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Healing TREE Online Brainspotting Therapy Training: BIPOC & LGBTQIA+ Clinician Scholarship Application
Thanks to the generosity of Susan Pinco, MSSW, PHD, BCD, Deb Antinori, MA, LPC, FT, RDT, and Regina Guthrie Faridnia, PhD, LCSW, Healing TREE is periodically able to provide scholarship opportunities for BIPOC and LGBTQIA+ clinicians to be trained online in Brainspotting Therapy. If you are interested in being considered for a scholarship, please fill out this application form. We will add you to our waitlist for these opportunities.

NOTE: Attendees must either be a student in an accredited program in counseling, psychotherapy, psychology, coaching, ministry or medicine or have graduated from an accredited program.
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First Name *
Last Name *
Email *
Phone Number *
License Number (if student, please note in what field) *
License Type (if student, please note in what field) *
Do you identify as BIPOC (Black, Indigenous and People of Color)? *
Do you work with a majority BIPOC client base? *
Do you identify as LGBTQIA+? *
Do you work with a majority LGBTIQA+ client base? *
Would you be able to afford this training if a scholarship was not provided? (It has an approximately $1,600 value.) *
What is your prior trauma training (including training in any brain-body based modalities), if any?
*
Why would you like to receive this training? How do you believe it will benefit your community?
*
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