Registration for Foundational Training Bundle

The Foundational Training Bundle includes the following courses:

1. Introduction to ISTDP (pre-requisite to other courses)
2. Foundational Therapist Training
3. Building Capacity in the Traumatized Client
4. Suicide Crisis Intervention: Treating the Cause of Suicidal Ideation
5. Caring for the Person of the Therapist in Session: Using Your Self Experience to Create Better Outcomes

Cost and Continuing Education:
You will enjoy 25% off the total of these courses (originally $510) by registering for our bundle, totaling $382. These courses, approved by the NASW Michigan Chapter, provide 15.5 CEUs.

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* 1. Contact Information

Name and Credentials

License Number

Email Address

Phone Number

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* 2. Select your dates for your training here. There may be multiple dates listed for each training - please only pick your one preferred date per training.

Foundational Therapist Training: 8/1/2025 from 12:30-4:30pm EST

Suicide Crisis Intervention: 9/10/2025 from 9am-12pm EST

Caring for the Person of the Therapist in Session: Using Your Self Experience to Create Better Outcomes: A 3-part series on 9/15/2025, 9/29/2025, 10/13/2025 from 8:30am-10am EST

Foundational Therapist Training: 11/21/25 from 12:30-4:30pm EST

Suicide Crisis Intervention: 12/12/25 from 9am-12pm EST

Building Capacity in the Traumatized Client: 1/23/2026 from 9am-12pm EST

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* 3. How did you hear about our trainings?

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* 4. Please share accommodations you need for our trainings here:

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* 5. Before beginning our more intensive trainings, we have each participant attend a 1-hour Introduction to Intensive Short-Term Dynamic Psychotherapy. We offer these regularly over Zoom.

I've already attended an introduction

I need to attend an introduction - send me options!

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* 6. Waiver of Liability

I, as a participant in this program, hereby assume all of the risks of participating in this event. I have agreed to execute this Waiver and Release of Liability Form for myself and acknowledge, agree to, and represent the following:

I understand that I am attending this event hosted by Mindful ISTDP, LLC in order to obtain knowledge, strategies, and techniques to address mental health.

I hereby release, waive, acquit and forever discharge Leslie Auld and Mindful ISTDP, LLC, as well as any employees, volunteers, instructors, representatives, agents, the event holders, event sponsors, and event volunteers (“Releasees”) from every claim, suit action, demand, or right to compensation for damages claimed or that I may have arising out of my own acts or omissions as a result of any advice given or otherwise resulting from my participation in this event. I further declare and represent that no promise, inducement, or agreement has been made other than what is expressed within this agreement.

I further waive and release Releasees from any liability incurred based on or resulting from the implementation of any information obtained at this event.

I indemnify and hold harmless Leslie Auld and Mindful ISTDP, LLC, as well as any other entities or persons mentioned above, from any and all liabilities, claims, demands, or actions made as a result of participation in this event, whether caused by the negligence of release or otherwise. I further indemnify and agree to hold harmless the aforementioned entities from any and all third party claims associated with my participation.

I understand that at this activity or event, I may be photographed. I agree, irrevocably and without restriction, to allow my photo, video, or film likeness to be used for advertising and/or any other purpose by Mindful ISTDP, LLC, as well as the event holders, producers, sponsors, and organizers. I also grant the aforementioned entities or persons the right to alter and copyright the same without restriction.

I recognize that this Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I certify that I have read this document and I fully understand its content. I am aware that this is a release of liability and a contract, and I sign it freely, voluntarily, and competently.

Please sign below:

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* 7. Today's Date:

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* 8. Payment:

Registration for one fully licensed professional - $382 USD

Registration for one graduate student - $191 USD

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