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.
Email *
About This Group
COST: $50/week or $350/8-week session ($50 savings)

GOALS:
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? *
Required
Which topics interest you most? *
Required
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. *
Next Steps:
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.
Thank you!
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy