Choose Therapy Placement Application Form
Welcome to the Choose Therapy placement application form. Please read the information and terms below before completing this application. After this application has been considered, you may be asked to attend an interview with us via Zoom. Please allow at least 4 weeks for us to get back to you with the initial outcome of your application.

Terms Of Application:

If your application is successful, you will be required to make a commitment to be available for at least four hours per week (there is an option to commit to more hours) to see clients as part of your counselling placement, for a minimum of one year.  

You are required to have monthly one-to-one supervision in line with BACP / UKCP / NCS / CORST requirements. Choose Therapy will provide free fortnightly organisational supervision, but you may also need to have private supervision in place in order to meet requirements. Attendance at organisational supervision is compulsory and a condition of your placement (other than pre-approved holidays).

Counsellors are required to be in personal therapy throughout their placement. We will require written confirmation of this from your qualified therapist.

Long breaks and sudden endings are to be avoided. In order to ensure your endings with clients are ethical and well managed, Choose Therapy requires a minimum notice period of 12 weeks if you wish to end your placement while you have active clients. You are able to take up to 4 holiday sessions per year (one session = up to 1 week of client bookings), but this must be agreed with your supervisor and the Choose Therapy admin team at least 4 weeks in advance (No more than 2 holiday sessions to be taken consecutively).

Completing an application below equivocates to agreement of these terms and a commitment to practice safely and ethically while on placement with Choose Therapy. If you do not feel able to meet these terms, please do not apply to Choose Therapy.  

All data collected on this application form will be processed according to the General Data Protection Regulation and the Data Protection Act 2018. Your personal information will be used solely for the purposes of this application and will be stored securely on our database.
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Email *
Personal Details
Please provide the personal details listed below.
Name *
First and last name
Email *
Telephone Number *
Pronoun
Phone number *
Date of Birth *
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YYYY
Address *
Will you be based in the UK for at least the next year? *
Current or Completed Counselling Training
Please provide the details of your current training counselling training course or the highest level of counselling qualification you have obtained if you have already completed training.
Name of Training Organisation *
Address of Training Organisation *
Course Title *
Start Date of Course *
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DD
/
YYYY
End Date of Course *
MM
/
DD
/
YYYY
Current Year of Study *
Course Modality (e.g. Psychodynamic, Integrative, CBT) *
Qualification Name *
Educational History
Academic/Educational History (Please detail all education and any relevant training you have completed or are undertaking with the most recent first) *
Placement / Counselling Experience History
How many hours of client experience have you completed? *
Previous Placement Details (please provide for each placement the name of the agency and number of hours completed at that agency - please enter N/A if not applicable) *
Employment History
Employment History (please provide name of employer, job title and length of employment for employments completed in the last 5 years) *
Personal Counselling, Psychotherapy and Supervision, Ethical Codes and Fitness to Practice
How many hours of personal therapy have you completed? *
How many hours of clinical supervision have you completed?
Are you a member of BACP, UKCP or any other professional body (please specify)?If not, under which Code of Ethics do you practice *
Please provide your professional body membership number: *
Do you have your own counselling insurance in place? *
Have you been convicted of a criminal offence? If yes, please state when and for what *
Do you have an DBS check? (We may require a new DBS when you join Choose Therapy) *
Can you provide counselling in any additional languages other than English
How would you assess your IT proficiency *
Weekly Availability
Here we are looking to identify your overall availability to complete client sessions and supervision. All counsellors must be able to complete at least 3 hours of client work per week, as well as a 2 hour supervision session every 2 weeks. Please select ALL times when you COULD be available for either client work or supervision.
Please select all slots you could be available for either client work or supervision: *
7am-9am
9am - 1pm
1pm - 5pm
5pm - 9pm
None
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Personal Statement (Please provide a brief personal statement, we suggest 500 words maximum, although less is also fine. You should try to demonstrate your skills and experience, both clinically and administratively and your motivations for working as a placement counsellor at Choose Therapy, as well as anything else you feel would be useful in assessing your application) *
Equality and Diversity
How would you describe your ethnic origin?  (Please use your own words or write "prefer not to say") *
Gender (Please use your own words or write "prefer not to say") *
Declaration
By submitting this application you agree to your information being held on our systems.

By completing the section below, I declare the information given in this application is accurate and true.
This is a digital signature - by typing your name here and submitting this form you are agreeing to the terms and conditions above *
A copy of your responses will be emailed to the address you provided.
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