Northeastern Society for Group Psychotherapy

Training Program Application

Northeastern Society for Group Psychotherapy

Application for the Principles of Group Psychotherapy Course

See page 2 for information about the course, links to the scholarship application, how to make payment, and CEU information. More information is also available on the main training page at nsgp.com!!

Email completed applications to Joel Krieg, LICSW, CGP at .

Name:

Address:

Telephone:

Email:

Professional Discipline:

Write as much as you need below. Feel free to go onto the second page.

Tell us where you are in your career.

Describe your current and past experience with groups, if any.

How did you learn about the program?

What do you hope to take away from the training experience(s)?

Principles Course Information:

The weekend didactic classes will meet from 9:30 a.m. to 1:00 p.m. on the following Saturdays: January 23th, February 6th, March 12th, April 2nd and April 30, with an Orientation Meeting on the evening of Friday, January 22rd. There will also be a day-long experience group meeting on May 14th. 24.5 CEU credits available.

The classes will be taught by different instructors to provide exposure to a variety of group leadership styles. The classes will be held at each instructor’s office or home in Brookline, Boston, Newton, and Cambridge. The day-long experience component will provide opportunity to consolidate learning in a participatory, experiential group in which class members will become group members for the day (4 distinct 1.5 hour meetings with breaks) followed by an hour wrap-up review of the experience, led by a senior group leader.**

Tuition: $550 (payable in full prior to December 21, 2015), which includes CEU credits. If you are interested in applying for a scholarship, click the link on the main training page to download the scholarship application!

Please make checks payable to NSGP, and mail them to Northeastern Society for Group Psychotherapy, Inc., PO Box 356, Belmont, MA 02478

Payment can also be made by credit card through the website.

Refund policy: Tuition credit will be given if cancellation is made 2 weeks prior to course date. Requests must be made in writing.

For more information call Joel Krieg: (617) 682-0057 or email:

**(For those also interested in a longer training group experience, please look this spring for information about the weekly training group, to begin in the Fall 2016!!!)

Northeastern Society for Group Psychotherapy, Inc., PO Box 356, Belmont, MA 02478-3201

NSGP Accreditation: The Northeastern Society for Group Psychotherapy, Inc. (NSGP) designates this educational activity for a maximum of 24.5 AMA PRA Category 1 Credit(s)™. Physicians (and all other participants) should only claim credit commensurate with the extent of their participation in the activity. NSGP, Inc. is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians. • NSGP is approved by the American Psychological Association to sponsor continuing education for psychologists. NSGP maintains responsibility for this program and its content. This program provides a maximum of 24.5 credits. • NSGP is an NBCC Approved Continuing Education Provider (ACEP™) and may offer NBCC approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program. This activity has been approved for a maximum of 24.5 clock hours. • For information regarding the status of Continuing Education Credits for social workers and to find out if an authorization has been issued, please call the NSGP office at 617-431-6747.