April 9-June 11, 2024: Survivor-Centered Approaches to Treating Complex Trauma: A Course for Mental Healthcare Providers

Thank you for your interest in Survivor-Centered Approaches to Treating Complex Trauma: A course for Mental Healthcare Providers. This is a 10-week online course that will meet once per week on Tuesday afternoons from 12:00pm-1:30pm EST. Completing this application is the first step in the approval process. We are accepting applications on a rolling basis. Any questions should be directed to the Training Department at mlmctraining@jri.org.

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* 1. Personal Information

Name *

Job title

Work email *

Phone number *

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* 2. Company Information

Company name

Company address

City/Town

State/Province

ZIP/Postal Code

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* 3. Type of company (e.g. private practice, hospital, congregate care, etc.)

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* 4. The age and gender identity of my clients are (Select all that apply):

Cisgender Female

Cisgender Male

Transgender Female

Transgender Male

Nonbinary, genderfluid, or genderqueer

Questioning

Under 10 years

11-14 years

15-17 years

18-24 years

25+ years

Other (please specify)

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* 5. Please check all that apply to your experience and provide details below.

Masters' Level Clinician

Survivor of commercial sexual exploitation**

At least 5 years of clinically related experience, specifically working with victims of trauma

Experience working with survivors of commercial sexual exploitation or human trafficking

Experience working with at risk youth

Please provide any additional details that you feel makes you an appropriate candidate to participate in this training:

The training Understanding and Responding to Victims of Commercial Sexual Exploitation (CSEC 101) or an equivalent training is a prerequisite to attend this course.

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* 6. Have you participated in a full day CSEC 101 training?

Yes

If yes, please provide the date you attended the training.

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* 7. If you answered "no" to the previous question, have you had any other type of prior training on the commercial sexual exploitation of children (CSEC) in the past two years?

Yes (see below).

I am registered to attend an upcoming CSEC training (see below).

If yes or attending an upcoming training, please note the title, date, name of the host agency, and format of training (webinar, full day, half day, etc.).

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* 8. Please mark any specialized training you may already have in any of the following clinical modalities.

EMDR

TF CBT

Motivational Interviewing

Other (please specify)

None of the above

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* 9. How did you hear about the Survivor-Centered Approaches to Treating Complex Trauma: A Course for Mental Healthcare Providers?

Through a colleague

Social Media

My Life My Choice's website

At another My Life My Choice training

Training email

My Life My Choice email blast

Other / Please specify your contact's name and organization if applicable:

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* 10. Are you interested in Social Work CEU's?

Yes

No/does not apply to me.

If yes, please enter license number

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* 11. The live sessions will be recorded for the use of participants and ongoing quality improvement for instructors. Do you consent to being recorded for these reasons?

Yes

April 9-June 11, 2024: Survivor-Centered Approaches to Treating Complex Trauma: A Course for Mental Healthcare Providers

Question Title

* 1. Personal Information

Question Title

* 2. Company Information

Question Title

* 3. Type of company (e.g. private practice, hospital, congregate care, etc.)

Question Title

* 4. The age and gender identity of my clients are (Select all that apply):

Question Title

* 5. Please check all that apply to your experience and provide details below.

Question Title

* 6. Have you participated in a full day CSEC 101 training?

Question Title

* 7. If you answered "no" to the previous question, have you had any other type of prior training on the commercial sexual exploitation of children (CSEC) in the past two years?

Question Title

* 8. Please mark any specialized training you may already have in any of the following clinical modalities.

Question Title

* 9. How did you hear about the Survivor-Centered Approaches to Treating Complex Trauma: A Course for Mental Healthcare Providers?

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* 10. Are you interested in Social Work CEU's?

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* 11. The live sessions will be recorded for the use of participants and ongoing quality improvement for instructors. Do you consent to being recorded for these reasons?

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* 12. Do you have any other questions?