TBRI Class Registration Form Bio Families

Trust-Based Relational Intervention
TBRI is a therapeutic model that trains caregivers to provide effective support and parenting strategies for children. As this class is designed for clients who are ready to enhance their parenting skills, we have identified key characteristics of parents who have been able to effectively implement TBRI strategies in their parenting journey therefore clients will undergo a vetting process before they are invited to attend.

Once the referral is received we will assess each client to determine if they are a good fit for the class. The clients will be invited to attend an mandatory Introductory Meeting. During the meeting they will be given more information about the class and then if they feel they are a good fit they will be required to submit a personal statement explaining why they believe they are a good fit for the class. This will help assess their readiness and commitment to the program.

Class Options are being updated-Please select the option that may work best with schedules. Clients may be moved into another class that best fits their schedule.
Choose a time and location (Dates/Times subject to change-In Person Nurture Groups Date/Time TBD*
Parent Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Please do NOT enter caseworker email here. We need an email address for the parent/caregiver who will be taking the class. Thank you!
Self pay clients will be sent an invoice via email which can be paid electronically.
To ensure the success of all participants, we have identified these key characteristics of parents who have been able to effectively implement TBRI strategies in their parenting journey. Please describe how your client demonstrates each of the following characteristics.
Reflectiveness: Engaging in self reflection to understand their own triggers and behaviors that influence their parenting.
Commitment to Participating: Attending and engaging in services and meetings to support and strengthen and deepen their parenting skills.
Open-Mindedness: Willing to embrace new ideas and approaches in parenting.
Focus on Connection: Parent prioritizes building strong, trusting relationships with their children and has consistent regular contact with children.
If you are unsure if your client is a good candidate please provide as much feedback as possible and we will further assess your client for readiness during the Introductory Meeting process.
Referring and/or Remitting Agency

Self pay clients can leave this section blank.
Contact Person (i.e. Caseworker)

First NameLast Name
Ordering Agency or Circuit

KVCMBCHPCHASChildren's DivisionSelf PayOther
Case Worker Phone Number
Please enter a valid phone number.
Email
example@example.com
I agree to receive email communications from Family Advocacy Solutions.
Should be Empty:

Trust-Based Relational Intervention

Referring and/or Remitting Agency