C.A.S.T. Application C.A.S.T. Application Name * Email * Highest Degree Held: * Ph.D.Psy.D.M.Ed.Ed.S.M.S.M.A.M.S.W.M.S.C.M.A.C.M.S.M.F.T.M.A.M.F.C.M.A.S.P.M.S.S.P.Other If other, field to enter type of degree * College from which this degree was earned: * Year that your first license first became effective: * 2024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973 State(s) in which you are currently licensed (for therapists in U.S.): * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Licensure outside the U.S Country Province State Territory Type of Employment: * Private Practice (self-employed)Group PracticeIn-Patient HospitalOutpatient HospitalPsychosocial RehabilitationRecovery ResidencePrivate AgencyGovernment AgencyOther Treatment Center Therapy Settings: * IndividualsCouplesFamiliesGroupsEducational Seminars Age Ranges You Serve * Pre-School Children Tweens Adolescents Parents and Minor Children Adults Seniors Geriatric Therapy Approaches * Cognitive Behavioral Therapy (CBT)Dialectical Behavior Therapy (DBT)Psychodynamic TherapyPsychoanalysis: Humanistic TherapyPsychoanalysis: Gestalt TherapyPsychoanalysis: Person-Centered Therapy (Rogerian Therapy)Psychoanalysis: Existential TherapyPsychoanalysis: Adlerian TherapyPsychoanalysis: Rational Emotive Behavior Therapy (REBT)Psychoanalysis: Solution-Focused Brief Therapy (SFBT)Psychoanalysis: Narrative TherapyPsychoanalysis: Acceptance and Commitment Therapy (ACT)Psychoanalysis: Mindfulness-Based Cognitive Therapy (MBCT)Psychoanalysis: Eye Movement Desensitization and Reprocessing (EMDR)Psychoanalysis: Interpersonal Therapy (IPT)Transpersonal Therapy: Family Systems TherapyTranspersonal Therapy: Structural Family TherapyTranspersonal Therapy: Strategic Family TherapyIMAGO Therapy: Emotionally Focused Therapy (EFT)IMAGO Therapy: Cognitive Processing Therapy (CPT)IMAGO Therapy: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)IMAGO Therapy: Behavior TherapyIMAGO Therapy: Multimodal TherapyIMAGO Therapy: Play TherapySandplay Therapy: Art TherapySandplay Therapy: Music TherapySandplay Therapy: Drama TherapySandplay Therapy: Group TherapySandplay Therapy: Group Therapy: Motivational Interviewing (MI)Internal Family Systems (IFS)Transactional AnalysisRelational-Cultural TherapyOther Approach Not Listed If Other, name approach: Have you completed the Advanced Spherology program? * YesNo What are some ways that you believe Spherology will complement your practice? * Are you willing to document personal and clinical examples of implementing Spherology for supervision purposes? * YesNoPersonal Examples OnlyClinical Examples OnlyWould need more information What format do you prefer for supervision? * In-PersonVideo ConferencePhoneEmailOnline Chat Do you prefer 1-on-1 or small group settings to discuss cases? * 1 on 1Small GroupNot interested in case consultation Are you willing to establish a mutually agreed upon research project to objectively assess the benefits/limitations of Spherology? This would be tailored to your work setting, your interests, and your availability. * YesNoWould need more information Submit If you are human, leave this field blank. Δ
