Boulder Psychotherapy Institute

Advanced Training in Applied Existential Psychotherapy (AEP)

An Experiential Psychodynamic Gestalt Approach   •   Boulder, Colorado

Register for Find a Local Therapist

Complete the first part of this form to add your free Basic Listing to the "Find a Local Therapist" directory. If you wish, you may go on to begin the process of creating your Expanded (paid) listing. You may fill out all or part of the Expanded Listing section. Your extra work will be saved but not published or charged for. After clicking the "Submit" button, you will "launch" your Basic Listing and receive a personal password. You may then return to the site at any time to modify or continue to Expand your entry.

In no case will you be charged until you are ready, even if you have started work on your Expanded (paid) Listing. Remember that you'll need your password to go back and edit both the Basic and the Expanded parts of the listing. Public users of the directory will see only the Basic part of the listing until you upgrade (Expand / pay / and launch) your listing.

Your free Basic Listing will become visible to the world as soon as you click any "Submit" button. Remember, no matter how much work you do on your Expanded (paid) Listing you will not be charged unless you complete the credit card authorization at the very end of the process (or make other arrangements with Reed). If you decide to authorize it, your credit card will be charged $150 for a one year Expanded Listing. (We will start our annual billing cycle on March 15th, 2010, so it's possible to get free exposure by signing up now.) If you Pay and Launch an Expanded Listing, you can be sure that we will help you in any way needed to make your listing as complete and attractive as possible.

We recommend that you write the sign-up form "descriptions" in a word processor. Then "save" your work, and then "copy and paste" into the form. (This is not absolutely necessary, but would secure and save your creative work.) Please be sure to click "Submit" each time you edit your entry, or your work will be lost. Send Reed an email if you have questions. He's happy to crop or edit your digital photo if you need help with that.

 Basic Listing
*First:
  Middle:
* Last:
  Company:
  Credentials:
Ph.D. Psy.D. M.D. D.D. R.N. M.A. M.S.
L.P.C. L.C.S.W. L.M.F.T. C.A.C. I C.A.C. II C.A.C. III
* Address:
* City:
* State:
* Zip:    Hide my address
  Phone:    Hide my phone
Short Description:
850 Characters Left
Hide this Listing:
* Email:   Email addresses are for BPI admin purposes only and not be shown on your listing.
* I am aware of, and follow, Colorado state laws regulating the practice of psychotherapy. I am also either an actively licensed mental health practitioner in the State of Colorado, or I am an unlicensed practitioner or licensed practitioner from another state who has completed the necessary registration as an unlicensed psychotherapist with the Colorado State Grievance Board. Or my field of practice does not require licensure or registration. For more information see http://www.dora.state.co.us/Mental-Health/.
You can stop now and create your free basic listing. Please help us fight spam by filling in the two words in the white box, then click the "Create Basic Listing" button.

Otherwise, you can continue filling out the expanded part of your listing. Any work you do on the expanded listing will be saved, and you can return at any time to view, edit, or pay to "launch" it, making it visible to users of the directory. When you are finished you can save the listing, or pay now and launch it immediately.
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 Expanded Listing
Image
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Expanded Description:
Office Address:
Office City:
Office State:
Office Zip:    Hide my office address
Office Phone:    Hide my office phone
Website:
Therapist Information
Therapist Gender:
  License or Registration:
Licensed Psychologist School Psychologist Psychiatrist
Psychiatric Nurse Licensed Professional Counselor Licensed Clinical Social Worker
Licensed Marriage and Family Therapist Certified Addictions Counselor Psychotherapist
   
  License Number:     State:
Years in Practice:
Fee Range:
Client Focus
  Mode of Therapy:
Individual Couple Family Group Organizational
       
Age Specialty:
Client Gender:
Client Sexual Orientation:
Ethnicity:
  Languages Spoken
(other than English):
American Sign Language Arabic Chinese French German
Greek Hebrew Italian Japanese Korean
Russian Spanish Tibetan  
Specialty Areas: (Check a maximum of 10)
1. Depression 2. Anxiety or Fears 3. Shyness or Social Phobia
4. Anger or Impulse Control 5. Addiction or Substance Abuse 6. Trauma or PTSD (Post Traumatic Stress Disorder)
7. Relationship & Marital Issues 8. Sex Therapy 9. Parenting Issues
10. GLBT Issues: Gay/Lesbian/Bisexual/Transexual 11. Open Relationship Issues 12. Domestic Violence
13. Divorce 14. Infertility 15. Adoption
16. Life Transitions 17. Work Issues 18. Diversity Issues
19. Grief or Loss 20. Spirituality 21. Creativity
22. Personal Growth 23. Chronic Pain or Illness 24. ADHD (Attention Deficit Hyperactivity Disorder)
25. OCD (Obsessive Compulsive Disorder) 26. Bipolar/Manic Depressive Disorder 27. Eating Disorders
28. Body Image Disorders 29. Brain Injury 30. Dementia
31. Tourette's Syndrome 32. Autism or Asberger's Syndrome 33. Sensory Integration
34. Learning Disabilities 35. Psychosis 36. Dissociative Disorders
37. Personality Disorders 38. Impulse Control Disorders 39. Attachment Disorders
40. Thinking Disorders  
Identify your top 4 specialties in order; use numbers above:   #1  #2  #3  #4
Treatment Approaches: (Check a maximum of 4)
Applied Existential Psychotherapy Art Therapy Bioenergetic Therapy
Body Oriented Psychotherapy Brainspotting Career Counseling
Cognitive Behavioral Therapy Core Energetic Therapy Dance Therapy
Dialectical Behavioral Therapy Eclectic Therapy EMDR (Eye Movement Densitization and Reprocessing)
Emotional Freedom Technique Existential Therapy Forensic Psychology and Psychiatry
Gestalt Therapy Hakomi Therapy Humanistic Therapy
Internal Family Systems Therapy Interpersonal Psychoanalysis Jungian Analysis
Jungian Oriented Therapy Modern Psychoanalysis Music Therapy
Neurolinguistic Programming Organizational Consulting Person Centered Therapy
Psychoanalysis or Psychoanalytic Psychotherapy Psychodynamic Therapy Psychological Testing
Rational Emotive Therapy Reichean Therapy Rubenfeld Synergy Method
Schema Therapy Self Psychology Sensorimotor Psychotherpay
Somatic Experiencing Therapy Somatic Psychology Transactional Analysis
Transpersonal Therapy Wilderness Therapy
* required
Now you can create your free listing OR pay for your extended listing and launch it immediately. Please help us fight spam by filling in the two words in the white box, then click the "Create My Listing" button.
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 My Information
This is a place to share information about yourself - books, publications, and the groups you lead. Also web links you'd like to share with others.

IMPORTANT! Please save any changes that you have made above by first clicking the "Submit" button, then return to this page to add to or edit "My Information."
My Publications/Media:
(May be added after initial registration)
My Presentations:
(May be added after initial registration)
My Groups:
(May be added after initial registration)
My Links:
(May be added after initial registration)
My Documents:
(May be added after initial registration)

1140 Lehigh Street, Boulder, Colorado 80305  •  303 494 0393

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