LGPS Institute Presenter and Experiential Leadership Application

Institute Presenter and Experiential Leadership Application
Thank you for your interest in contributing to an upcoming Louisiana Group Psychotherapy Society Institute. LGPS welcomes proposals from qualified professionals interested in serving as conference presenters and/or experiential group leaders. Please note that these opportunities are offered on a volunteer (pro bono) basis.
Eligibility Requirements

Presenters should be master's level clinicians or higher. Professional licensure is preferred. Preference may be given to Certified Group Psychotherapists (CGP) and individuals with significant group psychotherapy experience due to continuing education requirements.

Applicants are strongly encouraged to have attended and fully participated in at least one LGPS Institute. Familiarity with the LGPS Institute model, culture, community agreements, and experiential learning structure is an important consideration in the selection process for both presenters and experiential group leaders.

Individuals who have not previously attended an LGPS Institute may be considered on a case-by-case basis if they can demonstrate significant involvement with AGPA, advanced training in group psychotherapy, substantial group leadership experience, or other relevant qualifications that prepare them to contribute effectively within the LGPS Institute framework.
Presenter Benefits:
- Complimentary Institute Registration and Organizational Sponsorship for your agency or private practice, including:
  - One additional complimentary registration
  - Exhibitor table at the Institute
  - Logo recognition and visibility in Institute marketing and materials
  - Opportunity to briefly introduce and highlight your organization to attendees (approximately 5 to 10 minutes)
- Access to participant evaluation feedback following the Institute to support professional growth and future presentations
Experiential Group Leader Benefits:
- Complimentary Institute Registration
- Consultation and support from the Institute presenter before and during the Institute, including opportunities for case discussion and professional development
- Access to participant evaluation feedback following the Institute to support professional growth and future leadership opportunities
- Full Name
  
  First NameLast Name
- Degree/Credentials
  CIT, RAC, CAC, LAC, MSW, LMSW, LCSW, PLPC, LPC, LPC-S, CGP
- Organization/Practice Name
- Email Address
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Current Professional Role(s)
- Brief Professional Biography
- Upload CV
  
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- Have you previously participated in an LGPS Institute?
- If yes, please indicate:
  
  Other
- Have you previously served in a leadership role with LGPS?
- Statement of Interest
  Please describe your interest in contributing to LGPS and any relevant experience related to your proposed topic or group leadership.
- Diversity, Equity, Inclusion, and Belonging Statement (Optional)
  
  Please share any considerations related to diversity, equity, inclusion, accessibility, or cultural responsiveness that are incorporated into your work.
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- Which role(s) are you applying for?
- Eligibility Reminder:
  
  Presenters should be master's level clinicians or higher. Professional licensure is preferred. Preference may be given to Certified Group Psychotherapists (CGP) and individuals with significant group psychotherapy experience due to continuing education requirements.
  
  Important Note for Co-Presenters:
  
  If a presentation has multiple presenters, each presenter must complete and submit a separate proposal form.
- Will this presentation have a co-presenter? Please note: A maximum of two presenters is permitted per presentation. If you have a co-presenter, each presenter must complete and submit a separate proposal form.
  
  Other
- Presentation Title
- Presentation Description
  Please provide a concise description of your proposed presentation.
- Learning Objectives
  Please provide 4 or more learning objectives.
- Describe your experience and expertise related to this topic.
- Describe your group psychotherapy experience.
- Have you previously presented at professional conferences, workshops, trainings, or institutes?
  
  Other
- Are you able to present on Saturdays during the Fall Institute season? Please identify any Saturdays in September or October that you are unavailable.
- Organization's Logo
  
  Please upload your organization's logo if you would like it to be included in complimentary sponsorship marketing and materials.
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- Additional Comments
- Presenter Support Commitment
- Eligibility Reminder:
  
  Experiential Group Leaders should have meaningful group leadership experience. Preference is given to master's level clinicians, licensed professionals, and Certified Group Psychotherapists. Applicants must have attended and fully participated in at least one LGPS Institute.
- Credentials and Qualifications Relevant to Group Leadership
- Describe your group therapy and/or experiential group leadership experience.
- Have you previously led an experiential group for LGPS?
- If yes, please describe.
- Please confirm that you have attended and fully participated in at least one LGPS Institute.
- Are there any materials, room configurations, or accommodations required?
- Are you available to facilitate on Saturdays during the fall institute season? Please identify any Saturdays in September or October that you are unavailable.
- Additional Comments
- I understand that submissions will be reviewed by the LGPS Institute Planning Committee based on factors including applicant qualifications, group psychotherapy experience, relevance to the institute mission, educational value, diversity of offerings, and programmatic needs. I understand that submission does not guarantee selection and that LGPS may contact applicants regarding other volunteer opportunities that align with their experience and interests.
- By checking this box, I acknowledge and agree to the statements above, confirm that I have reviewed the LGPS Guidelines for Institute Participants, and agree to uphold the principles, expectations, and responsibilities outlined therein if selected to serve as a presenter and/or experiential group leader.
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