Field Placement Application
THIS APPLICATION IS A PREVIEW TO HELP YOU DETERMINE YOUR QUALIFICATIONS FOR OUR FIELD PLACEMENT.
ONCE PAYMENT HAS BEEN MADE YOU WILL BE DIRECTED TO THE OFFICIAL APPLICATION.
Criteria for acceptance onto the course
General notes:
This course will allow the trainee to obtain a minimum of 10 and a maximum of 30 client contact hours. The trainee will be responsible for securing local clients for the purposes of this field placement. This pre-requisite course discusses ethical methods of pro bono and sliding scale work that can also be used as a marketing and practice-building strategy.
Please read the full course description that includes Trainee and Field Supervisor responsibilities along with a course description. https://www.onlinetherapyinstitute.com/field-placement-for-online-therapists-and-coaches/
To ensure your training meets your needs, please answer the following:
- Will this Field Placement fulfil requirements for any of the following you are pursuing:
- Certified Professional Coach (CPC) through Grow Training Institute (GTI) or GTI/Online Coach Institute (OCI)
- Yes/No * delete as applicable
- Board Certified Coach (BCC) through CCE
- Yes/No * delete as applicable
- Florida Certification Board’s Certified E-Therapist (CET) credential
- Yes/No * delete as applicable
- Certified Professional Coach (CPC) through Grow Training Institute (GTI) or GTI/Online Coach Institute (OCI)
- Will this Field Placement fulfil requirements for any other license, certification or university requisite?
If so, what other requisite is this Field Placement fulfilling?
Criteria for Application
To be accepted onto the course, you should:
- Be educated to bachelor/diploma degree level
- Mental Health Professionals must be able to practice independently. If not able to practice independently, therapists must provide contact information and letter of reference from current clinical supervisor.
- Coaches must be certified or pursuing certification with a recognized coach organization.
- Be a member of a recognised professional counselling or coaching body with an ethics code (e.g. IAC, AC,
- ICF,NBCC, ACA, BACP, APA, BACP Coaching Division, or give reasons for non-membership/demonstrate intention to become one)
- Be a member of the Online Coach Institute Social Network
- Therapists and Coaches must have completed at least 20 hours related to the delivery of online therapy or coach services. 5 of these hours must be OTI/OCI’s course, Giving Back- The Ethics of Pro Bono and Sliding Scale Services for Online Therapists and Coaches (5 clock hours)
- Therapists and Coaches must submit proof of malpractice insurance
- Provide one reference from a colleague, supervisor or mentor
Personal Information
Name:
Full address, including your Zip/Postcode:
Preferred email address (this email address will be the one you use to access the course if accepted):
Telephone numbers (landline and cell/mobile):
Resume/CV
Please attach your resume/CV to your email with this form. You can also cut and paste it at the end of this form if you prefer, or post it to the addresses below.
Insurance
Please attach a scan of your insurance certificate with this form. You can also cut and paste it at the end of this form if you prefer, or post it to the addresses below.
USA/CANADA
Online Therapy Institute, PO Box 392, Highlands NJ 07732, USA
UK AND EUROPE
Online Therapy Institute, 9 Lion Well Wynd, Linlithgow, EH49 7EL
REST OF WORLD
In case of neither the above addresses being convenient, please email info@onlinetherapyinstitute.com
Professional Organisation Member Information
Please provide the organisation(s) you are a member of, your membership number if applicable, and indicate (*) the organisation that has the code of ethics you adhere to. If you are not a member of a professional organisation, please state what code of ethics you follow (see examples):
EXAMPLE 1:
BACP* (530937), UKCP, ISMHO
I follow BACP code of ethics (past member) and OTI Ethical Framework for Use of Technology
EXAMPLE 2:
In the U.S. if you are not a member of a professional organization, list the state’s code of ethics or certification code of ethics you follow such as Commission on Rehabilitation Certification or National Board of Certified Counselors
I am a Certified Rehabilitation Counselor so I follow the CRCC Code of Ethics* and/or I am a Distance Credentialed Counselor so I follow the NBCC Code of Ethics.
EXAMPLE 3
AC*. I am a member of BACP/BACP Coaching Division and the Association for Coaching
nterest in pursuing a Field Placement through OTI/OCI
Please tell us in around 500 words why you are pursuing a Field Placement through OTI/OCI:
Reference Provider
We will follow up, via email, the person you supply to vouch for your suitability to undertake the Coach Competency Series. Applications will NOT be approved without this information. Please supply the name, address and email address of one person familiar with your work or your intended goals:
Special Needs
The Online Coach Institute specifically welcomes and supports trainees with differing needs. If you have any needs that you think we should know about, please provide us with details on the form. We will endeavour to meet any needs you have and take them into account while on the Certificate course, and will discuss this further with you to ensure they are met:
Preferred start date
Please bear in mind it will take up to 10 days to process your application and more if we are waiting for posted documents or a response from the person supplying you with a reference: