Small Group Case Consult Provider Application

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Form Instructions

Small Group Case Consultation Providers take on an expanded leadership and educational role within the SE™ community. Group case consultations include elements of the teaching function, so special attention has been given to establishing criteria at this level of approval. Those approved for small group case consults will be on the SE Faculty Track or will have significant related teaching or group consultation experience. Assisting at SE Professional Trainings and providing individual case consultations are not considered sufficient experience to qualify as an SE small group case consult provider.

Case consultation groups are intended for review of SE course material and consultation about clients with whom the SE student/SEP is working. Approval as a small Group Case Consultation Provider does not authorize the provider to make actual presentations of SE material or to otherwise engage in teaching SE methods.

We appreciate the service that our approved case consultation providers offer to our students. We understand that providers also benefit professionally and financially from offering these sessions. Please note, however, that being a case consultation provider should not be considered a career path. We cannot guarantee that providers will progress through the provider levels or maintain approval to provide credited sessions/consults after receiving initial approval. Please be sure you have read and understood our Group Case Consult Provider Guidelines.

Completing this application will take about 20 minutes. Please note that you will be required to upload your curriculum vitae(cv) or resume and faculty recommendations during this application process. In addition to this application, you are also required to sign the Provider Informed Consent & Release Agreement. You will be given a link to the agreement in the application.

Please make sure all required documents are included. Incomplete applications will cause a delay in processing. Once your application has been submitted you will receive a confirmation email. If you do not receive this confirmation email, please contact the Assisting Team.

Please allow up to 4 weeks for your application to be processed. Once approved, you will receive a letter via email authorizing you to provide Individual Consultations at the level of your application and approval.  This letter may be presented to your local organizer, lead assistant or faculty member as proof of your authorization. 

If you have questions, please visit our FAQs . If you have additional questions or need further support with your application, please schedule an Assistant and Provider Graduate Services Appointment from the Contact Page of our website.  

Before starting the application, make sure you have:

CV/Resume
2 Faculty Recommendation Forms
Signed the Provider Informed Consent Agreement

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Contact Information

First Name

Last Name

Email

This should be the email on file with SEI.

Phone

Please enter a valid phone number in the international format.

Address

Street Address

City

State/Province

Zip Code/Postal Code

Country

Consent Agreement

I have signed the Provider Informed Consent Agreement.

YesNo

Link for Consent Agreement

Provider Informed Consent Agreement

Click the link to sign the agreement. The agreement will only need to be signed once by each individual applicant and will be applicable for approval to provide personal sessions, and individual or group case consults. You will be directed away from the application to sign. Please return to complete application submission.

Provider Documents

I am already an approved assistant internationally and have my EASE/ABT Approval to upload in place of the Faculty Recommendation Letter.

YesNo

Upload your EASE/ABT Approval here.

Please upload PDF File.

Please upload your resume or CV.

Please upload PDF File.

Please upload a Small Group Case Consultation Recommendation Form from a SE Faculty Member for this level. (Two recommendations are required.)

Please upload PDF File.

Please upload a second Small Group Case Consultation Recommendation Form from a SE Faculty Member for this level.

Please upload PDF File.

Please submit your SEP Certificate of Completion.

Please upload PDF File. In order to qualify to be an assistant or provider you are required to be an SEP.

Other Information

Please list all languages in which you feel comfortable working.

Additional Comments

Agreements and Expectations

Please make sure all required documents are included. Incomplete applications will not be accepted.

If you have questions, Please visit our FAQs. If you cannot find answers to your questions there, you may contact via our Contact Us page.

Please allow up to 3 weeks for your application to be processed. Once approved, you will receive a letter via email authorizing you to assist or provide sessions at the level for which you have applied. This letter may be presented to your local organizer, coordinator or faculty member as proof of your authorization.

Please select if you do not wish your information to be included on the publicly available SE Credit Provider List. Provided information includes name, work phone, email, professional title, city, state/province, country, languages spoken, and levels approved for.

Is the information you have previously provided regarding your Name, Profession and/or Title, languages spoken, address, email and phone number the same information you would like used for your listing?

YesNo

Provider Information Update

We would like to make sure we have the right information for your listing. Please fill out the fields below and an SEI Staff Member will work to update the information on the back end.

First Name

Last Name

Email

Phone Number

Profession

Title

Address

Street Address

City

State/Province

Zip Code/Postal Code

Country

Agreements and Expectations

Follow the link to read Agreements and Expectations between Somatic Experiencing® International, faculty, assistants, students, coordinators, SEP’s, committee members, administrative staff, and all participants involved in the organization, to promote a welcoming and supportive environment.

By submitting this application, I certify that all the information included in this application is true and complete.

I acknowledge that the Somatic Experiencing International reserves the right to approve or deny any application, revoke approval at any time, and approve or deny the participation of any person, in its sole discretion, with or without cause, and in accordance with its policies and the law.

I have read the Agreements and Expectations and understand the conduct agreements between Somatic Experiencing® International, faculty, assistants, students, coordinators, SEP’s, committee members, administrative staff, and all participants involved in the organization, to promote a welcoming and supportive environment. I acknowledge that I will adhere to the Agreements and Expectations in all activities related to Somatic Experiencing International.