a. I have at least 100 clinical hours to date
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Yes
No
please state the number of clinical hours you currently have:
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b. I have significant experience of direct work with clients or service users that I attained prior to my course of study
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This may have been achieved in a work or a voluntary setting
Yes
No
If yes, please provide further details
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c. I have completed my course of study and wish to gain further clinical experience in this placement
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Yes
No
If yes, please provide further details
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We ask all trainees to see a minimum of four clients a week while on placement with us, please confirm that this is manageable for you.
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Yes
Unsure/No
Please confirm that you are available to remain in the placement seeing clients for a minimum of one year.
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Yes
Unsure/No
Name
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First Name
Last Name
Do you prefer to be known by another name?
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Gender
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Ethnicity
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Phone number
Email
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Date of birth
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Which area of the country are you based?
What is the name and full address of your training provider
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What year of study are you in?
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How long is your course of study?
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How many clinical hours have you currently completed and where?
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Please specify where you have undertaken these (the name of the placement provider), and if they were face to face or online.
How many clinical hours in total do you need before qualifying?
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Do you have any other qualifications, training or skills you’d like to tell us about?
Please tell us about your work/employment experiences and jobs you’ve had
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Please state your weekly availability to see clients (the greater your availability, the more likely it is that we can consider your application for a placement).
Please state all days and times that you could be in Elephant and Castle every week for at least the year after your placement starts. Please also state your availability to see clients online, if this is different to your in-person availability. No applications will be considered without this information
How long you have been in therapy? Please state months/years
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We only accept trainees on placement who are currently in personal weekly therapy. If there is a reason as to why you are not currently in therapy, please include the details here.
What are your areas of clinical interest, and why?
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Please do offer as much detail here as possible.
It is important that trainees on placement ground their practice in solid theoretical approaches. Please tell us here what your therapeutic approach is, and what theories you refer to in your work with clients.
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What do you understand by the term “integration”?
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What do you know of the work of Freud, Jung, Rogers, and Yalom?
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Tell us what you know, and feel free to share your opinions.
What do you understand by the term “therapeutic frame”?
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What is your understanding of therapy “delivered with heart and soul?"
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Why would you like a placement with us?
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What draws you to this placement?
Please provide a personal statement below, and please consider including the following information about yourself
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- Why you want to be a therapist?
- What your approach is to working with clients?
- Describe how you resolve difficulties.
- What does “working with difference” mean to you?
- What do you think about low-fee services like ours?
- Who is your ideal client?
- Do you have any work experience that you’d like to tell us about?
- If you have any questions about the placement.
- Anything else you’d like to tell us about you.
When can you start seeing clients?
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We may need to discuss the answers you provide here, and/or at interview with your training organisation. We will always discuss this with you first. Please indicate if you agree that we can do this by selecting yes below. Our placement offers a transparent, supportive, and professional experience of clinical work, unfortunately, if you tick no, we are not able to progress your application at this time
Yes
No
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From time to time we may send you information about mental health, courses, and other information you might find useful. Please select yes if you’re ok for us to add you to our mailing list, or no if you’d prefer that we didn’t.
Yes please, add me to your mailing list.
No, thank you.
Where did you learn about this clinical placement opportunity?
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