Individual Supervision Form

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Greetings from Room, The Mindcare Space!

Join our Supervision Program to learn and get individual supervision in insight-oriented approaches to therapy. Thank you for expressing your interest! Please fill in your details to register with us.

Details:

Frequency: Weekly 2 hours.

Fees: Rs. 1180 / session (Inclusive of GST).

Full Name *

Contact details *

WhatsApp number and email

Age *

Sex and Pronouns *

Name of last graduating college *

Name of current organisation / Practice *

Qualifications *

Preferred Psychological School of Approach *

Eclectic is of course the norm, but preferences/comfortable approaches are expected

Existential Psychotherapy

Humanistic Psychotherapy

Psychodynamic Psychotherapy

Other:

Required

Are you taking therapy for yourself? *

Yes

Are you familiar with basics of Humanistic Therapy models? *

Yes

Other:

Are you familiar with basics of Existential Therapy models?
*

Yes

Other:

Are you familiar with basics of Psychodynamic Therapy models?
*

Yes

Other:

Experience with Number of clients *

Have you taken supervision before *

Yes

If yes, with whom and reason for change?

Preferred mode of Supervision *

Online

In person (For ahmedabad residents)

Frequency of Supervision expected *

Supervision will be one hour per session

Weekly

Biweekly (Twice a week)

Frequent or common challenges faced in the sessions with every client *

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