Course Description:
Many of us feel anxious when discussing social issues such as racism, gender, sexuality, and many others. In this training, you will learn what implicit bias is and how it operates in our therapeutic relationships. You will develop your capacity to gain conscious awareness of your perception and judgment to make more intentional and equitable decisions. You will gain courage to more effectively communicate with your clients about difficult topics and feel more confident to serve diverse populations. Join us to reduce your anxiety about discussing social change, elevate your existing clinical abilities, and gain practical steps you can take to promote social justice within your work and everyday life.

Date:
Friday, March 13th from 9am-12pm EST over Zoom

Led by:
Reid Depowski-Knowles, LMSW and Taibriana Wilkins, LMSW

This course through Mindful ISTDP is approved by the NASW-Michigan Social Work Continuing Education Collaborative.

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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. Attending our free Introduction to Intensive Short-Term Dynamic Psychotherapy (ISTDP) is strongly recommended before joining this course.

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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.

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* 6. Today's Date:

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* 7. Payment:

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