ISST Application Form for Certification 2015 Check appropriate box ☐Standard ☐Advanced Level Name and Credentials: ____________________________________________ Email Address: ___________________________________________________ Country: ________________________________________________________ Licensed as Psychotherapist: ___________(yes) _____________ (no) Type of License and Number: _______________________________________ Date of License (date of renewal / expiration): _________________________ To qualify for Standard or Advanced level certification in Schema Therapy a person must fulfill the following two qualifications: 1. Academic training: Hold at least a master's degree in psychology, clinical social work, psychiatric nursing or a counseling area that leads to licensing; or a medical degree with psychiatric residency (or residency equivalent if it is defined differently in that country). 2. License or certification for practice: In countries that certify or license the above professions, a person must be certified or licensed by either the government body or professional organization which grants this. If no such control exists in a country, the standard of one of the national or international professional psychotherapy organizations must be met to fulfill this requirement. If you belong to another group that is licensed or certified to practice psychotherapy in your country, please submit this information with your academic qualifications to be considered for certification application. Please ask the Training & Certification Coordinator for a review by the Certification Committee which has members representing international areas if in doubt about whether you or a training applicant meets these qualifications and to have alternatives evaluated.
ISST Application Form for Certification 2015 Check appropriate box ☐Standard ☐Advanced Level Name and Credentials: ____________________________________________ Email Address: ___________________________________________________ Country: ________________________________________________________ Licensed as Psychotherapist: ___________(yes) _____________ (no) Type of License and Number: _______________________________________ Date of License (date of renewal / expiration): _________________________ To qualify for Standard or Advanced level certification in Schema Therapy a person must fulfill the following two qualifications: 1. Academic training: Hold at least a master's degree in psychology, clinical social work, psychiatric nursing or a counseling area that leads to licensing; or a medical degree with psychiatric residency (or residency equivalent if it is defined differently in that country). 2. License or certification for practice: In countries that certify or license the above professions, a person must be certified or licensed by either the government body or professional organization which grants this. If no such control exists in a country, the standard of one of the national or international professional psychotherapy organizations must be met to fulfill this requirement. If you belong to another group that is licensed or certified to practice psychotherapy in your country, please submit this information with your academic qualifications to be considered for certification application. Please ask the Training & Certification Coordinator for a review by the Certification Committee which has members representing international areas if in doubt about whether you or a training applicant meets these qualifications and to have alternatives evaluated.