Course Description:
This training will teach you what healthy emotional functioning is, which provides a framework for approaching treatment goals no matter your therapeutic approach. You will learn how to complete effective intakes and early sessions with a new client. You will gain tools for creating a clear therapeutic task throughout your work and how to maintain an internal focus, which gives you and your client a roadmap for co-creating change together.

Date:
Friday, February 13th from 12pm-4pm EST over Zoom

Led by:
Reid Depowski-Knowles, LMSW

Cost and Continuing Education:
$150. This course through Mindful ISTDP is approved by the NASW-Michigan Social Work Continuing Education Collaborative and provides 4 CE credits.

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* 1. Contact Information

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* 2. How did you hear about this training?

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* 3. Please share accommodations you need for this training here:

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* 4. It is recommended that each participant attends a 1-hour Introduction to Intensive Short-Term Dynamic Psychotherapy prior to this training. We offer these for free over Zoom, and they offer 1 CE credit.

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* 5. 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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* 6. Today's Date:

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* 7. Payment:

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