FAMILY Partnership Training Institute Application

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* 1. In what setting(s) do you engage and partner with families of loved ones with mental health and/or substance use challenges?

In an out-patient clinical setting, such as a therapist's office, hospital, etc.

In an in-patient clinical setting, such as a residential treatment facility, psychiatric ward, etc.

As a part of a wrapround team

At a community-based organization

At a family-run organization

Other (please specify)

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* 2. In what professional capacity do you interact with families?

Mental Health Provider (includes therapists, social workers, counselors, etc.)

Substance Use Support Provider

Wraparound Facilitator

Family Peer Specialist

Other (please specify)

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* 3. How do you interact with families as a part of your profession?

I partner with family members as a part of the treatment team of the individuals I directly support.

I offer training and resources about behavioral health to family members of the individuals I directly support.

I directly support family members as they navigate the behavioral health system with their loved ones, including accompanying them to meetings to support advocacy efforts.

I offer family-based services such as family therapy.

Other (please specify)

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* 4. Give some specific examples of how you have partnered with families in the past year. (300 word limit)

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* 5. Why are you interested in learning more about partnering with families? (300 word limit)

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* 6. At the end of the FAMILY Partnership Training Institute, I expect to be able to... (100 word limit)

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* 7. Please confirm that you understand that the time commitment for the FAMILY Partnership Training Institute includes ~1 hour reviewing an online course lesson, a 90-minute meeting on Zoom with other participants, and ~1 hour of reflection activities/readings (homework) per month?

Yes, I can commit to this level of work.

No, I cannot commit to this level of work.

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* 8. Contact Information

Name *

Company *

Address *

Address 2

City *

State *

ZIP *

E-mail Address *

Phone Number *