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Mental Health Professionals Form for Listing on the Askios e-group

the Askios website

The Askios Database of Mental Health Professionals is a nationwide listing of counsellors, psychiatrists, psychologists and social workers who provide therapeutic services for individuals affected by Child Sexual Abuse. The database is located on the Askios e-group, and is only accessible to members.

Members of the Askios e-group include survivors, activists, and other professionals. Listing your services on our Mental Health Professionals' database will be especially useful whenever someone is looking for a referral. Your details will be visible only on the Askios e-group, to registered members. They will not appear on this website or the Askios blogs, and not visible to the general public.
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** Please note this form is for INDIVIDUAL professionals. If you wish to list an organisation's details, fill out the form for organisations instead.
 
To be listed, simply type your text into the form below, then click on "Submit".
 

Form for Mental Health Professionals

Name:
Gender:
Year of Birth:
Profession:
Title/Specialisation:
Qualifications:
Obtained from (institute, year):
Are you a member of any professional society/association?
Telephone:
Email address:
City:
Office/Clinic address:
The majority of your clients are:
Any special training on CSA? (diplomas, certificates, courses, workshops, conferences, internships) Please include duration of training and year received:
Do you use any particular therapeutic methods with CSA cases? Please specify:
Do you have experience working with adult female survivors of CSA?
Do you have experience working with adult male survivors of CSA?
Do you have experience working with child victims of CSA?
Do you have experience working with sex offenders?
Do you have experience conducting support groups?
Which of the following related issues do you have particular experience with?
Comments, suggestions or any other information:
  

Thank you for filling out this form.
Your input will be of immense help
to those seeking professional assistance
on child abuse issues.