Motivational Interviewing Training Registration Request Form
This form is to request registration for ONE (1) of the three (3) Motivational Interviewing (MI) Training Cohorts with Kris Wright, LPCP. Trainings will take place weekly on a consistent day/time (8 consecutive sessions) lasting 2 hours. Video taping of practicing a minimum of four (4) of the skills, and review of tapes with the trainer is required for each person accepted into the training program. Maximum 15 people per training cohort. Registration will be sent on a first-come-first-served basis. Once the maximum of 15 people have been reached per cohort, the cohort will no longer be available. All cohorts will be 10:00am-12:00pm ET; cohort 1-Fridays 2/27/26-4/17/26, cohort 2-Tuesdays 4/28/26-6/16/26, cohort 3-Tuesdays 7/7/26-8/25/26
Name
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First Name
Last Name
Email
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example@example.com
Which CSC program are you with?
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Please Select
CAPSTONE
CHOP FEP
CSG EPIC
ENGAGE
HOPE
InSight
OMW
Pathways to Hope
PEACE
PERC
Safe Harbor
STEP
JH EPIC
JH EPIC-RAISE
UMD RAISE CP
MPRC FEC
Other
What role do you serve on your team?
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Please Select
Director/Team Leader/Admin
Prescriber/nurse/medical team member
Counselor/Therapist/Social Worker
SEES/Case Manager
Peer Specialist
Data Coordinator/ Research Assistant
Other
Can you commit to 8 sessions weekly and the required homework (video taped practice + review of tapes)?
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Yes
No
Name of supervisor you received approval from for this commitment:
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Please list examples of common conversation topics you would be interested in reviewing (e.g., substance use, hallucinations, delusions, medications, etc.):
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Click the submit button below to choose your training cohort
Submit
Questions?
Reach out to HeadsUp Education and TeleHealth Manager, Crystal Vatza, MSCC, LCP, BC-TMH at crystal.vatza@pennmedicine.upenn.edu.
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