GROUP Counseling Referrals

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As part of the social, emotional, and behavioral supports provided to our students, we are working on organizing small group intervention that is focused on specific areas of need. After we have identified group topics and potential participants, we will develop groups focusing on students with similar needs, who will work well together. Groups will meet during regular SOAR time if they are not being pulled for content intervention.

Date of Referral *

YYYY

Name of person making GROUP referral: *

Suggested Topics *

If there are other topics that you think would benefit students, please feel free to suggest.

Healthy Relationships

Boundaries

Friendships

Bullying

Social Skills

Anxiety

Negative Thinking

Self-esteem

Organization

Academic Motivation

Divorce

Grief

Other:

Required

Suggested Student(s) Last, First Name *

Please list students you think would benefit from the group suggested.

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