Clinical Application 2025 Full Name *AddressTelephone Name of Graduate SchoolName of Degree Program (Psy.D. Ph.D. MA…)Current Year of Graduate Study (first, second, third year…)Do you speak Spanish or any other language; Please specify:Coursework From the list below, please circle courses you have takenTheories of Family TherapyMulticultural/Cultural Diversity CourseLifespan Development-particularly child/adolescent developmentEthics and Reporting LawsCrisis Intervention & Trauma (including suicide assessment & intervention)Other Intervention Courses (i.e. CBT, Psychodynamic) Please Specify Name(s) of Course(s):Other Intervention Courses (i.e. CBT, Psychodynamic) Please Specify Name(s) of Course(s):Clinical Interests & Experiences: Provide brief answers to the questions below. If you are granted an interview, you will be asked to more fully discuss your answers. Who and with what problems would you most like to work with clinically and how does this fit with your future career goals?What has been the extent of your clinical experience thus far?Do you have experience working with adolescents and or transition-aged youth?Do you have experience working with life crises? (Assessment of depression, suicide, dangerousness, mediation, and verbal conflict)Identify specific clinical theories of intervention that are appealing to you at this time:What experience do you have working with people of color, specifically with African-American and other black people?What do you know of Oakland’s community in terms of having knowledge about issues faced by youth and families?What personal strengths and skills do you bring into your clinical work?Do you have any other skills that might be helpful?What are your training needs? What are you hoping to learn?Time Availability Are you available all-day Thursday?Select OneYesNo What evenings (Mon-Thurs) are you available (up until 8:00PM)?MondayTuesdayWednesdayThursdayAre you available for Saturday On-call? (The typical commitment of time is about one Saturday every five weeks)Select OneYesNo What time limits or other restrictions should we discuss?Letter of recommendation from someone who knows your clinical work.Choose FileCurriculum Vitae.Choose FileSubmit RJOY_admin2025-01-28T18:15:41-08:00
