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2022 KOSTA 개인 상담 신청서
2022 KOSTA 개인 상담 신청서
안녕하세요! 상담 신청을 위한 중요한 질문들이오니 잘 읽고 답변해주세요. 
2022 KOSTA 개인 상담 신청서
  • 1
    The undersigned, seeking a biblical life coaching adhered by KOSTA/USA, hereby acknowledges his or her understanding of the following conditions and further releases to the life coaching program, its mentors, and staffs, from any liability or claim arising from the undersigned’s participation in the above-mentioned the life coaching program: 1) It is understood by the participant that the life coaching program will be provided by supervised mentors, not as licensed therapists; 2) That all programs provided during KOSTA Conference is in accordance with the biblical principles adhered to its ministry and are not necessarily provided in adherence to any local or national psychological or psychiatric association; 3) That no representation has been made, either expressly or implied, that the life coaching, as conducted by the mentors, is accepted as customary psychological and/or psychiatric therapy within the definitional terms utilized by those professions. 4) Certain statements may not be protected as privileged communications under law. Do you agree with Waiver of Liability?
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  • 2
    1) I assure to keep confidential information from the mentoring session. (저는 세션 중 거론된 상담가의 정보 포함, 개인적인 내용은 비밀로 지키기로 약속합니다.) 2) I am committed to resolving/adjusting/rectify my problems by coming into obedience to the Word of God. (저는 세션 중 거론된 문제를 하나님의 말씀인 성경 안에서 풀어나가기로 약속합니다.) 3) If I am dissatisfied in any way with the session, I will first discuss it with the program staff directly. (세션의 결과에 불만이 있을 경우, 상담실 스태프와 먼저 상의를 먼저 할 것을 약속합니다.) 4) Mentors and mentees have a right to report the session if they notice severe life-threatening situation. (상담가와 내담자는 세션 중에 생명에 지장이 있는 응급상황이 감지될 경우 관련 기관에 신고할 수 있는 권리가 있습니다.) *** If you have any questions about these guidelines, please consult with the KOSTA staff or one of our mentors. (위의 내용에 질문이 있을시에는 상담실 스태프나 상담자님께 상의해주시면 감사하겠습니다.) I, (아래 자신의 이름 서명), affirm the accuracy of the personal information provided herein, and have read the information above and agree to the conditions set forth therein that the life coaching I receive will be based on the mentor’s understanding of the Bible as the Word of God and its practical applications.
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  • 3
    Gender
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  • 4
    Name
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  • 5
    Age
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  • 6
    Group #
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  • 7
    Phone #
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  • 8
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  • 9
    Preference of Counselor
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  • 10
    Preferred Time to Meet
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  • 11
    Have been treated for a psychiatric, emotional, or mental illness?
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  • 12
    Have you ever experienced the KOSTA life coaching?
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  • 13
    Desired KOSTA life coaching topics
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  • 14
    Relational Issues--원하는 상담분야에서 관계를 선택하셨을 경우 작성해 주십시오.
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  • 15
    Faith Issues--원하는 상담분야에서 신앙생활을 선택하셨을 경우 작성해 주십시오.
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  • 16
    Career Issues--원하는 상담분야에서 진로를 선택하셨을 경우 작성해 주십시오.
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  • 17
    Mental Health Issues--원하는 상담분야에서 정신건강을 선택하셨을 경우 작성해 주십시오
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  • 18
    I don't enjoy being around people as much as I used to.
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  • 19
    I feel worthless (I don't find much value in myself).
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  • 20
    I feel hopeless (I don't see a future in my life).
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  • 21
    I feel isolated and alone.
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  • 22
    I feel sad more days than not.
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  • 23
    I have thoughts of ending my life.
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  • 24
    I have sleep difficulties.
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  • 25
    I feel like I can’t turn my mind off.
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  • 26
    I have spells of terror or panic.
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  • 27
    My heart races for no good reason.
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  • 28
    I feel tense.
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  • 29
    I am concerned that other people do not like me.
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  • 30
    I feel self-conscious around others.
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  • 31
    I avoid a situation where I am surrounded by people I don't know.
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  • 32
    I am not able to concentrate as well as usual.
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  • 33
    It is hard to stay motivated.
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  • 34
    I am unable to keep up with my work.
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  • 35
    I am confident I can succeed in whatever I do.
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  • 36
    I think about _____________ more than I would like to. (Check all that apply)
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  • 37
    I feel out of control when I _____________. (Check all that apply)
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  • 38
    I often regret after _____________. (Check all that apply)
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  • 39
    When I drink alcohol I can't remember what happened.
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  • 40
    I have difficulty controlling my temper.
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  • 41
    I get angry easily.
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  • 42
    I frequently get into arguments.
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  • 43
    I sometimes feel like breaking or smashing things.
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  • 44
    I am afraid I may lose control and act violently.
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  • 45
    I have thoughts of hurting others.
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  • 46
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