Introduction

Thank you for applying to the Ohio Gambling Treatment Fellowship Program (The Fellowship). The goals of the program are to prepare clinicians in providing gambling treatment services, aiding private practitioners and community agencies in improving gambling treatment services, professional development and strengthening Ohio’s workforce. This includes skills such as the ability to provide clinical treatment in person, telephonically and virtually, to serve as a trainer on topics related to gambling treatment and to serve as a general resource regionally and at the state level on gambling treatment.
 
The Fellowship is comprised of training, clinical consultation, case conceptualization and professional development. The program concludes with Fellows providing an oral case presentation. 
 
Please submit the application in full by Monday, September 5, 2022. Applications submitted after Monday, September 5, 2022 may not be considered.

For any questions regarding this application or The Fellowship program, please contact Fellowship@PGNOhio.org.

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* 1. Application Information & Contact Information

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* 2. Licensure Status

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* 3. Resume

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* 4. 100 Word Professional Bio
(essay format)

Gambling Scope of Practice

To participate in the Fellowship Program, candidates must demonstrate their capacity to obtain Gambling Disorder competency in gambling treatment. In Ohio, Gambling Disorder competency can be obtained in chemical dependency by holding the gambling endorsement (GAMB) through the Ohio Chemical Dependency Professionals (OCDP) Board or for social workers and counselors by adding Gambling Disorder Competency to their Scope of Practice through the Counselor, Social Workers and Marriage and Family Therapist (CSWMFT) Board. The requirements for both are below:

          • Education – 30 hours of gambling-specific education
          • Contact Hours – 100 contacts hours obtained through screening/assessments and treatment
          • Supervision – 4 hours of supervision

Completion of this section provides verification the applicant has the ability (in his/her current role) to obtain gambling-specific contact hours. Examples of how to obtain contact hours include but are not limited to implementing problem gambling screens individually or in group settings, discussing gambling treatment in group settings, implementing gambling assessments and providing direct gambling treatment.

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* 5. References

Two professional references are required

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* 6. Essay
 
In no more than 500 words, please describe how you will utilize the skills and knowledge gained through this program to advance the gambling treatment field in Ohio. Please attach the essay as a separate document.

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Program Calendar of Important Dates

<strong>Program Calendar of Important Dates</strong>

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* 7. Confirmation of Program Dates

I have received all program related dates, and am able to attend/perform all necessary events/requirements.

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* 8. Have you ever had a professional license/certificate reprimanded, suspended, revoked, surrendered or in any other way sanctioned? (If yes, please attach a written explanation in the next section)

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* 9. If you selected YES to ever having your professional license/certificate reprimanded, suspended, revoked, surrendered or in any other way sanctioned, please attach a written explanation.

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* 10. Do you currently live or work at least 51% of the time in Ohio?

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