CFT Therapist & Supervisor Directory Survey

Compassionate Mind Australia is developing a directory of therapists and supervisors who are trained in Compassion Focused Therapy (CFT) and provide services in Australia. If you are interested in being part of the directory, please provide information below. Please note that information from questions below may be provided to third parties for the explicit purpose of supporting service access and provision, so please consider this comparable to professional publicly available information. Further details, when available, can be found at https://www.compassionatemind.org.au/therapist-directory .

1.Full name:

2.Please provide an overview of yourself and CFT therapy services provided:

3.Contact details

Preferred name:

Email address:

Website URL:

Practice Address/location:

4.Therapist Information

Languages spoken

Highest degree/qualification

Professional registration / licensing details

6.Please list your CFT training (e.g. trainings/courses/workshops attended), with whom you did your training (e.g. Paul Gilbert). You can also list other compassion-based training.

For each workshop, please include (Title, Year, No of days, Presenter)

1. (Title, Yr, No of days, Presenter)

2....

7.CFT practice and Supervision

Number of years practice using CFT?

Who have you had supervision with?

Frequency of supervision?

8.Do you want to be considered for the Supervisor list?

(Minimum criteria: advanced training and practice, personal practice, and supervision in CFT + profession specific training in supervision)

Yes

No (please go to the end of the survey)

If yes, please complete the following questions

9.Please provide an overview of your own CFT (and/or compassion based) personal practice

10.Are you an accredited supervisor with your professional body (if applicable)

Yes (please provide details of supervisor training, year completed)

By submitting this form, I confirm that I understand that this information is provided for a directory of CFT-interested individuals, and that Compassionate Mind Australia (CMA) is not endorsing or recommending anyone on this directory for clinical services or supervision. I also understand that I may be contacted by Compassionate Mind Australia (CMA) requesting further details or clarification of the information I have submitted. All data collected through this form is used solely for the express purposes outlined and only provided from CMA to third parties upon request for information relating to the provision of CFT services. If at any time you would like to have your information removed or you have any questions, please email info@compassionatemind.org.au