Becoming an SPT Supervisor Application
 For Certified Synergetic Play Therapists who meet the prerequisite requirements, we
 offer a path to becoming a Certified Synergetic Play Therapy Supervisor.

Prerequisite requirements are as follows:

• Be at least two years, post SPT Certification holding a clinical caseload during that time with a focus on the application of SPT principles
• Demonstrate at least a year's worth of post certification supervision/consultation with an SPT Supervisor within 2 years of starting the course
• Hold current LPC or LCSW Mental Health license (or equivalent licensure/ability to offer supervision in
your state or country)
• Hold "current" status of the "Certified Synergetic Play Therapist™" credential
• Purchase and participation in the SPT Community Membership for at least one year within 2 years of starting the course

If you meet these requirements and are interested in being a part of the next SPT
Supervisor class, please address the following:
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Your First and Last Name *
Preferred Phone Number *
Preferred Email Address *
 What year did you become Certified in SPT and who was your consultant during the program?
In the two years prior to this application, have you received at least a year's worth of supervision/consultation from an SPT Supervisor? If so, who was your supervisor?
How have you stayed engaged in continuing to learn and deepen your understanding of SPT principles post Certification?
If you are more than three years post SPT Certification, have you completed the requirements for recertification, and what did you do to meet those requirements?
Why would you would like to become an SPT Supervisor? *
This course requires work with at least two supervisees throughout the training (including video taping of supervision sessions). Will you have access to meeting at least monthly with two supervisees throughout the training? *
I understand that after I submit my application, I will be contacted by a course consultant as part of the process and to finalize my application. I understand that SPTI will need to confirm that I meet the above requirements before acceptance into the program. I also understand that I will not make a payment to the program until after this process is complete. *
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