Inclusive Therapists Membership Application

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Hi, we're glad that you're here. Are you the owner or leader of this group practice?* This field is required.

YESNO

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Thank you for your interest in applying on behalf of this practice. We kindly ask that the owner or leader of the practice complete the application instead.

If you’d like to create your own independent directory profile (not on behalf of the group), please follow this link to sign up for our Simple Plan instead.

We look forward to getting to know you!

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Wonderful! As a kind reminder, please complete this verification personally — not on behalf of your organization. (Each team member you add as a sub-account in the future will also need to complete their own verification before their directory profile can be activated.)* This field is required.Thank you for your care in this process.

YES, I UNDERSTANDNO, I will reach out for clarity

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Warm welcome! Do you currently have an Inclusive Therapists account (including Scholar membership)?* This field is required.

Yes, I have an accountNo, this is new for me

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Wonderful! We invite you to click here to log in and complete the verification process through your account.

This link is also available on your Dashboard. We'll see you there, thank you!

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Transparency and Intent Check

This community centers the needs of Black, Brown, Indigenous, People of Global Majority and our intersections (e.g., 2SLGBTQIA+, Neurodivergent, Disabled communities of color/global majority).

Site-users are predominantly Black, Brown, Indigenous, People of Global Majority with intersecting marginalized identities seeking providers with shared lived experience.

Providers without said shared lived experience who are interested in referrals alone: we encourage you to join our free Scholar Membership to participate in community and learn alongside us first.

If you wish to join in alignment with and support of our mission, please continue.

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We invite you to pause and reflect:

Have you completed all of the required readings?

If so, are you able to clearly name tangible actions you are taking in alignment with this community’s values and priorities?

If yes, we warmly invite you to continue.
If not, we encourage you to take the time you need and return when you are ready to.

There is no rush -- this process is about moving with intention and clarity.

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We welcome post-graduate, licensed mental health professionals to join us, including:

psychotherapists and counselors
relationship, marriage, family therapists
clinical social workers
psychologists
psychiatrists and psychiatric nurse practitioners

Post-graduate provisionally licensed therapists (e.g. licensed associates and interns) are welcomed to join. On your profile, please state your location of residency and/or clinical supervisor's name, as required by your licensing board.

Coaches (and providers divesting from licensure): please review this FAQ and reach out to us first to assess for fit.

Students & student interns: we invite you to join our free Scholar membership. You are welcomed to upgrade to a directory profile after graduation, when you begin your licensure journey.

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Please have credentials ready to upload:

Licensed or provisionally-licensed providers: your current license, or your supervisor's license
Post-graduate, pre-licensed providers: your supervisor's license
For coaches and providers divesting from licensure: relevant forms of credentials that support your practice

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Verifying Authenticity

We deeply value transparency and integrity. Submitting AI-generated responses compromises safety and places unnecessary burden on our team (and our planet), thus resulting in disqualification.

Spelling and grammar are not important here. We encourage you to respond in your own words to help us better understand who you are.

Every response is reviewed by our team, and we utilize AI-detection tools as part of this process. In the spirit of collective care and safety, please ensure that all responses are written entirely by you and are not generated or modified by AI. Thank you.

Note: Voice messages, video & ASL recordings are warmly welcome! Please click here for directions.

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In the spirit of community, please confirm that this application is written entirely in your own words, and that it is not AI-generated: Type "VERIFY" below.* This field is required.AI-generated content can result in disqualification of one's application.

Type "VERIFY" above if your response was not AI-generated.

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Firstly, what is your name?* This field is required.Chosen or preferred names warmly welcomed!

First Name

Last Name

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Welcome {firstlyWhat}! What's your email address?* This field is required.

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

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What does Landback, Indigenous Sovereignty, and Reparations mean to you, based on your identity & relationship to this Land?* This field is required.If you (and your lineage) have benefited from living on Stolen Land and from exploited Black labor, we invite you to share how you relate to these movements, along with any meaningful, tangible actions you’ve taken in response. If you haven’t taken tangible action yet, let us know here — we’d be glad to share resources and extend an invitation to mobilize with us.

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In what ways have you responded to the ongoing genocides in Palestine, Congo, Sudan, Tigray and violently exploited regions?* This field is required.This community is boldly anti-genocide. Kindly share any specific, tangible action that you've taken. If you haven’t taken tangible action yet, let us know here — we’d be glad to share resources and extend an invitation to mobilize with us.

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What are some practical, proactive ways that you integrate anti-carceral strategies into your practice? (i.e., reduce risk of state surveillance, police intervention, involuntary hospitalization). Please include the names of at least 2 specific non-carceral resources that you offer. (Please be specific, and refer to "Differentiating Between Carceral, Less-Carceral, Non-Carceral" on this page for guidance).Being specific about local resources is encouraged and will help expedite the verification process. If helpful, please refer to the required readings for guidance.

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What is your current role?* This field is required.Please select all that apply.

Licensed Provider

Post-Graduate, Pre-licensed Provider (Under Supervision)

Coach, Paraprofessional, or Provider Divesting from Licensure

Student or Student Intern

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For coaches and providers divesting from licensure:

Due to the vastness of the "coaching umbrella", suitability for our directory is verified on a relational, case-by-case basis. We require coaches with formal mental healthcare training to kindly contact us before proceeding.

If you have already received confirmation from us, please proceed.

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Do you agree with all 3 of these statements? 1) I received confirmation that my coaching practice is a fit for this directory 2) I will not claim to offer clinical services without a license 3) I will clearly showcase my credentials to inform visitorsPlease tell us if you agree:

YESNO

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Thank you! Have you ever had a license suspended or revoked? If yes, please pause here and contact us before continuing to apply.* This field is required.

YESNO

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Please kindly click here to contact us before continuing to apply. We're here to listen. Thank you.

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Please upload your credentials here:* This field is required..PDF, screenshot or a photo of your credentials are accepted. Thank you!

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files

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1. On Identity & Community: We invite you to share your positionality, and briefly describe your relationship to QTBIPOC communities. What does being in a QTBIPOC-centered community mean to you?* This field is required.Positionality refers to how your identity intersects with power and social structures. QTBIPOC is an imperfect, shorthand acronym for Queer & Trans Black, Indigenous, and People of Color — including Queer, Trans, Nonbinary, Intersex, and ACE+ Black, Brown, Indigenous, People of Global Majority This term emphasizes intersectionality, reminding us that QTBIPOC experiences are distinct and not synonymous with the broader LGBTQIA+ community.

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2. On Racial Justice: How do you integrate racial justice values in your work and communities? Feel free to share your reflections on areas such as: tending to racialized trauma, addressing anti-Blackness/colorism, solidarity building, etc. In honor of those whose shoulders we stand upon, please share the frameworks or lineages that ground your work, including your (QT)BIPOC teachers or mentors.* This field is required.If you have white body/skin privilege, please also share with us your developmental work on your relationship with “whiteness”, and actions you take towards dismantling white supremacist ideology personally and professionally. Please be specific about the frameworks or lineages that ground your work, and who your (QT)BIPOC teachers are.

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3. On Gender and Sexuality Justice: How do you integrate gender and sexuality justice values in your work and communities? Feel free to share your reflections on areas such as: cis-heterosexism, intersectionality, culture, spirituality, etc.* This field is required.If you have cisgender and/or non-queer privilege, please also share with us ways that your practice offers 2SLGBTQIA+ affirming care. Please provide specific examples.

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4. On Disability, Fat, and Neurodivergence Justice: How do you integrate disability justice values in your work and communities? Feel free to share your reflections on areas such as: anti-carceral care, class and ableism, tending to internalized ableism, etc.* This field is required.If you currently have non-disabled, thin-body, and/or neurotypical privilege, please also share with us ways that your practice is designed to uplift the needs of Disabled, Fat, and Neurodivergent people. Please provide specific examples.

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Ready to send? Click Review and Submit below to review your responses, and send it our way.

Thank you for taking time to share your story with us. We will get in touch once we review your application. Sending you gratitude, and wishes of rootedness and ease.

Warmly, the Inclusive Therapists Team