Greene Clinic Training Program Application

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Form to be completed for all applicants to Greene Clinic's three training programs

What is your name?

Which training program are you applying for? *

Postgraduate track (full-time, paid, for therapists with 3+ years clinical experience)

Middle/intern track (part time, paid, for psychology interns and recent graduates of masters' level training programs)

Student track (practicum, field-placement, psychology externship, or student internships)

What is your graduate degree?

On what date did/will you graduate from your program?

What is your date of birth?

How did you hear about the Greene Clinic?

Please briefly explain your interest in working at the Greene Clinic. (200 words maximum) *

Please briefly describe your previous work experience in the field of mental health (no need to be exhaustive; we will read your CV).

Please briefly describe any other prior work or volunteer experience that informs your work as a therapist.

Please describe your interest in psychoanalysis. Do you have any prior experience with treating patients psychodynamically?

Please note any other modalities that inform your approach to treatment, and whether you have experience with other approaches to psychotherapy.

Please indicate whether you are interested in the following:

Treating children

Treating teens

Treating adults

Treating couples/relationships

Treating families

Treating severe and persistent mental illness

Running a DBT group

Conducting neuropsychological assessments

Other:

Please describe any areas of specialization or specific populations that you like to work with, including elaborations on your experiences working with any of the areas in the previous question:

Please state any languages you are fluent in aside from English.

Our patient population often makes requests for therapists who have cross-cultural experience, identify as LBGTQ and/or BIPOC, have familiarity with immigration, or are open to religious/spiritual exploration. Please describe any ways you might contribute to the diversity of clinic, including your racial, ethnic, or cultural background, class background, gender or sexual identity, age, or life experiences.

Please share any papers or books that have been influential to your thinking.

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