DBT Group Interest
Hello, please complete this form if you are interested in joining the DBT group. Answering these questions will give me more information about what you're looking for and whether this group fits your needs. 

In addition to the standard DBT materials, this group will provide more information from a trauma informed and neurodivergent informed perspective in terms of how to think about and adapt the skills. This group will also give space to discuss the impacts of systemic oppression on our mental health and explore ways to utilize the skill to support ourselves in moving through the world. 

Groups will be virtual at this time to accommodate members in other parts of the state. If there is enough interest, there may be a in person group option in the future. Groups will likely be held Wednesday evenings from 5:30 to 7 PM. Cost will be $50 per group. The sliding scale range is $50-20.

For more information about my practice, check out my website. riverswellnessllc.com

Sign in to Google to save your progress. Learn more
Name *
Phone number *
Email address *
What is your experience with DBT? *
What do you hope to get out of the DBT group? *
Who is your primary therapist? *
DBT is a long-term commitment. Often people are in group for a year or more. As with any new skill, it takes  time to learn the skills, then to build mastery in terms of incorporating them into your life. A single round of moving through the skills will take about 16 weeks. Do you feel ready to commit to this process? *
If you would like to use insurance for this group, you would need to check if you have out of network benefits that may offer some coverage. You will also be required to have a diagnosis and for this group to be considered medically necessary according to insurance requirements. I will provide you with a superbill you can submit to your insurance if desired. 
Clear selection
Are you interested in sliding scale options? If so, what would be a doable group charge for you?
The proposed time of group sessions is Wednesdays from 5:30pm-7pm EST. Please note if that time works for you or would another time work better for you.  *
Is there anything that would make this group more accessible for you?
Questions?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Rivers Wellness.

Does this form look suspicious? Report

Google Forms