Body Image Support Group: Part 1

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We will be running our Body Image Support Group again starting February 18th. This group will run Tuesdays virtually from 5-6pm for 12 weeks. This group is intended for any and all individuals struggling with body image concerns as a result of systemic and sociocultural factors including but not limited to diet culture. This group will be led by Advanced Placement Social Worker, Lexi Mulkusak, and Licensed Professional Counselor-In Training, Edna Dawit. Lexi specializes in providing eating disorder, anxiety-based, and some trauma treatments for adult clients. Edna is training to provide eating disorder treatment as well as exposure response prevention. She also specializes in treating anxiety, depression, life transitions, interpersonal conflict, ADHD, identity development, adoption, and trauma (sexual abuse and assault, physical abuse, racial, community violence).

This group uses the workbook created by Rachel Sellers and Mimi Cole to deconstruct diet culture, learn how to respect, nourish, and care for the whole self. Members will work with co-facilitators to extinguish body shame and move towards body acceptance and kindness. Members are encouraged but not required to have a copy of A Body Image Workbook for Every Body by Rachel Sellers and Mimi Cole. Co-facilitators will provide handouts to those who do not have access to the book. The group provides practical skills to use in your everyday life, supplemental materials, peer support, etc.

Cost: $75/session. This cost is not necessarily your out of pocket expenses after processed with insurance. There is a $75 deposit to attend the group that is fully refundable with completion of the group or with drop out prior to the 2nd session. Insurances accepted: Dean, Quartz, GHC, Aetna, Multiplan, Optum/United Healthcare, Evernorth, Cigna, Health Partners of MN, The Alliance, SHIP, UMR. If you do not have any of these insurances, you would be responsible for paying out-of-pocket. Please verify with your insurance that you have coverage to attend groups using the billing code 90853.

Please complete the information below to get signed up. Please make sure all fields are completed to allow us to verify your payment information/insurance prior to the group. Call our office if you have any questions.

Thank you!

Email *

Full Name *

Telephone # *

Date of birth *

YYYY

Email *

Are you a current Synergos Counseling client? *

Yes

Other:

If you are not a Synergos Counseling client, do you want to privately pay (credit card) or use insurance? *

Privately pay

Using insurance

If using insurance, what insurance do you have? *

Please verify that you understand there is a $75 deposit required that is refundable at the end of the group or with drop out prior to the 2nd session, otherwise it would be considered non-refundable. *

yes

Required

Please verify that you understand our cancellation policy which requires notice in writing or a voice message to our office 24 hours before each Tuesday group that you are unable to attend to avoid financial penalty. Additionally, if you do not provide any notice and miss a group you will be charged the full cost of the group. The missed or late cancel penalty will be charged to your card on file. Thank you! *

I have read and understand the late cancellation policy

Required

Who referred you to this group? *

Additional Information

You will receive a call from our staff within 48 business hours. If you do not, please call our office at 608-405-5111 or email contactus@synergoscounseling.com to verify you have been added to the group attendance list. There is a $75 deposit to attend the group that is fully refundable with completion of the group or with drop out prior to the 2nd session, otherwise it would be considered non-refundable. **We ask that you miss no more than two sessions to ensure the creation of a safe, conducive culture among group members. If you decide the group is not the right fit for you, please let us know by Friday at noon prior to the third group to prevent any financial penalty. Thank you!

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