Training Registration Form
Training Registration Form
Two Day Basic Training- Trauma Focused Cognitive Behavioral Therapy
Dates: April 23 and 24, 2014 Wednesday and Thursday
From 9:30 am to 5:30 pm
Training meets the qualifications for 14 hours of continuing education credit for MFTs, LPCCs, LEPs, and/or LCSWs as required by the California Board of Behavioral Sciences.
Training Location: 1800 S. Brand Blvd. Suite 123 Glendale, CA 91204
Trainer: Lisette Rivas-Hermina, LMFT, PCE # 5356
Phone: 818.956.5090 Fax: 818.956.5092
We are located at Seeley’s Studios Building at the intersection of Glendale Blvd/Brand Blvd. and San Fernando Road, across from Rally’s Burger and next door to Enterprise Car Rental. Enter our suite through the parking lot, behind the building.
Two Day TF-CBT Training Fees
Understand the efficacy of the TF-CBT model demonstrated in multiple studies
Incorporate Standardized Measures in treatment like the UCLA PTSD Index.
Identify the PRACTICE Components and their goals in TF-CBT.
Demonstrate how to implement TF-CBT using a variety of interventions.
Use interventions that integrate cultural values and beliefs throughout implementation of the model.
Recognize the role of vicarious trauma and the importance of self-care.
Request for CEUs $35.00 per person.
Understand the efficacy of the TF-CBT model demonstrated in multiple studies
Incorporate Standardized Measures in treatment like the UCLA PTSD Index.
Identify the PRACTICE Components and their goals in TF-CBT.
Demonstrate how to implement TF-CBT using a variety of interventions.
Use interventions that integrate cultural values and beliefs throughout implementation of the model.
Recognize the role of vicarious trauma and the importance of self-care.
Request for CEUs $35.00 per person.
CANCELLATION POLICY
If you sign up for a training and cannot attend, you must inform us at least 15 business days or
more from the training date to receive 50% of the registration fee back to you. Fee will be
returned in a form of a check. No cash refunds will be provided. No refunds will be given if
cancelled within 14 business days from day of training. You must attend both days of the two
day training as scheduled, in order to receive credit and certificate of attendance. No credit
and/or refunds will be given to those who attend one day only. If you attend one day only, you
lose your fee and credit. No exceptions. Check payments must be received in our office no
later than 3 weeks after we receive your registration form in order to reserve your space. NO
one will be allowed to attend the training if payment has not been received and processed by
the first day of training. No exceptions. No onsite registration. A fee of $50 will be charged to
you if your check is returned for insufficient funds. Training will start promptly at 9:30 am. You
must bring to this training a copy of your certificate of online completion of the FREE
online training. Training materials are provided to participants the first day of the training. No
materials will be provided in advanced.
LEARNING OBJECTIVES
Upon completion of training, participants can be expected to:
1. Understand the efficacy of the TF-CBT model demonstrated in multiple studies.
2. Incorporate Standardized Measures in treatment like the UCLA PTSD Index.
3. Identify the PRACTICE Components and their goals in TF-CBT.
4. Demonstrate how to implement TF-CBT using a variety of interventions.
5. Use interventions that integrate cultural values and beliefs throughout implementation of the
model.
6. Recognize the role of vicarious trauma and the importance of self-care.
CONFIRMATION NOTICES AND CERTIFICATE OF COMPLETION
We will confirm your registration by email once payment is received and with a follow up email
about a week before the training. Please call us if you do not receive a confirmation.
Registrants are responsible for parking on the surrounding streets. The parking lot in our building
has a valet service for $8.00 per day (cash only) payable to the independent valet company.
We do not handle parking fees. We do not validate parking. Lunch is on your own. Successful
completion includes full attendance of both days and submission of the training evaluation form
that will be provided to you at the end of the training. No partial credit will be given. Certificates
of completion are provided at the time of adjournment. You will be asked to sign a Training
Participation Agreement acknowledging that you received a certificate of attendance and that if
you request a certificate again, you will pay the $25 administrative fee. If you are coming from
an agency and someone else registered you, certificates will also be emailed to the person
responsible for registering you (the participants).
CONFIRMATION NOTICES AND CERTIFICATE OF COMPLETION
We will confirm your registration by email once payment is received and with a follow up email
about a week before the training. Please call us if you do not receive a confirmation.
Registrants are responsible for parking on the surrounding streets. The parking lot in our building
has a valet service for $8.00 per day (cash only) payable to the independent valet company.
We do not handle parking fees. We do not validate parking. Lunch is on your own. Successful
completion includes full attendance of both days and submission of the training evaluation form
that will be provided to you at the end of the training. No partial credit will be given. Certificates
of completion are provided at the time of adjournment. You will be asked to sign a Training
Participation Agreement acknowledging that you received a certificate of attendance and that if
you request a certificate again, you will pay the $25 administrative fee. If you are coming from
an agency and someone else registered you, certificates will also be emailed to the person
responsible for registering you (the participants).
CONTINUING EDUCATION UNITS INFORMATION
Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), Licensed
Educational Psychologist (LEP), and Licensed Professional Clinical Counselor (LPCC): Rivas-
Hermina Trauma Recovery Services, INC, is an approved provider with the State of California,
Board of Behavioral Sciences, Provider # PCE 5356. Full attendance of this training meets the
qualifications for 14 hours of continuing education credit as required by the California Board of
Behavioral Sciences. For participants outside of California, please check with your own State
for CE regulations. Please bring your license number to the training. Certificates of successful
completion will not be issued without your license number. Please note that CEs are awarded
to licensed therapists ONLY. Interns do not need to pay for CEs as they do not qualify for them.
Please do not pay CEUs for your staff if they are not licensed! No CEs for psychologists are
offered at this facility.
REQUEST FOR DOCUMENTS NEEDED TO VERIFY TRAINING
Documents verifying training need to be requested upon registration; please mark the
corresponding boxes with an “X”. Documents we provide, if you request them, are the
following: attendance roster, receipt for payment, training agenda, certificates of attendance,
and CEU certificates. These documents are sent electronically via email about a week after the
training has taken place; please save them for your records. Future requests for training
verification will require the submission of a Request for Training Verification Form and will incur
a $25.00 administrative fee per each copy requested.