Registration for DBT Family Skills Training

Name *

First

Last

Email for Class Materials and Resources *

Name of Family Member, Partner or Friend *

First

Last

Additional email address or Class Materials and Resources *

Experience with DBT (Dialectical Behavior Therapy) *

DBT Couple or Family Therapy DBT Individual Therapy DBT Family Skills Training Standard DBT Skills Group or Teen-Parent Skills Group Read Marsha Linehan's text, manual, or memoir. Read books by Fruzzetti, Hoffman, Koerner, Swenson, Manning or Rathus & Miller This will be my first experience with DBT!

How did you learn about DBT Family Skills Training? If you were referred by a health professional, please include the name if possible. *

Class Agreement. Please initial that you (and participating family members) consent to the following. -- 1. I/we will maintain confidentiality of any personal information of members from this class or discussion group. I/we agree to not share information about a participating family member/partner/friend without their consent in the Tuesday sessions or in the discussion groups. -- 2. I/we understand this class is not providing psychotherapy or clinical treatment and agree that I/we will not record, photograph, or otherwise capture or distribute class content or materials. -- 3. I/we will inform the the class instructor if missing a session or having any concerns about the class. -- 4. I/we understand this skills class is to be recorded as an additional learning resource. The recordings will be available until the end of the class. -- 5. I/we intend to make time (1-2 hrs/wk) to practice the week’s skills and read the handouts for the upcoming class. -- 6. While not a requirement, I/we understand that it may be helpful to have a therapist to consult while participating in this class. -- 7. I/we understand that members of previous classes found it a more effective, shared experience when class members participated with their webcams on. I/we understand the expectation is for webcams to be on with necessary, yet infrequent exceptions. *

I am now sending payment for (early registration fee of $650 if by Jan. 10th), standard fee of $750 or reduced fee of $325 for my family: *

using PayPal to jmaderlmft@gmail.com mailing check to CIP/Mader, 110 Circadian Way, Chapel Hill NC 27516

DBT Family skills training

* Registration *

2023 DBT Family Skills Training
(Online starting January 31st)

Please use the button below to complete your registration. Thank you!

DBT Family skills training​​

* Registration *​​2023 DBT Family Skills Training​(Online starting January 31st)​​

Please use the button below to complete your registration. Thank you!

DBT Family skills training

* Registration *

2023 DBT Family Skills Training
(Online starting January 31st)