Interest Form: SHINE
Thank you for your interest in attending this therapy group! Enrollment for the group is ongoing and the start date will be scheduled based on the number of people interested. To be notified when the minimum group size is reached, please fill in the information below.
About This Group
COST: $50/week or $350/8-week session ($50 savings)
1. Understand the ways your past experiences impact you in the present,
2. Learn evidence-based clinical strategies for addressing trauma & negative thoughts and feelings,
3. Develop coping skills to break old patterns.
4. Increase healthy self-care practices that support your mental health, and
5. Connect with other women to share experiences and gain social support.
SIZE: 5-7 individuals
LOCATION: Online via ZOOM
COMMITMENT: 90 minutes each week for 8 weeks
DATES & TIME: Wednesdays 5:30 - 7:00pm
First & Last Name
Mobile phone number:
What is your area of greatest struggle?
Relationship with Self
Which topics interest you most?
Developing coping skills
Reframing negative thoughts about yourself
Getting support from other women
Dealing with anger, rage, and irritability
Redefining your relationship with your parent(s)
Confronting issues from the past
Coping with life stressors
Handling issues in the workplace
Learning to manage emotions more effectively
If not listed above, please share what topics you would like to discuss in this safe space with other Black women.
Choose your preferred payment option. Payment will be collected upon confirmation of the group dates and enrollment.
$350 per 8-week session ($50 discount)
Once I have at least 5 people interested, I will send an email letting you know and telling you how to proceed. If you have any questions, please reach out and let me know.
Send me a copy of my responses.
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