Application: for Experiental or Combined Delivery

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Application: for Experiental or Combined Deliverykatharineknapp2022-06-02T15:36:42+00:00

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Workshop Application

Which experience are you interested in?

SEP Personalized Experiential Delivery of SSP

SEP Virtual Group Experiential Delivery of SSP: 12 session package

SEP/SSP Virtual Group Case Consulting for Combined Delivery

SE/SSP Individual Case Consulting for Combined Delivery

How did you hear about this workshop?*

Why are you interested in this group?*

A prerequisite of this cohort is that you are a somatic experiencing provider or student. How many years have you been practicing SE?*

In what role do you work?*

Therapist

Somatic Provider

Bodyworker

Healthcare Provider

Other

Other:*

If trained as mindfulness or somatic provider what type? What are your certifications? If Somatic Experiencing trained, what faculty have you trained with?*

Are you trained beyond the foundational 3 year SE training? If so, list your additional SE training.*

Are you trained in SSP (year when completed training)?*

Contraindications for this experience: please check off any of the following that apply to you:*

I do not experience any of the following descriptions.

active suicidal ideation

active bipolar disorder

lack of emotional support

dangerous living environment

active addiction or eating disorder

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