Registration form for MHP

Personal Information

Email(Required)

Phone(Required)

Name(Required)

First Last

Date of birth(Required)

Nationality(Required)

Country of residence(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Academic Background

I have a degree in the field of(Required)

My highest academic degree is(Required)

University: Doctorate/Ph.D.

University: Master’s degree

University: Bachelor’s degree

Other higher education degree

I have received diploma validation in the Netherlands(Required)

I have a LOGO verklaring(Required)

Yes

No

Work Experience & Professional Specialization

I treat patients with psychological problems and psychiatric disorders (DSM) for(Required)

0-5 years

6-10 years

more than 11

I have theoretical and practical training in(Required)

Hold down the CTRL/CMD button to select multiple options.

I am experienced in treating patients with(Required)

Hold down the CTRL/CMD button to select multiple options.

I can work with the following patient population(Required)

Adults (older than 18)

Adolescents (between 12-18)

Children (younger than 12)

I prefer to work(Required)

Online

Offline

Both

Language Skills

My English proficiency(Required)

My Dutch proficiency(Required)

I am also fluent in(Required)

Hold down the CTRL/CMD button to select multiple options.

Mobility

I live in the Netherlands and have a car(Required)

Yes

No

I live in the Netherlands and have a valid driver's license(Required)

Yes

No

Uploads

Please upload your CV (EN) in PDF-format(Required)

Accepted file types: pdf, Max. file size: 32 MB.

Please upload your a copy of your original diploma in PDF-format

Accepted file types: pdf, Max. file size: 32 MB.

Please upload, if available, a copy of diploma validation issued by IDW in PDF-format

Accepted file types: pdf, Max. file size: 32 MB.

Consents

If we have a possible placement for you, we will create an anonymous PsyGlobal resume based on all your answers and send it to the Mental Health Organization. Please let us know if we have your consent to do so.(Required)

Yes

No

Can we contact you for open vacancies, training opportunities and other relevant information? You can unsubscibe at any time.(Required)

Yes

No

Due to the European GDPR privacy law - or Dutch AVG, we need to ask for your permission to save your personal data in our database for 12 months. Please let us know if you give permission to save your data.(Required)

Yes

No

Acceptance and Commitment Therapy (ACT)
Art Therapy
Body-Oriented Therapy
Client-Oriented Therapy
Coaching (ICF, NOBCO, NOLOC)
Cognitive Behavioral Therapy (CBT)
Counseling
Couples Therapy
Dialectical Behavior Therapy (DBT)
Emotion / Emotionally-Focused Therapy (EFT)
Existential Therapy
Eye Movement Desensitization and Reprocessing Therapy (EMDR)
Gestalt Therapy
Grief Counseling
Family Counseling
Interpersonal Psychotherapy (IPT)
Jungian Therapy
Logotherapy
Mindfulness-Based Cognitive Therapy (MBCT)
Mindfulness-Based Stress Reduction (MBSR)
Play Therapy
Process-Based Therapy (PBT)
Psychoanalytic / Psychodynamic Psychotherapy
Psychodrama
Psychosomatic Therapy
Schema-Focused Therapy (SFT)
Sex Therapy
Systemic Therapy
Transaction Analysis (TA)
Trauma-Focused Therapy (TFT)
I have received no training yet
Other
Solution-Focused Brief Therapy (SFBT)
Positive Psychotherapy
Maudsley Model of Anorexia Treatment for Adults (MANTRA)
Play Therapy (diverse)
Group therapy
Video Feedback Intervention for Positive Parenting to Autism (VIPP)
Tension Releasing Therapy (TRE)
Ericksonian Hypnosis
Compassion-Based Therapy (CFT)
Brain Work Recursive Therapy (BWRT)
ABA Therapy

Addictions (alcohol, tobacco, drugs, games, etc.)
ADHD
Anxiety Disorders (e.g., panic disorder, phobias)
Autism
Burnout & Occupational stress
Chronic Fatigue Disorder
Crisis & Acute trauma
Deviance & Agression
Eating Disorders
Elimination Disorder
Family Dynamics
Gender Dysphoria
Identity Crisis
Intellectual Disability
Loss & Grieving
Mixed Anxiety-Depressive Disorder (MADD)
Mood Disorders (e.g., Depression)
Neuropsychological Disorders (Dementia, Parkinson's, Alzheimer's, MS, etc.)
Oncology
Personality Disorders (antisocial, borderline, schizoid, paranoid, narcissistic, etc.)
Post-Traumatic Stress Disorder (PTSD)
Psychosomatic Disorders
Relationship Difficulties
Schizophrenia and/or Psychosis
Self-Esteem
Self-harm / Suicide attempts / Suicide Prevention
Sexual Dysfunctions
Sleep Disorder
Stress Adaptation & Resilience
Other

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