Psychotherapist Candidate Questionnaire

WE WANT TO GET TO KNOW YOU BETTER!

(All questions require an answer)

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* 1. What is your name (first and last)?

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* 2. I acknowledge that the position requires that I live within an hour's commute of Barrie, Ontario

Yes, that works for me

No, that does not work for me

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* 3. Name the institution your received your Bachelor's degree, and they type of degree received

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* 4. Name the institution you received your Master's degree, and the type of degree you received.

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* 5. How many years of clinical treatment provision do you have??

Less than 3 years

3 - 5 years

More than 5 years

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* 6. Describe what made you interested in this type of work in general.

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* 7. What are your longer term professional goals? Where do you see yourself in 5 - 10 years?

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* 8. How would you best describe your treatment approach?

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* 9. What age of clients do you enjoy working with the most?

children under 12

Youth 12-18

Adults

Couples

Families

Other (please specify)

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* 10. What age of clients do you enjoy working with the least?

Children under 12

Youth 12-18

Adults

Couples

Families

none

Other (please specify)

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* 11. What is your expected hourly rate?

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* 12. Have you worked with First Responders providing clinical treatment?

Yes

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* 13. Have you worked with First Responders in any capacity?

Yes

If yes please specify

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* 14. Are you trained in any of the following modalities and have certification?

EMDR (Eye Movement Desensitization and Reprocessing)

PE (Prolonged Exposure)

CPT (Cognitive Processing Therapy)

ERP (Exposure and Response Prevention)

ACT (Acceptance and Commitment Therapy)

CBT (Cognitive Behaviour Therapy)

Other (please specify)

None of the above

Psychotherapist Candidate Questionnaire

WE WANT TO GET TO KNOW YOU BETTER!

Question Title

* 1. What is your name (first and last)?

Question Title

* 2. I acknowledge that the position requires that I live within an hour's commute of Barrie, Ontario

Question Title

* 3. Name the institution your received your Bachelor's degree, and they type of degree received

Question Title

* 4. Name the institution you received your Master's degree, and the type of degree you received.

Question Title

* 5. How many years of clinical treatment provision do you have??

Question Title

* 6. Describe what made you interested in this type of work in general.

Question Title

* 7. What are your longer term professional goals? Where do you see yourself in 5 - 10 years?

Question Title

* 8. How would you best describe your treatment approach?

Question Title

* 9. What age of clients do you enjoy working with the most?

Question Title

* 10. What age of clients do you enjoy working with the least?

Question Title

* 11. What is your expected hourly rate?

Question Title

* 12. Have you worked with First Responders providing clinical treatment?

Question Title

* 13. Have you worked with First Responders in any capacity?

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* 14. Are you trained in any of the following modalities and have certification?

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* 15. Specifically, why would you like to work at Psychology Matters?