter In This Issue CACPT Call for Research
More informationCore Curriculum. Offered Throughout Eastern North Carolina
The End-of-Life Nursing Education Consortium (ELNEC) Core Curriculum Offered Throughout Eastern North Carolina June 13-14, 2017 September 19-20, 2017 October 26-27, 2017 O. Marks Building Eastern AHEC
More informationA Canadian Learning Organization. Registration Form for CBT-CR Utilizing Cognitive Behaviour Therapy in Couples Therapy
Registration Form for CBT-CR-01170617 Utilizing Cognitive Behaviour Therapy in Couples Therapy January 9, 2017 to June 18, 2017 Registration Deadline January 6, 2017 Early Bird Discount: November 18, 2016
More informationStandards of Practice for Hospice Programs (2010) (Veteran-related Standards)
Standards of Practice for Hospice Programs (2010) (Veteran-related Standards) National Hospice and Palliative Care Organizations (NHPCO) Standards of Practice for Hospice Programs (2010) is a valuable
More informationConnecticut TF-CBT Coordinating Center
Connecticut TF-CBT Coordinating Center Welcome Packet W Introduction e are pleased to welcome you to the Connecticut TF-CBT Network! We are excited to collaborate with and support your efforts to provide
More informationAffiliate Provider Application Instructions and Check Sheet
WellSpan EAP P.O. Box 1827 York, PA 17405 1827 Phone: 866 227 6527 Fax: (717) 851 4493 Affiliate Provider Application Instructions and Check Sheet Enclosed is an Affiliate Provider Application for your
More informationEnriching Your Bereavement Program
2016 Enriching Your Bereavement Program October 13 14, 2016 Golden Nugget Biloxi, MS Thursday, October 13, 2016 2:00 PM 2:15 PM Welcome and Opening Remarks Melita Miller, RN Board President 2:15 PM 3:45
More informationAGREEMENT FOR SERVICE / INFORMED CONSENT FOR MINORS
Introduction AGREEMENT FOR SERVICE / INFORMED CONSENT FOR MINORS This Agreement has been created for the purpose of outlining the terms and conditions of services to be provided by San Diego Psychotherapy
More informationEYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR)
EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR) BASIC TRAINING June 21-23 & September 5-8, 2017 Pre-study 1 month Prior to commencement of training Early Bird Date: April 7, 2017 Winnipeg, MB Life
More informationA Canadian Learning Organization
Comprehensive Certificate Program in Cognitive Behaviour Therapy for Registered Nurses Application Form for CBT-CC/RN-09160118 September 26, 2016 to January 27, 2018 Registration Deadline August 5, 2016
More informationFull Circle: Basic to Advanced Skills in Clinical Supervision for Creative Arts Therapists, Professional Counselors, and Psychotherapists.
These 7-hour courses can be taken as a stand-alone courses or as a part in our series of: Full Circle: Basic to Advanced Skills in Clinical Supervision for Creative Arts Therapists, Professional Counselors,
More informationProfessional Development Courses childhood.org.au/training
2015-2016 Professional Development Courses childhood.org.au/training Sensorimotor Psychotherapy Level III Training Program in Affect Regulation, Attachment and Trauma. Advanced Skills/Certification Course
More informationCPRS Application. Certified Peer Recovery Specialist. VCB CPRS Application Revised February
CPRS Application Certified Peer Recovery Specialist VCB CPRS Application Revised February 2017 - www.vacertboard.org - info@vacertboard.org 1 DIRECTIONS/CHECKLIST Documentation of high school diploma/ged
More informationACADEMY FOR GUIDED IMAGERY PROFESSIONAL CERTIFICATION TRAINING STUDENT CONTRACT
ACADEMY FOR GUIDED IMAGERY PROFESSIONAL CERTIFICATION TRAINING STUDENT CONTRACT This contract sets forth the terms and conditions under which I agree to enroll in Professional Certification Training with
More informationCLASSIFICATION TITLE: Counseling Psychologist II (will change)
NAME: CLASSIFICATION TITLE: Counseling Psychologist II (will change) WORKING TITLE: Licensed Psychotherapist, Case Manager TITLE CODE: UNIT: Student Success DEPT: CAPS SUMMARY STATEMENT Under the direction
More informationInstructions and Application
Association of Traumatic Stress Specialists Providing international recognition and certification for training, education and experience in traumatic stress services, response and treatment Instructions
More informationChild Life Services. A child s work is play
Child Life Services A child s work is play Child Life/ Child Development Services Hospitals can be a confusing environment for a child. Child Life/Child Development Services seeks to ease that fear by
More informationDivision of Child Life and Integrative Care. Child Life Internship Manual
Division of Child Life and Integrative Care Child Life Internship Manual TABLE OF CONTENTS I. Internship Description Page 1 II. Application Deadlines Page 2 III. Philosophy and Program Description Page
More informationLocation: Huntingdon with work across Cambridgeshire and Bedfordshire
Job Description Job title: Multi Systemic Therapy Problem Sexual Behaviour Worker Location: Huntingdon with work across Cambridgeshire and Bedfordshire Hours: 37 per week Grade: Therapist scale (5 point
More informationAnnual Renewal Application:
Annual Renewal Application: Registered Play Therapist (RPT) Instructions: Renewal of your Registered Play Therapist (RPT) credential is contingent upon the receipt and acknowledgement of ALL items below.
More informationLaurie Musick LPC-S San Marcos Counseling Suttles Ave, San Marcos Tx Intake Form
Intake Form PLEASE PRINT CLEARLY Today s Date PERSONAL INFORMATION PATIENT (S) RESPONSIBLE PARTY Date of Birth Gender Responsible Party s SSN Address Address (if different) City, State Zip City, State
More informationPost-Doctoral Fellowship in Clinical Psychology. Counseling & Psychological. Services. Princeton University
2018-2019 Post-Doctoral Fellowship in Clinical Psychology Counseling & Psychological Services Princeton University Welcome to Counseling and Psychological Services! CPS is Princeton University s campus
More informationComprehensive Counseling & Consulting, LLC
Welcome to Comprehensive Counseling & Consulting, LLC! We look forward to working with you! Below you will find the intake packet which may be printed out and completed before your first appointment. We
More informationIntensive Services Progress Note
Intensive Services Progress Note This form is to be completed for all group and individual therapy sessions offered as part of comprehensive treatment for Intensive Service Programs such as Partial Hospitalization
More informationCURRICULUM VITA. M.S. Clinical Mental Health Counseling 2009 University of Scranton, Scranton, PA
CURRICULUM VITA Department of Counseling and Human Services 800 Linden Street 453 McGurrin Hall Scranton, PA 18510 570.941.4129 brandice.ricciardi@scranton.edu EDUCATION M.S. Clinical Mental Health Counseling
More informationMusic Therapy Internship Fact Sheet
Internship Site & Director UC Davis Children s Hospital 2315 Stockton Boulevard Sacramento, CA 95817 Tori Steeley, MT-BC tsteeley@ucdavis.edu (916) 734-2066 Populations Served Music Therapy Internship
More informationSpecialized On-Demand Education for Home Care Staff
Home Care Association of New Hampshire and RCTCLearn offer Specialized On-Demand Education for Home Care Staff Providing your agency s staff with high quality continuing professional education doesn t
More informationTHE CHILDREN S HOSPITAL OF PHILADELPHIA CHILD LIFE, EDUCATION and CREATIVE ARTS THERAPY DEPARTMENT
THE CHILDREN S HOSPITAL OF PHILADELPHIA CHILD LIFE, EDUCATION and CREATIVE ARTS THERAPY DEPARTMENT Dear Applicant, Thank you for your interest in our child life training program. Three times a year, for
More informationUNIVERSITY OF CALIFORNIA, SAN DIEGO COUNSELING AND PSYCHOLOGICAL SERVICES (CAPS) POST-DOCTORAL RESIDENT EVALUATION
UNIVERSITY OF CALIFORNIA, SAN DIEGO COUNSELING AND PSYCHOLOGICAL SERVICES (CAPS) POST-DOCTORAL RESIDENT EVALUATION Postdoctoral Fellow Name: Evaluation Period: Supervisor s Name: Date of Evaluation: Competency
More informationChildren s Senior Psychotherapist. Therapeutic Services GRADE: 05. Context and Purpose of the Job
JOB TITLE: TEAM: GROUP: LOCATION: REPORTS TO: Children s Psychotherapist Therapeutic Services Operations Luton Children s Senior Psychotherapist GRADE: 05 HOURS: 21 hours per week Context and Purpose of
More informationAn American Psychological Association Accredited Internship in Clinical Psychology
An American Psychological Association Accredited Internship in Clinical Psychology 2015 2016 Program Affiliated with University of Southern California USC Keck School of Medicine and Children s Hospital
More informationStacie Beam-Bruce, LICSW, ACHt License# LW Main Ave S Suite 203 North Bend, WA 98045
Stacie Beam-Bruce, LICSW, ACHt License# LW601172112 103 Main Ave S Suite 203 North Bend, WA 98045 INFORMED CONSENT AND CLIENT AGREEMENT WELCOME TO MY PRACTICE. I am pleased to have the opportunity to work
More informationTHE COUNSELING PLACE ADULT INTAKE FORM Yearly Family Income:
Person to Contact in Case of Emergency Name Relationship Best Contact Number Alternative Contact Number Office Use Only Intake Date Reason for referral Counselor THE COUNSELING PLACE ADULT INTAKE FORM
More informationRBT /Behavior Technician/ ABA Therapy We re growing!
RBT /Behavior Technician/ ABA Therapy We re growing! Career Opportunities at MindSource Center Job Summary: MindSource Center, LLC is seeking energetic and motivated individuals to provide 1:1 ABA Therapy
More information(TRACK). Dear APE Student,
APE Program ~ TRACK Grant Dear APE Student, Thank you for your interest in the Adapted Physical Education (APE) grant program at CSU, Chico. Students pursuing an APE Authorization or a Master s degree
More informationTHE ALLENDALE ASSOCIATION. Master s Level Psychotherapy Practicum Information Packet
THE ALLENDALE ASSOCIATION Master s Level Psychotherapy Practicum Information Packet 2017-2018 INTRODUCTION TO ALLENDALE The Allendale Association is a private, not-for-profit organization located in Lake
More informationMAYERSON CENTER FOR SAFE AND HEALTHY CHILDREN TRAINING OPPORTUNITIES
MAYERSON CENTER FOR SAFE AND HEALTHY CHILDREN TRAINING OPPORTUNITIES 2018 The Mayerson Center for Safe and Healthy Children (Mayerson Center) is a division of Cincinnati Children s Hospital Medical Center
More informationX Name of Patient (Please Print) X Signature of Patient (or Parent/Legal Guardian) X Name of Parent/Legal Guardian (Please Print)
In Office Policies Identification - For the protection of our patients, and to reduce medical identity theft, all patients are required to present a valid insurance ID card and/or driver s license at the
More informationComprehensive Outreach Education Certificate Program & Health Modules
Comprehensive Outreach Education Certificate Program & Health Modules Community Health Education Center Lowell Community Health Center 161 Jackson Street Lowell, MA 01852 Tel: 978.452.0003 Email: CHEC@lchealth.org
More informationDescription Advanced Studies Masters Child Life (ASCL) Degree 2013
Description Advanced Studies Masters Child Life () Degree 2013 Advanced Studies Masters Child Life Degree/Program is an advanced degree program for careers working with infants, children, teens (from birth
More informationBRITISH ASSOCIATION FOR BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPIES (BABCP) MEMBERS
ACCREDITATION as an AACBT COGNITIVE and BEHAVIOURAL THERAPIST for ACCREDITED BRITISH ASSOCIATION FOR BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPIES (BABCP) MEMBERS General Information Provisionally or Fully
More informationTeaching Field: Behavioral Health Science Higher Learning Commission (HLC) Faculty Qualifications
Teaching Field: Behavioral Health Science Higher Learning Commission (HLC) Faculty Qualifications Courses require a Master's degree or higher from a regionally accredited college or university in a related
More informationComprehensive Outreach Education Certificate Program & Health Modules
Comprehensive Outreach Education Certificate Program & Health Modules Community Health Education Center Lowell Community Health Center 161 Jackson Street Lowell, MA 01852 Tel: 978.452.0003 Email: CHEC@lchealth.org
More informationAll Level I courses VNSG 1400 ; Must be placed into college level reading,engl0300 or 0347 in writing and Math 0306 in math VNSG1330 & VNSG 1332
HOUSTON COMMUNITY COLLEGE Coleman College for Health Sciences Vocational Nursing Program VNSG 1238 Mental Illness CRN- 83757 Willie Lee Gay Hall Campus-Room 103 4:00-6:00 pm MONDAY Lecture/ discussion/web-enhanced/presentations/powerpoint
More informationWestCoast Postdoctoral Residency Program
WestCoast Postdoctoral Residency Program Training Year 2014-2015 Postdoctoral Residency Program WestCoast Children s Clinic What s inside Committed to training the next generation of Child & Adolescent
More informationINTERNSHIPS in Clinical Social Work, Clinical Counseling, and Expressive Therapy
ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL INTERNSHIPS in Clinical Social Work, Clinical Counseling, and Expressive Therapy At Alexian Brothers Behavioral Health Hospital (ABBHH), we offer numerous training
More informationFALL Professional Medical Interpreter Training. An intensive 40-hour training program that prepares participants for national certification.
Professional Medical Interpreter Training FALL 2015 An intensive 40-hour training program that prepares participants for national certification. Community Health Education Center Lowell Community Health
More informationREGISTRATION FORM. Workshop Highlights CONTINUING EDUCATION WORKSHOPS - FALL/WINTER
12 SEPTEMBER Coordinating Patient Care in the Age of Reform 9/17-10:00 am - 1:00 pm *Part 1 of a four-part Educational Series: CARE COORDINATION ACROSS THE CONTINUUM: YOUR CHANCE TO BE THE CHANGE * Accessing
More information2018 STA NATIONAL CONFERENCE REQUEST FOR PROPOSALS. Transformation in Sandplay through Image, Story, and Ceremony
Sandplay Therapists of America Affiliated with the International Society for Sandplay Therapy (ISST) 2018 STA NATIONAL CONFERENCE REQUEST FOR PROPOSALS Transformation in Sandplay through Image, Story,
More informationAPPLICATION FORMS. for CCS
Michigan Certification Board for Addiction Professionals APPLICATION FORMS for Certified Clinical Supervisor (IC&RC reciprocal) CCS 2008 MCBAP All Rights Reserved Directions for Submitting Application
More informationNew York Certified Peer Specialist NYCPS Application Please clearly write or type all application forms
Do not write above line New York Certified Peer Specialist Please clearly write or type all application forms Full Name: Email: Date of Application: Date of Birth: Phone Number: Home Address: City, State
More informationCREDENTIAL APPLICATION FOR MASTER ADDICTION COUNSELOR
CREDENTIAL APPLICATION FOR MASTER ADDICTION COUNSELOR. I. Personal Data: If any documentation required for the MAC credential application was issued under a previous name, you must submit a copy of the
More informationREQUIREMENTS TO QUALIFY AS A QUALIFIED MENTAL HEALTH PROFESSIONAL-CHILD (QMHP-C)
REQUIREMENTS TO QUALIFY AS A QUALIFIED MENTAL HEALTH PROFESSIONAL-CHILD (QMHP-C) Qualified Mental Health Professional-Child or QMHP-C means a registered QMHP who is trained and experienced in providing
More informationJodi Bremer-Landau, PhD Licensed Psychologist
WELCOME TO MY PRACTICE Welcome! I recognize that it takes a lot of courage to seek services and I truly appreciate your interest in working together. I look forward to making progress with you as we journey
More informationCHILD CLIENT INTAKE FORM
Please fill out this form before your first session. The information will help me assist you more effectively and efficiently. Parent/Guardian Full Name Address State Zip Email Phone: Home Cell Work Preferred
More informationClinical Internship Accreditation Application. Internship Accreditation Oversight Committee
Clinical Internship Accreditation Application Internship Accreditation Oversight Committee Approved by the (formerly Child Life Council) Board of Directors May 2014 Clinical Internship Accreditation Application
More informationSummer Recreation/Adult Education Program
H E W L E T T W O O D M E R E PUBLIC SCHOOLS HEWLETT-WOODMERE PUBLIC SCHOOLS Summer 2 0 1 7 Recreation/Adult Education Program Registration begins Monday, June 12th Evening Registration: Mondays, June
More informationUmeka Franklin, MSW, PPSC, LCSW
Umeka Franklin, MSW, PPSC, LCSW Education University of Southern California Doctorate of Education Candidate In progress University of Southern California May 2002 Masters of Social Work Active Pupil Personnel
More informationAPPLICATION FORMS. for CADC
Michigan Certification Board for Addiction Professionals APPLICATION FORMS for Certified Alcohol and Drug Counselor (IC&RC reciprocal) CADC Directions for Submitting Application Completion of this packet
More informationEmergency Contact: Name Relationship Address
Participant Information Name Treatment Start Date Address City State Zip Home/Cell Phone Work Phone Birth date Age SSN Marital Status Primary Insurance Provider Insurance ID # Primary Insured Name: Primary
More informationTHE ALLENDALE ASSOCIATION. Post-doctoral Residency in Clinical Psychology Information Packet
THE ALLENDALE ASSOCIATION Post-doctoral Residency in Clinical Psychology Information Packet 2017-2018 INTRODUCTION TO ALLENDALE The Allendale Association is a private, not-for-profit organization located
More informationInstructions and Application
Association of Traumatic Stress Specialists Providing international recognition and certification for training, education and experience in traumatic stress services, response and treatment Instructions
More informationDanny Pettry s Independent Education Program
Danny Pettry s Independent Education Program Page 1 of 5 Danny Pettry s Independent Education Program Email: Danny@DannyPettry.Com This course was created: March 2015 Thank You... for choosing Danny Pettry
More informationCourse Descriptions COUN 501 COUN 502 Formerly: COUN 520 COUN 503 Formerly: COUN 585 COUN 504 Formerly: COUN 615 COUN 505 Formerly: COUN 660
Course Descriptions COUN 501: Counselor Professional Identity, Function and Ethics (3 hrs) This course introduces students to concepts regarding the professional functioning of counselors, including history,
More informationCOUNSELING PROGRAMS SITE SUPERVISOR MANUAL
COUNSELING PROGRAMS SITE SUPERVISOR MANUAL Table of Contents General Information... 1 Programs... 1 Accreditation of Specialty Programs... 2 Clinical Mental Health Counseling Specialty... 2 Rehabilitation
More informationMayo Clinic Hospice. Your guide Your hospice
Mayo Clinic Hospice Your guide Your hospice What opened the door for me to invite hospice in was when somebody told me that hospice was for helping people live life to the fullest. Father of a Mayo Clinic
More informationTRINITY HEALTH THE VALUE OF SPIRITUAL CARE
TRINITY HEALTH THE VALUE OF SPIRITUAL CARE 2015 Trinity Health, Livonia, MI 20555 Victor Parkway Livonia, Michigan 48152?k The Good Samaritan MISSION We, Trinity Health, serve together in the spirit of
More informationIf you are credentialed and a contract is required for your network participation; the contract will be
We would like to thank you for your interest in enrolling as a Licensed Independent Practitioner ( LIP ) in the Cardinal Innovations Healthcare ( Cardinal Innovations ) provider network. Enrollment requires
More informationInstructions and Application
Association of Traumatic Stress Specialists Providing international recognition and certification for training, education and experience in traumatic stress services, response and treatment Instructions
More informationComparison of the current and final revisions to the Home Health Conditions of Participation
Comparison of the current and final revisions to the Home Health Conditions of Participation Significant changes are designated by ** underlined, and bolded. Where the condition or standard is ** and underlined,
More informationREQUIREMENTS TO QUALIFY AS A QUALIFIED MENTAL HEALTH PROFESSIONAL-ADULT (QMHP-A)
REQUIREMENTS TO QUALIFY AS A QUALIFIED MENTAL HEALTH PROFESSIONAL-ADULT (QMHP-A) Qualified Mental Health Professional-Adult or QMHP-A means a registered QMHP who is trained and experienced in providing
More informationITT Technical Institute. NU2740 Mental Health Nursing SYLLABUS
ITT Technical Institute NU2740 Mental Health Nursing SYLLABUS Credit hours: 5 Contact/Instructional hours: 90 (30 Theory Hours, 60 Clinical Hours) Prerequisite(s) and/or Corequisite(s): Prerequisite or
More informationWillows Counselling Service
Lead Trainer: Briony Martin Other Trainers: Helen Slator Dr Stephen Brooke Tanya Orr The above are experienced Counsellors, Supervisors and Trainers, who meet the training requirements of both ACC and
More informationPlease inform any interested, eligible applicants about our scholarships. Regulations that govern this award are also included.
CAREER DEVELOPMENT SCHOLARSHIP To: Guidance Office From: Scholarship Committee Patricia Leary, Chair Donald O. Sandridge, Co-Chair Date: December 2015 Subject: Official Application Form and Information
More informationPerson to Contact in Case of Emergency. THE COUNSELING PLACE YOUTH INTAKE FORM Yearly Family Income:
Person to Contact in Case of Emergency Name Relationship Best Contact Number Alt. Number Office Use Only Intake Date Reason for referral Counselor Who Can Pick Up Client (if Minor) THE COUNSELING PLACE
More informationBefore we begin our sessions together, please complete the enclosed forms:
Welcome! I am honored that you would consider allowing me to walk with you on your journey. You re taking a courageous step. You deserve to be heard, healthy, and whole. Before we begin our sessions together,
More informationPsychology Externship Information
November 20, 2017 Psychology Externship 2018-2019 Information Contact information for externship: o Address: 720 N St. Asaph St. Alexandria, VA 20314 o Psychology Externship director: Kirimi Fuller, Psy.D.;
More informationTrauma-Focused Cognitive Behavioral Therapy for Traumatized Children and Their Families
Allegheny Health Network Trauma-Focused Cognitive Behavioral Therapy for Traumatized Children and Their Families Thursday and Friday, March 15 & 16, 2018 George J. Magovern, MD Conference Center Pittsburgh,
More informationWest Virginia Board of Examiners in Counseling
West Virginia Board of Examiners in Counseling 815 Quarrier Street, Suite 212 (800) 520-3852 rclay27@msn.com www.wvbec.org November 15, 2010 Dear Licensed Professional Counselor; Thank you for applying
More information2018 SCHOLARSHIP APPLICATION MERCY HEALTH FOUNDATION LORAIN COUNTY Applications accepted from Monday, February 26 th through Friday, March23 th
2018 SCHOLARSHIP APPLICATION Applications accepted from Monday, February 26 th through Friday, March23 th Instructions: Type or fill out the application in ink (PRINT CLEARLY). Do not write in pencil.
More informationChapter 1 Section 5.1. Requirements For Documentation Of Treatment In Medical Records
Administration Chapter 1 Section 5.1 Requirements For Documentation Of Treatment In Medical Records Issue Date: June 1, 1999 Authority: 32 CFR 199.2; 32 CFR 199.6(b); 32 CFR 199.7(b), and (b)(1) 1.0 ISSUE
More informationDavis Technical College (Davis Tech) PRACTICAL NURSE PROGRAM An ACEN accredited program APPLICATION FOR ADMISSION
Davis Technical College (Davis Tech) PRACTICAL NURSE PROGRAM An ACEN accredited program APPLICATION FOR ADMISSION This application is valid from: September 5, 208 to October 7, 208 Program starts: February
More informationSummer Camp Parent Handbook
Summer Camp Parent Handbook Page 2 Mount Dora Recreation Services Page 15 Welcome to Mount Dora Community Recreation Services. This parent handbook is designed to familiarize parents/guardians with our
More informationNASW CONTINUING EDUCATION PROVIDER APPROVAL
NATIONAL ASSOCIATION OF SOCIAL WORKERS WASHINGTON STATE CHAPTER NASW CONTINUING EDUCATION PROVIDER APPROVAL The NASW Washington State Chapter offers an approval program for continuing education providers
More information200 Hr Hatha Yoga Teacher Training Application & Registration
200 Hr Hatha Yoga Teacher Training Application & Registration SUBMITTING APPLICATION: Please save this application to your computer. Once complete, send as an e-mail attachment to info@wellness-within.ca
More informationCharity Vasquez, MS. CCLS Professional Summary Child Life: Academic Institution: General:
Professional Summary Charity Vasquez, MS. CCLS 714-869-4530 (c) cvasquez@apu.edu Assistant Professor Program Director of M.S. in Child Life Department of Psychology Azusa Pacific University 901 E. Alosta
More informationSoul Injury & Soul Recovery:
Cincinnati Children s Hospital Medical Center Center for Professional Excellence, Education 3333 Burnet Avenue, MLC 3020 Cincinnati, Ohio 45229-3039 9 th Annual Tri-State Conference on Grief and Loss Soul
More informationRyan White Part A Quality Management
Quality Management Mental Health Services Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) The creation of this public document is fully funded by a federal Ryan White CARE Act Part A grant
More informationApplication for Admission
Application for Admission Nonprofit Finance Certificate, Spring 2018 Applicants must have a bachelor s degree from an accredited university or college. Rice University, Susanne M. Glasscock School of Continuing
More informationCertification Renewal Policies and Procedures
Certification Renewal Policies and Procedures Updated September 2018 pg. 1 The policies, procedures, and deadlines described in these instructions are subject to change. Please be sure to verify that you
More informationSafe Harbor Christian Counseling Client Intake Packet:
Welcome to Safe Harbor Christian Counseling (SHCC). We hope your counseling experience with us will be positive and that our assistance will be beneficial to your mental health. Please read all documents
More informationLinda F. Little, Ph.D. Clinical Psychologist
Page1 Phone: 360-385-7459 Linda F. Little, Ph.D. Clinical Psychologist Email: LindaFLittlePhD@gmail.com License: PY60468249 Welcome! You have made an important decision to deal with a challenge or change
More informationSCHOOL HEALTH SEMINARS
2018 PROFESSIONAL SCHOOL HEALTH SEMINARS for E Every student needs and deserves a safe, challenging, and supportive learning environment especially students who have medical or learning needs, cultural
More informationMARATHON PHYSICAL THERAPY & SPORTS MEDICINE. Canton Dedham Easton Newton Norton Norwood Pembroke
Pelvic Floor Physical Therapy Questionnaire Patient Name Answering the following questions will help us to manage your care better. Do you now have or have you had a history of the following? Y/N Bladder
More information