Black Play Therapy Foundation Phase 3 Application Form

“Get You To The Finish Line” Play Therapy Training Program

“Get You to the Finish Line” Program: This initiative is designed to support Black licensed mental health professionals in Phase 3 of the play therapy credentialing process.

Program Overview

The Foundation provides a comprehensive program that is specifically designed to equip participants with the essential knowledge and skills required to fulfill the prerequisites of the credentialing application for the Association for Play Therapy (APT). This program includes in-person sessions, live webinars, and recorded training modules, as well as group and individual consultations.

Phase 3 focuses on advanced techniques to deepen your play therapy knowledge and skills. Participants in the program will receive training and group and individual consultation from a Registered Play Therapist-Supervisor (RPT-S™), which is essential to their development of new skills as play therapists. Additionally, participants will receive guidance with credentialing and preparation to submit their credentialing application to the Association for Play Therapy.

Training and Consultation

Phase and Cost: The Program is divided into two Phase 3 options, which cover training, materials, and RPT-S™ consultation. The Participant investment is:

Option A: $500 – Participants need up to 24 hours of training and no more than 7 hours of RPT-S™ consultation to complete the APT credentialing requirements.
Option B: $1000 – Participants are just getting started in Phase 3 and need 47 hours of training and up to 12 hours of RPT-S™ consultation to complete the APT credentialing requirements.

Application Review and Payment

A Program Committee will review participant applications. Upon acceptance into the Program, Participants are required to make payment in full prior to the first scheduled training in August 2024.

Verification of Phase 3: To qualify for this program, you must submit all requested documentation to verify that you have received the necessary training and RPT-S™ consultation required to be in Phase 3 of the APT credentialing process.

APT Credentialing Standards: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://cdn.ymaws.com/www.a4pt.org/resource/resmgr/credentials/standards_&_applications/rpt_standards.pdf

APT Credentialing Application: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://cdn.ymaws.com/www.a4pt.org/resource/resmgr/credentials/standards_&_applications/rpt_application.pdf

Name*

First NameLast Name

Licence Type*

Licence State & Number*

Licence Expiration Date*

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Have you completed Phase 1 and Phase 2 of the APT credentialing requirements?*

YesNoUnsure (The Foundation will review your training and supervision)

Choose your Phase 3 Program for Review:*

Option A: Participants need up to 24 hours of training and no more than 7 hours of RPT-S™ consultation to complete the APT credentialing requirements.Option B: Participants need between 25 to 47 hours of training and up to 12 hours of RPT-S™ consultation to complete the APT credentialing requirements.

Please write a 250-word statement explaining why you want to become a Registered Play Therapist™ and how you plan to use play therapy within the Black community. (Please ensure your statement is well-organized, clearly written, and reflects your genuine voice and intentions).*

We will be reviewing responses for

Upload your APT Application (Social Justice applications will not be accepted without a copy of you APT application. Your partially completed application will be used to verify that you are in Phase 3).*

Upload your CE certificates*

Upload your signed RPT-S™ Consultation Form (This is to verify how many hours you need to complete the required 35 hours).*

Consent and Acknowledgment I understand that acceptance into the "Get You To The Finish Line" Program is contingent upon the submission of all requested documentation and a thorough review of my application.

Yes

Please upload an image for identity verification.

Signature

Date