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.

Tip: if you want only a Basic Listing, but you go ahead and complete the checkboxes for the Expanded Listing, your Basic Profile will be found (along with the Expanded Entries) when users search for "Specialty Areas' or "Treatment Approaches".

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 as a one time fee.

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:
B.A. Ph.D. A.T.R. Psy.D. M.D. D.D. M.Ed
Ed.D R.N. M.A. M.A., M.A. M.S. L.A.C. L.P.C.
L.P.C.C L.C.S.W. LSW M.S.W. N.C.C. L.B.S.W. L.M.F.T.
MFT MFTC L.M.H.C. C.A.C. I C.A.C. II C.A.C. III B.A.C.P.
BC-DMT RPT J.D. S.E.P.    
  If you have a specific accredited academic credential, or state license that is not included among the check boxes, you may request that it be added by emailing BPI.
* Address:
* City:
* State:
* Zip:    Hide my address
  Phone:    Hide my phone
* Short Description:
  (required)

850 Characters Left
Hide this Listing:
* Email:   
Email addresses are for BPI admin purposes only and not be shown on your listing.
* Compliance: I am aware of, and follow, Colorado state laws regulating the practice of psychotherapy. I am also either an actively licensed, or registered, mental health practitioner in the State of Colorado, or I am a registered practitioner, or licensed practitioner from another state who has completed the necessary registration as a registered psychotherapist with the Colorado Department of Regulatory Agencies. Or my field of practice does not require licensure or registration. For more information see Colorado Dept. of Regulatory Agencies (DORA).
IMPORTANT INSTRUCTIONS:

If you stop now, (and click the"Create Basic Listing" button) you will have created your "Free Basic Listing". Or, you can continue-on to begin creating your "Expanded Listing". If you go on, you can return any time to work on it more. You won't be charged until you specifically indicate you want to "Pay and Launch".

Once you "Submit" your profile you will receive a password by email so that you can "Log-In" to return. The "Log-In" link is in the left column of the "Find a Local Therapist" page. Once you "Log-In" you can edit or expand your listing. If your password doesn't arrive it will be in your computer's email spam filter, or in your ISP's, email spam filter. You can also ask Reed to generate a new password and email it to you.

Your email address is your unique identifier, so you cannot create another account with that password. You will need to "Log-In". In other words, if you have a "Basic Listing", you need to "Log-In" to change it, or make it into an "Expanded Listing".

You can continue filling out the "Expanded" part of your listing now or at any time. Any work you do on the "Expanded Listing" will be saved, and you can return at any time (with your password) to view, edit, or "Pay and Launch". This will make your profile visible to users of the directory.

Please Note — The items in the very bottom category — "My Information", can only be added after you have created an "Expanded Listing" and returned (Logged-In) with your password.

You can edit and "Submit" (Create Listing) as often as you like without being charged. When you are ready you can choose "Pay Now and Launch" from the "User Option Page" which is presented when you "Log-In". Under no circumstances will you be charged until you indicate are ready to pay.

* Security:

Expanded Listing

You may continue to work on an expanded listing. You will not be charged our one time fee of $150.00 unless you choose "Pay and Launch" and then select either pay by credit card or pay by check. If you continue, your work will be saved when you click "Create My Listing." You can return anytime via the small log-in link, at the very bottom of our BPI web pages. Use your email address and password to log in.

Image:
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How do I upload my picture?
Add a Video: I have a short video I would like to display on my expanded page. Please send me additional instructions.
I would like help in creating a short video. Please send me information about third party assistance.
I do not want a Video right now. A video can be added later by contacting Reed.
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 (M.D.)
Psychiatric Nurse Licensed Professional Counselor L.P.C.C.
Licensed Clinical Social Worker LSW M.A., M.A.,
Licensed Mental Health Counselor Licensed Marriage and Family Therapist Certified Addictions Counselor
Registered Psychotherapist Licensed Addiction Counselor BACP Sr. Reg. Psychotherapist & Supervisor
Coach  
  If you have a license or registration that is not included here among the check boxes, you may request that it be added by emailing BPI.
  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 45.Hearing Loss 5.Addiction or Substance Abuse
6.Trauma/PTSD (Post Traumatic Stress) 7.Relationship & Marital Issues 8.Sex Therapy
9.Parenting Issues 46.Introversion 10.GLBT Issues
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 (Attn. Deficit Hyperactivity) 25.OCD (Obsessive Compulsive Disorder)
26.Bipolar/Manic Depressive Disorder 27.Eating Disorders 28.Body Image Disorders
29.Brain Injury 30.Dementia 31.Sensory Integration
32.Learning Disabilities 33.Psychosis 47.Play Therapy
48.Teen Issues 49.Young Adults 34.Dissociative Disorders
35.Personality Disorders 36.Impulse Control Disorders 37.Attachment Disorders
38.Thinking Disorders 39.Family Therapy 40.Death & Dying
41.Bereavement 42.Peri-natal Mood Disorder 43.Adult Children of Self Absorbed Parents
44.Tinnitus  
Identify your top 4 specialties in order; use numbers above:   #1  #2  #3  #4

If you have a specific specialty area that is not included here among the check boxes, you may request that it be added by emailing BPI.
Treatment Approaches: (Check a maximum of 4)
Applied Existential Psychotherapy Acceptance & commitment thpy (ACT) Art Therapy
Bioenergetic Therapy Body Oriented Psychotherapy Brainspotting
Career Counseling Cognitive Behavioral Therapy Contemplative Psychotherapy
Core Energetic Therapy Dance Therapy Dialectical Behavioral Therapy
Eclectic Therapy EMDR Eye Mvemnt Desensitization & Reprocessing Emotional Freedom Technique
Energy Psychotherapy Existential Therapy Family Therapy
Focusing Forensic Psychology and Psychiatry Gestalt Therapy
Hakomi Therapy Humanistic Therapy Hypnotherapy
Internal Family Systems Therapy Integrative Therapy Interpersonal Psychoanalysis
Jungian Analysis Jungian Oriented Therapy Modern Psychoanalysis
Music Therapy Neurolinguistic Programming Organizational Consulting
Person Centered Therapy Play Therapy Psychoanalysis
Psychoanalytic Psychotherapy Psychodynamic Therapy Psycho-Emotional Kinesiology
Psychological Testing Rational Emotive Therapy Reichean Therapy
Rubenfeld Synergy Method Schema Therapy Self Psychology
Sensorimotor Psychotherpay Solution Focused Brief Tx Somatic Breath Work
Somatic Experiencing Therapy Somatic Hydrotherapy Somatic Psychology
Transactional Analysis Transpersonal Therapy Wilderness Therapy
Writing Therapy  
If you have a specific treatment approach that is not included here among the check boxes, you may request that it be added by emailing BPI.
Now you can create your free listing OR pay for your expanded listing and launch it immediately. Click the "Create My Listing" button to proceed.
* Security:


 My Information. This section can be competed only after you have established your expanded listing.
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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