December 16, 2023, 9:00 am -5:00 pm: Phoenix Center Personal Growth Workshop

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This all-day workshop will offer a transformative experience for participants in their recovery process of healing and growing from trauma. Using experiential methods from psychodrama and group work, we will explore our strengths, relationships, beliefs, and goals for healing.

If you are interested in participating in our upcoming personal growth workshops, please complete the following questionnaire in its entirety.

Please note that completing this questionnaire does not guarantee your spot in our workshops. Therapist will assess each candidate for appropriateness. We will reach out to you within a week of request to schedule a conversation.

Payment for personal growth workshops:

Our services are paid out-of-pocket by clients. We have limited low-cost spots based on special financial needs. Please let us know if you have any financial concerns. We cannot guarantee low-cost spots for every participant. This will be discussed on a case by case basis and with limited availability.

Email *

Full Name *

What name do you go by?

What personal pronouns do you use?

Date of Birth *

Phone number *

Have you participated in a personal growth workshop at the Phoenix Center in the past? *

All interested participants are expected to have a therapist and be willing to sign a Release of Information in order for our therapist to connect with your therapist to assess for appropriateness and continuity of care. Do you have a therapist and are you willing to sign a release? *

Yes

Therapist Name and Contact Information *

What are your goals for attending a personal growth workshop at our center? *

Please share about any past experience with psychodrama or experiential therapies *

Please share about your history of therapy or other treatment services. How long have you been working with a therapist, when did you begin to seek therapy, for what reasons, etc. *

If you have ever been hospitalized for mental health, alcohol/substance use, or disordered eating please provide us with some basic info about your experience.
*

Please share about any history with substance or alcohol use *

Are you currently, or have you ever, experienced suicidal or homicidal thoughts?
*

Have you received any mental health diagnoses from a medical or mental health professional? Please provide details - which diagnosis? when?

Please name all the people, places or things that you consider support systems in your life today *

Please list some coping skills that support you during moments of stress or overwhelming feelings. How do these coping skills work for you? *

Do you have any medical diagnoses or conditions that we should be aware of which may impact your participation in movement and action-based exercises? *

Do you have any accommodations requests? (mobility, hearing, vision, etc.)
*

Please share about dietary needs/limitations so that we can provide you with lunch
*

Do you have any financial concerns that could limit your participation in a personal growth workshop if selected as a participant? *

Is there anything else that you'd like us to know about you?

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