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Name
Age
Location
Pref method of session:
Online
Offline
How many years have you been practicing as a therapist?
What populations/clients do you currently work with?
What settings have you worked in?
What presenting issues or diagnoses do you currently work with?
What do you consider outside your scope at this stage?
Are you currently working with any high-risk clients (suicide, complex trauma, severe psychiatric diagnosis)?
How do you conceptualise clients?
(You may share modalities you’re trained in or leaning towards)
Do you identify with a specific theoretical orientation?
What trainings or certifications have you completed?
Are you currently pursuing additional training? If yes, please specify.
What do you most want support with in supervision?
What are your expectations of supervision?
Anything else you’d like me to know?
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9th floor park center building,
24 Park Street, Kolkata, West Bengal 700016
+91 98300 15724
9th floor park center building,
24 Park Street, Kolkata, West Bengal 700016
+91 98300 15724