Male Survivor Online Therapy Group Interest Form 
Thank you for your interest in [Men's Group Winter 2023 group]. Currently, we are accepting referrals and connecting with practitioners and organizations that work with male identified folks. 

This group is for all male-identified participants with trauma histories. We welcome the full spectrum of manhood, including straight, gay, bi-sexual, queer and trans men. Trauma impacts us on a physical, social, spiritual, emotional, and cognitive levels. In this group, we will provide a stable, safe, and emotionally nurturing space limited to a small cohort. In addition to psycho-education on trauma and PTSD, we will explore the unique challenges men face both surviving and healing from trauma. 

This is an opportunity to experience the healing effects of being in a community and members are invited to share their experiences, give and receive support, discover they are not alone, and learn healthy ways of relating to themselves and connecting to others.

The process of joining group involves two individual consultations. These meetings offer the opportunity to better get to know each other, explore goals and expectations, go over group agreements, anticipate what might be hard for you in the group (and what you, the group, and Adam and I can do to support you), and address questions and/or concerns. It's also a chance to get a sense of what a typical group session is like.

Complete the form and contact Jocelyn or Adam for updates on group enrollment!

Please fill out this application and we will be in touch soon. 

Applications are reviewed on a rolling basis and it can take up to a 48 hours for us to respond to your interest. 

Thank you for your patience and direct any questions to JocelynEve28@gmail.com or adamgladstone@drgladstonetherapy.com
Sign in to Google to save your progress. Learn more
Name *
Age *
Email *
Phone *
Tell us a bit about why you are interested in this group?
 *
What are your goals for this therapy group? What do you hope to gain from this experience?
 *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms