This is the application for a Ambassador role. Please read through the entire application before beginning. offers examples of DBT skills (e.g., Mindfulness, Opposite Action, Paced Breathing, etc.) through the form of video. It also offers free resources such as a Safety Plan and Guide, Crisis Resources, posters, and other downloadables. DBT stands for Dialectical Behavior Therapy and was developed by Dr. Marsha Linehan.
Your information will be reviewed by our founder Dr. Ursula Whiteside, or a member of the team. Your responses are confidential within
There is a new Academy each quarter (applications due the quarter before). If not accepted for this cycle, you can reapply the next quarter (e.g. Quarter 1=Jan thru Mar, 2=Apr thru Jun, 3 = Jul thru Sep, 4 = Oct thru Dec).
Becoming an Ambassador and attending an Academy is about learning, sharing and empowering ourselves and others.
Email address *
What tools have you used from the website? *
Having utilized the tools on the website increases your likelihood of acceptance for an Academy.
Other information. We seek to have ambassadors who are representative of all of us. Select those that you are aware of and apply to you (e.g., no need to go look these up if you aren't familiar). Many people have more than one. This information is confidential (only Ursula Whiteside and select members of her team who also have Lived Experience will review). For mental health or substance problems, these can be current or former. We do not exclude people based on their experiences. *
First and Last Name *
Your answer
Cell Phone Number *
Your answer
What Do You Do? *
Education Level *
Besides work, school, or homemaker - what have you typically do with your time in the past two months? (e.g. coach basketball, read novels, hide in my room, play video games) *
Your answer
Race and Ethnicity *
City and State or Zip Code *
Your answer
Demographic - Age *
Demographics - Gender Identity *
Is it okay to? *
*Most Important Question*: Tell us more. What did you find helpful about DBT skills (e.g. Mindfulness, Opposite Action, Paced Breathing, Mindfulness of Current Emotion, etc) and/or (DBT skill videos plus other resources)? Why would you like to share? Please provide at least 3 sentences or more about your experience. If you have received DBT or used DBT skills, tell us about your experience (i.e. how long and what was included, whether you used DBTs skills, whether you benefited). *
Your answer
Thank you for your interest!
Additional Resources:
Suicidal thoughts are not uncommon. It's an important indicator that something in our lives need to change.

Save the suicide prevention lifeline is 1-800-273-8255 (you don't have to be suicidal to call; friends and family members welcome). Also, please save the Crisis Text Line to your phone 741741 (just text "matters" or any word to start a convo).
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