Application for the AAP Program:

Anthroposophic Psychotherapy Certification Program

(an Educational Program)

Starting Date for Module #1: October 13, 2023

APCP Program Timeline October 2023-August 2025

Today’s Date:

Applicant’s Name:

Mailing Address (Street, City, State, Zip Code, Country):

Telephone Number:

E-mail address:

Profession:

While the Certification Program in Anthroposophic Psychotherapy is designed particularly for licensed psychotherapists, we also welcome applications from medical professionals and others who work psychotherapeutically with clients, with the understanding that in these cases full certification as an Anthroposophic Psychotherapist may not be possible.

State or Jurisdiction, License Type, and License Number:

Please paste the URL for a webpage where your license status can be verified:

Please paste the URL for any webpage (homepage) regarding the services you offer to clients:

Please let us know the average number of sessions you provide per week for clients:

Please list the 3-year program in Anthroposophic Psychology or Anthroposophic Psychotherapy which you have completed, along with the name of the institution providing the program and the years attended. Example: AAP 3-year Certificate Program in Anthroposophic Psychology, CA Cohort, 2014-2017:

If you are an international applicant or your 3-year training was not from AAP, please give the name and email of an individual who was in charge of your training. If possible, please also email a document which shows the curriculum of the training in Anthroposophic Psychology or Psychotherapy that you completed. Name and email of director of my training:

Did you complete a capstone project or research paper during your 3-year training in Anthroposophic Psychology? If so, please give the year and title:

Please attach your capstone project or research paper (if any) to the email when you submit this application.

Professional degrees and/or certifications with name of institution and year:

Please share with us the various modalities of therapy and/or schools of therapy which influence your own practice:

Please share more about your therapeutic practice. Do you specialize in certain types of clients or in the treatment of certain types of disorders? Do you see clients of all ages? Do you engage in group therapy, couples therapy, family therapy, or other modalities? Do you work in an integrative way with other practitioners?

Please share with us what you are most interested in learning or experiencing as part of your participation in the Anthroposophic Psychotherapy Certification Program:

Please tell us about any modalities or specific areas of expertise which you might like to share with the cohort during our time together:

I give permission for my email to be included in a group email list/thread for trainers and participants in the Anthroposophic Psychotherapy Certification Program. ☐ Yes or ☐ No

I give permission for my contact information (full name, email, and telephone number) to be shared with trainers and participants in the Anthroposophic Psychotherapy Certification Program.

☐ Yes or ☐ No

I give permission for my image (from any candid or posed photographs or videos during the training) to be utilized in promotional or educational material for the Association for Anthroposophic Psychology. ☐ Yes or ☐ No

Are you seeking official certification in Anthroposophic Psychotherapy from AAP? ☐ Yes or ☐ No

Do you attest that you have read the requirements for Certification in Anthroposophic Psychotherapy which are listed on the AAP website (anthroposophicpsychology.org)? ☐ Yes or ☐ No

Do you attest that you have at least three years of experience providing psychotherapy under a professional license? ☐ Yes or ☐ No

Can you commit to attending the full Anthroposophic Psychotherapy Certification Program, consisting of seven modules, from October 2023 through August 2025, totaling six online weekend modules (Friday night through Sunday), plus one in-person 3-day module in Pennsylvania (see online schedule)? ☐ Yes or ☐ No

(Required for certification in anthroposophic psychotherapy from AAP. Completion of the full 2-year program will be indicated on the certification you receive once you have met all certification requirements.)

Please include any comments related to your anticipated attendance:

Please note that only one module can be made up due to illness or absence, and this will require additional time and work on your part to verify your comprehension of missed program content. Full program participation is highly valued and encouraged if you are seeking certification in anthroposophic psychotherapy.

Can you commit to attending live online anthroposophic psychotherapy educational sessions (on Monday evenings) at least 10 times over two years? ☐ Yes or ☐ No

(Required for certification in anthroposophic psychotherapy from AAP.)

These are Monday evening sessions, separate from the modules, and they may be recorded.

Can you commit to attending live online case consultation/presentation groups (on Monday evenings) a minimum of 10 times over two years? ☐ Yes or ☐ No

(Required for certification in anthroposophic psychotherapy from AAP.)

These are Monday evening sessions, separate from the modules, and they are NOT recorded.

Can you commit to completing 3 written case studies (over 2 years) which include a case conceptualization and treatment approach that incorporates anthroposophic perspectives and demonstrates a capacity to appraise and provide integral treatment which falls within the purview of anthroposophic psychotherapy? ☐ Yes or ☐ No

(Required for certification in anthroposophic psychotherapy from AAP.)

Do you attest that you will fulfill the financial contract you arrange with AAP for payment for participation in the Anthroposophic Psychotherapy Certification Program? ☐ Yes or ☐ No

Please note that delayed completion of certification requirements after the August 2025 program end date may involve additional charges to review and verify certification requirement completion.

Are you interested in receiving Continuing Education Units (CEUs)? ☐ Yes or ☐ No

Please note that while we seek to provide CE units for our seminars, these cannot yet be guaranteed.

Please indicate the licensing body which your CE units need to be approved for:

Please note that while we seek to provide CE units for our seminars, these cannot yet be guaranteed, nor can we guarantee that your specific licensing body will accept the CE units we are able to provide.

Have you ever had action taken against you for unprofessional conduct by a licensing agency or professional organization? ☐ Yes or ☐ No

Please indicate the organizational Code of Ethics which you promise to abide by, for example: American Psychological Association, American Counseling Association, Canadian Counseling and Psychotherapy Association:

Are you willing to abide by the Code of Ethics of the International Federation of Anthroposophic Psychotherapy Associations (IFAPA)? ☐ Yes or ☐ No

Additional comments. Please write here anything else you would like us to know about you, your application, and your participation in the Anthroposophic Psychotherapy Certification Program:

Do you attest that the information that you have provided is true? ☐ Yes or ☐ No

Your Signature:

Please continue to review and sign the following Enrollment Agreement.

Enrollment Agreement

Informed Consent

I attest that I am over the age of 18.

I attest, to the best of my knowledge, that I have no physical or psychological condition that would preclude me from taking this course.

I understand that I am registering for an instructional course that may involve physical, emotional, and psychological activities and that, in all such undertakings, there is always a risk involved.

I understand that the instructional staff cannot always monitor my physical, emotional, and psychological state, and I am therefore responsible for assessing the risk that any activity poses for me and for choosing a safe course of action and self-care.

I understand that I can always choose to refrain from any activity that might become overly stressful and/or risky for me.

I understand that due to the nature of this course (when held in person), there may be physical contact between the training staff and students, or student to student in educational exercises. I understand I always have the right to refuse or decline to be touched or use touch in educational exercises.

Certification in Anthroposophic Psychotherapy

I understand that the terms ‘Certified in Anthroposophic Psychotherapy’ and the title ‘Anthroposophic Psychotherapist’ are used by the Association for Anthroposophic Psychology (AAP) and member organizations of the International Association of Anthroposophical Psychotherapy Associations (IFAPA) to identify graduates of a certification program in anthroposophic psychotherapy who obtained certification and who are legally authorized in their local/state/province or country to practice as a mental health professional.

I understand that the terms ‘Certified in Anthroposophic Psychotherapy’ and ‘Anthroposophic Psychotherapist’ do not, in any way – real or implied – supersede local laws governing my legal authorization to practice as a mental health professional.

Confidentiality and Data Protection Agreement

I understand that when I choose to share data (information) in the training, that data is considered “made public” to the participants of the training in the course of the training, and is not confidential.

I understand that I am in control of my own data (what information I choose to share, and the means by which I choose to share it).

I understand that in the course of training, I may be exposed to personal information shared by course facilitators and students. I agree to hold this information in confidence as I would confidential information, whether it is shared in a practice exercise or in the course of contact with other students or trainers, during or after the training course.

I understand that in the course of training, I may be exposed to personal information shared by course facilitators and students about their own clients (historical and current). I agree to hold this information in confidence as I would confidential information, whether it is shared in a practice exercise or in the course of contact with other students or trainers, during or after the training course. If at any point, I am able to identify a client being discussed, I agree to state this and remove myself from the activity which includes such disclosures.

I agree to not share any personal data* in any written or audio-video recorded educational activities (digital or hard-copy) excepting my own name. (*”Personal data” includes full name, address, birth date, social security number or other identification number.).

I agree to not share any personal data* of any of my clients (historical or current) in any written or audio-video recorded educational activities (digital or hard-copy). When writing or speaking about specific cases, I will conceal identifying information. (*”Personal data” includes full name, address, birth date, social security number or other identification number.).

I understand that I may submit assignments to AAP faculty and trainers for the purposes of assessment and feedback; and I allow faculty and trainers the permission to review the data within those assignments.

Your Signature:

Signature Date:

Thank you so much for completing the application and enrollment agreement for AAP’s Anthroposophic Psychotherapy Certification Program. Please email your completed application (plus any existing capstone project) to: admin@anthroposophicpsychology.org

Friendly Disclaimer: Please note that the Anthroposophic Psychotherapy Certification Program is set up as a schooling in spiritual, or esoteric psychology and psychotherapy. The program is an educational schooling. While self-development and mental health are comprehensively addressed conceptually, and through experiential activities, the program is NOT designed to be a group therapy experience. One cannot achieve a professional ethical standing as an anthroposophic psychotherapist/counselor without a creditable licensure in a designated mental health discipline plus a comprehensive schooling in anthroposophic psychotherapy. Lastly, the program supplements conventional academic achievements. It does not grant a recognized licensure in mental health, psychotherapy, social work, psychology, or counseling.