RCG Therapist Applicant Pre-Screening

Practicum/Internship Applicant Pre-Screening

Thank you for your interest in Reflections Counseling Group! This is a pre-screening used to determine if you will move forward to the interviewing process. Please complete this form in its entirety or your application will be voided from the hiring process.
Name:*

First Name Last Name
E-mail Address:
Phone Number:*

Area Code Phone Number
What school are you attending?*
What degree are you seeking?
Is this your first and only practicum/internship site?

YesNo
Do you feel comfortable working with couples and families?

YesNo
Do you feel comfortable creating and facilitating a group?

YesNo
Do you currently work in the mental health field and/or have experience in the field?

YesNo
Do you have an identified niche or ideal client?*
This is not a deterrent but helps us ensure hiring for the current needs of the practice. We are an inclusive practice and work with all demographics and ages, however, we want our therapists to work with clients they feel skilled and comfortable working with. Don't be shy in advocating for yourself!
What age groups do you feel most comfortable working with?

Children aged 3+Seniors 62+Children aged 5+Families and couples of all agesAdolescents aged 14+Adults 18+
Reflections Counseling Group is LGBTQIA+ affirming, anti-racist, and committed to working in communities of color, are you comfortable working with these populations and/or communities?

YesNo
Do you hold any special training(s) and/or certification(s)? If not, answer N/A*
How did you hear about Reflections Counseling Group? If someone referred you, we want to say thank you!
Why are you interested in practicum/internship with Reflections Counseling Group?*
Are you able to commit to at least 2 days per week with availability for a minimum of 10 client sessions per week?

YesNo
I have completed the application in entirety with no unanswered responses. *Incomplete pre-screening applications will not be considered for employment.*

Yes
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