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					                                          PRACTIC UM APPLI CATION

 The Counseling and Mental Health Center at the University of Texas at Austin offers a comprehensive practicum
 experience including two central areas of clinical work, namely individual psychotherapy and group psychotherapy.
 Students who are interested in training focused on individual therapy only may apply to participate in the individual
 psychotherapy practicum.

 Before you begin completing the application, please make sure you carefully read through the information and instructions
 below. Also, please make sure you have read the description of the practicum carefully and are willing to meet the
 requirements outlined.

 Eligibility Requirements:
     Applicants for the Psychotherapy Practicum at CMHC must meet the following criteria:

     1. Be enrolled in the doctoral program in Counseling Psychology or Clinical Psychology at UT-Austin
     2. Have successfully completed (or be in the process of successfully participating in) at least one clinically-focused
        practicum training experiences lasting at least two semesters (or have comparable employment or training

 Selection Criteria:
     In addition to the requirements listed above, preference will be given to applicants who:

     1. Demonstrate a strong and genuine commitment to the study and application of multicultural counseling principles
     2. Are interested and invested in participating in a training program that encompasses a “Use of Self” training model,
        and possesses the necessary characteristics to be successful in such a program (e.g., self-awareness, openness,
        willingness to self-disclose)
     3. Are interested in training in a multidisciplinary university counseling center
     4. Have a desire to receive training in both brief and longer-term individual psychotherapy skills
     5. Have accumulated clinical experience with various populations and presenting issues
     6. Have experience with conducting clinically-focused intakes
     7. For those candidates interested in the group psychotherapy experience, having completed a course in Group
        Psychotherapy is considered useful but is not required.

 Application Process:
         To apply for the Psychotherapy Practicum at CMHC, please submit the following:

         1. The Psychotherapy Practicum application form
         2. A current resume/vita
         3. A letter of recommendation from a clinical supervisor or written evaluation from a previous practicum site

If you have any questions about the practicum or application process, please contact the Practicum Training Director, Mark
Zentner, Ph.D., who may be contacted by phone at 475-6922 or via email

Please return application electronically to:

                                         Application Form on next page
             Applications Accepted Through February 14, 2011

NAME: ___________________________________________________________________________

ADDRESS: ________________________________________________________________________

PHONE NUMBERS: Home: ________________________ Work: ____________________________

                 Cell: _________________________ Other: ___________________________

EMAIL Address: __________________________________________________________________

PROGRAM ENROLLED IN:______________________________YEAR IN PROGRAM: _________

Please rank your preferences for the following practicum options:
 ____Combined Practicum (group and individual therapy)
 ____ Individual Practicum (individual therapy only)

Are you interested in the Anxiety Track? Yes ___ No ___

If so, please rank order your preferences for:
                 Anxiety Treatment Track: ____
                 General Therapy Track: ____

Site: __________________________________________Hours: _____________________

Population: ____________________________________ Supervisor: _______________________

Site: __________________________________________Hours: _____________________

Population: ____________________________________ Supervisor: _______________________

Site: ___________________________________________Hours: _____________________

Population: ___________________________________ Supervisor: _______________________

Site: ______________________________________________Hours: _____________________

Population: ____________________________________Supervisor: _______________________

Additional Questions Related to the Psychotherapy Practicum
  1. Please describe how you conceptualize your approach to individual
     therapeutic work.

 2. Individual Therapy Goals and Strengths -- What do you see as some of your
   strengths in this area? What are some of your growth edges as an individual therapist
   and what are some skills you would like to gain in this area?

 3. What experience/training have you had in working clinically with diverse
   populations? Please comment on your goals in terms of working with the
   diverse student population at UT.
 Please answer the following questions if you are interested in the Combined
 Practicum (i.e., both group and individual therapy).

4. What experiences and training have you had, to date, related to group
  theory, group process, and group leadership issues?

5. Group Therapy Goals and Strengths -- What do you consider to be some of your
  strengths as a group therapist? What are some of your growth edges as a group
  therapist and what are some skills you would like to gain in this area?

6. The remaining questions pertain to students interested in the Anxiety Track:

    1. Are there specific anxiety disorders you would like to learn more about
    and treat? Please specify.

    2. Please briefly describe what specifically interests you about the
       Anxiety Track.