The Therapist Observer program is open to clinicians and qualified clergy with training in pastoral counseling. All licensed clinicians are eligible to participate. If you aren't a licensed clinician or PSAP (Pastoral Sex Addiction Professional), please call the office before registering. You must observe an individual workshop before you can observe a couples’ workshop. Currently, observers are not permitted at the teens & parents workshop.

When your registration and payment are submitted, you’ll receive a payment confirmation email. Within one business day, you’ll get a separate email from the Bethesda Workshops team with further information and instructions about the workshop paperwork.

Please select the type of workshop:

Please select the date of the workshop you wish to observe:  

First Name:
Last Name:
I prefer to be called by:
Gender:
Name of Organization or Practice:
Mailing Address:
City: 
State: 
Zip:
Preferred Phone:

 Cell   Home   Work 
Alternate Phone:

 Cell   Home   Work
Alternative Phone:

 Cell   Home   Work
Preferred E-mail address:

For Clinicians

Highest Degree Earned:
Institution:
License Type:

License Number:  

Date Received:  

If Non-licensed, Indicate Practice Setting:
Supervisor’s Name:
Supervisor’s Position:
Supervisor’s Phone:
Client Population (adults, gender-specific, couples, adolescents, etc.):
Areas of Practice Focus:
Professional Liability Insurance Carrier:
Limits of Coverage:

For Clergy

Position:
Church:
Highest Degree Earned:
Institution:
How did you hear about Bethesda Workshops?:
 Therapist   Friend in Recovery   Former Participant   Pastor   Web Search    Bethesda Workshops Leader  
 Other 
Describe your training about sexual addiction, including working with partners and couples.
Please list type of training, presenter, and approximate date.
List books read about sex addiction/addicts/ partners/ couples.
What do you hope to gain by attending a Bethesda Workshops’ intensive as a Therapist Observer?

Payment Options
$300 is the minimum required payment.

Non-refundable Deposit
By typing my initials, I understand that $300 of what I will pay is a non-refundable deposit that cannot be counted as a donation for tax purposes. If I cannot attend the workshop, I understand that my deposit may be transferred to one of the next two scheduled workshops (a change fee may apply). If Bethesda Workshops determines that I am not an appropriate candidate for the workshop setting, my deposit will be refunded.:  
Additional Comments:
Participant Signature:

  REGISTRATION IS NOT COMPLETE WITHOUT PAYMENT