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PROFESSIONAL ACTIVITIES CONSIDERED FOR FELLOWSHIP
I. GENERAL LEADERSHIP
For Categories 1 – 7, list experience on an annual basis.
Leadership in AGPA, GPF, NRCGP, IAGP, its Affiliates or other
Professional Organizations should be included. Specify position,
organization and length of service.
| 1.
Officer |
AGPA |
Affiliate/Regional |
International |
Other Professional Organizations* |
| 2.
Board |
| 3.
Chair |
| 4.
Committee Member |
| 5.
AGPA Representative |
| 6.
Faculty at Scientific Meetings (specify date, title and length) |
Institute |
Workshop/Seminar
3 hours |
Seminar/paper presentation 1 hour |
| 7.
Group Therapy Related Awards and Honors (list) |
AGPA |
OTHER |
* Promotion of group therapy through other professional
organizations
II-A. CLINICAL PRACTICE AND ADMINISTRATION
| 1.
Active Group Psychotherapy Practice |
List
number of ongoing group(s) per year. |
| 2.
Group Therapy Programs (Development and/or Administration) |
- Initiation of/development of
|
List experience. |
|
|
List number of years per experience. |
|
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List number of years, experience and
name of program. |
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List number of years, experience and
name of program. |
- Participation as group therapist
|
List number of groups per year. |
| 3.
ProBono Services (Group Leader, Supervisor, Consultant) |
List
number of groups per year. |
II-B. TEACHING AND TRAINING
| 1.
Group Therapy Supervision/Consultation |
List
number of ongoing groups per year. |
| 2.
Group Therapy Teaching (College setting, agencies, post graduate
programs, Internet/Chatrooms) |
List
courses, location, and number of semesters. |
| 3.
Part Time Lecturer/Presenter |
List
each presentation and its length. |
| 4.
Leader of a training group |
List
number of groups per year and duration. |
| 5.
Faculty at Scientific Meetings. |
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|
List
Institute title, location and length. |
|
|
List
Workshop/Seminar title, location and length. |
- Seminar/Paper Presentation
|
List
Seminar/Paper Presentation title, location and length. |
* Activities listed above should not duplicate those listed under
General Leadership
II-C. RESEARCH
| 1.
Director of Research Project re: Groups |
Describe experience and duration. |
| 2.
Developing Research Methodology |
Describe experience and duration. |
| 3.
Holding a Research Position |
Describe experience and duration. |
| 4.
Promoting Research on Groups (Teaching, grant writing, thesis or
dissertation committees) |
Describe experience and duration. |
II-D. PUBLICATIONS
| 1.
Publications on Groups in peer reviewed journals, chapters,
books |
List
references. |
| 2.
Editorial Staff of a Newsletter (Group Circle, Group Solution,
Group Assets or other newsletter) |
Describe experience and publications. |
| 3.
Editorial Board (IJGP or other group journal) |
Describe experience and duration. |
| 4.
Other related but non-group focus |
Describe experience and duration. |
| 5.
Book Reviews (Group Related) |
List
references. |
Revised March 2002 |
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