Application: Experiential Psychedelic-Assisted Therapy Training Apr23

Experiential Psychedelic-Assisted
Therapy Training Application

IN PERSON • LOS ANGELES, CA •

APRIL 18-23, 2023

Name

Which dates are you applying for?

IN-PERSON ATTENDANCE: Our March 2025 training is held in-person in Los Angeles: Sunday March 30th to Friday April 4th

I acknowledge that I am available for all in-person training dates and times

SCHOLARSHIP: Are you applying for a scholarship? Please only check this box and apply if you would otherwise be unable to afford this training. See further scholarship details at the bottom of this page.

Phone Number

Date of Birth:

Address

City

State

Zip Code

Country

Preferred Pronouns

Education background: Please share your past education experience (degrees, trainings, and certifications):

Current Occupation and Licensure Type/State: (Note: Clinical license required)

Person we should contact in case of an emergency:

Name and telephone number of your Primary Care Physician:

Are you taking any regular medications? If so, what?

Let's shift gears! Now, we would like to know more about you and your past experiences. Please keep your following responses to a brief paragraph or two.

In what capacity have you facilitated psychedelic medicine, if any? Experience not required for trainees .

What influence has psychedelic medicine had on your life?

What is your “why” for wanting to apply and attend?

What concerns or fears do you have about working with psychedelic medicine?

Have you or anyone in your family been hospitalized for a psychiatric illness?

Have you ever been hospitalized for a psychological difficulty?

Are you currently working with a psychotherapist or mental health counselor?

Please describe your eating habits and relationship with food:

Are you currently experiencing significant sadness, depression, grief, or emotional distress?

Are you currently experiencing significant anxiety or panic attacks?

How often do you drink alcohol? What amount?

Have you had a dependency on alcohol or recreational drugs?

Have you ever had or do you now have a prescription drug dependency or substance use difficulty?

Are you currently pregnant or could you possibly be pregnant over the span of the training?

Check this box to remind yourself to take a deep breath :) Thanks for taking the time to fill this out. You are almost there!

What is your personal growing edge that you would like to address in this training?

Do you have a relationship with spirituality? What does your spiritual practice look like?

Do you meditate? If so, how often?

Do you have circles of regular support in your life (therapy, family, friends)? Please describe:

What coping mechanisms and defense strategies are your “go to” patterns for dealing with life’s stressors?

At Inbodied, we firmly and wholeheartedly believe that integration is at the heart of efficacy and responsibility when working with psychedelic medicine. What does integration mean to you and how would you practice it now?

If you are a psychotherapist, do you have a prescribing physician with whom to partner?

Yes

If you are a medical doctor or nurse, do you have a psychotherapist who is qualified to support with psychotherapy and/or integration?

Yes

Please submit a short, 3-4 paragraph personal narrative, including any relevant information you want us to know about you, and what your vision is for working with psychedelic medicine in the future?

Confirm that you have reviewed and agree to the Application Fee, Deposit, and Cancellation Policy details below.

Yes (required)

Today’s Date:

Typed Name (to act as Signature):

Cancellation Policy

Full tuition payment is due within a week of acceptance notice.

Application fees are non-refundable (with exceptions for Scholarship applicants). We are unable to transfer tuition payments to a subsequent training in the event of any cancellations. Please understand that cancellations impose a burden on our staff and the below policy covers us in the event we are unable to fill a cancelled spot.

If you cancel more than 60 days prior to the training start date, you will receive a full refund of tuition fees, minus deposit.
If you cancel between 60 and 30 days from the training start date, you will be refunded 75% of tuition fees.
If you cancel less than 30 days from the training start date, you will be refunded 50% of tuition fees.
Cancellations 2 weeks or less from the training start date forfeit all of the tuition fees.

Accommodations & Meals

Accommodations are (all but) required and highly encouraged. Trainees will be staying at our training retreat center in Topanga Canyon in Los Angeles for 5 nights (April 18, 19, 20, 21, 22). Prices range from $850-$1500 for five nights.

Meal options include dinner Wednesday evening through breakfast Sunday, set rate of $500/vegetarians or $575/meat eaters—all-inclusive for five nights, six days.

Scholarships

Inbodied believes ketamine-assisted psychotherapy should be made inclusive and accessible to all people regardless of race, gender, socioeconomic status, or marginalized identities.

Scholarships are available for our KAP Trainings based on financial need, BIPOC or other marginalized identities, and a commitment to serving disadvantaged communities.

If you are in need of a scholarship to attend, please indicate that in the Scholarship Application question on the training application and you will be sent a link to fill out the Scholarship Application. As a limited number of scholarships and application slots are available, please only apply if you would otherwise be unable to afford this training. We ask that all scholarship awardees pay the $500 deposit as an investment in this training. Please note that scholarships do not include food or lodging fees.

Deadlines for scholarship applications are listed within course registration pages. Applicants will be contacted once scholarship award decisions have been made. Scholarship applicants not chosen will receive a full refund for their application deposit. Please only apply for one training scholarship opportunity at a time.

Scholarship Application: Click here to apply.

*This scholarship program was modeled after PRATI Group. Thank you!

Experiential Psychedelic-AssistedTherapy Training Application

Cancellation Policy

Accommodations & Meals

Scholarships

Join Our Free Trial

Experiential Psychedelic-Assisted
Therapy Training Application