Registration form one registration per participant



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REGISTRATION FORM

One registration per participant

Registration is official with payment

Friday, May 13, 2016

The registration fee includes light continental breakfast, snacks, drinks and lunch. Our policy is to email all handouts. Please include a valid email address with your registration to receive the handouts prior to the Workshop.

Please Circle: *Student $50

Member $125

Non-Members $145

ICLE (CEU) Processing Fee $20

Lunch: ____Regular ____Vegetarian

Total Amount Due:____________________

Name

_________________________________

Address



City/State/Zip

Phone

Email Address

Send check or money order payable to: MIAPT to accompany this registration form.

SEND BY MAIL TO:

Michigan Association for Play Therapy (MIAPT)

ATTN: MIAPT East Regional Workshop

P.O. Box 80392

Lansing, MI 48908

OR register and pay online using PayPal at the MIAPT website: miapt.org.

*A participant registering as “student” must be a full-time student at a college or university and provide a written letter from their University verifying their status.

2016 MIAPT

East Regional Workshop





Sandtray:

Therapeutic Interventions - Neurobiology – Families

Marta “Dikke” Hansen, LICSW &

Christina Johnson, MA, LPC

Friday, May 13, 2016

First Presbyterian Church of Ann Arbor

1432 Washtenaw Ave

Ann Arbor, MI 48104




2013 MIAPT

West Regional Workshop

Michigan Association for Play Therapy

P.O. Box 80392



Lansing, Michigan 48908

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CONTINUING EDUCATION…

Continuing Education: A workshop for mental health professionals is co-sponsored by the Michigan Association for Play Therapy and The Institute for Continuing Education. Continuing education credit is offered in the disciplines listed below. The program offers 6.00 contact hours, with full daily attendance required. The continuing education processing fee is $20.00 per person and may be included in the registration fee by checking the appropriate box. Applications for continuing education credit will be available at check in; attendees are required to sign-in upon arrival and sign-out upon departure on attendance sheets provided at the workshop registration area. If you have questions regarding continuing education, the program, presenters, grievance issues, or for a listing of learning objectives, please contact The Institute at: 800-557-1950; e-mail: instconted@AOL.com.

Psychology: The Institute for Continuing Education is approved by the American Psychological Association to sponsor continuing education for psychologists. The Institute maintains responsibility for this program and its content.

Counseling:  The Institute for Continuing Education is an approved provider by the Ohio Board Counseling and Social Work, Provider  RCS 030001.  NBCC credit is not offered for this workshop.

Social Work: The Institute for Continuing Education is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), www.aswb.org, 1-800-225-6880, though the Approved Continuing Education (ACE) program. The Institute for Continuing Education maintains responsibility for the program. Licensed social workers should contact their individual state jurisdiction to review current continuing education requirements for licensure renewal. ASWB Provider No. 1007.

Marriage Family Therapy: The Institute for Continuing Education is an approved provider by the Ohio Board MFT, Provider RTX 100501.

Play Therapy: The Institute for Continuing Education is an approved provider of continuing education by The Association for Play Therapy. APT Provider No. 98-040.

Nursing: The Institute for Continuing Education is an approved provider of continuing education in nursing by California Board of Nursing, Provider CEP 12646. Nurses are responsible for checking with state board to determine if credit issued through an approved provider of the CA Board of Nursing, is accepted. Skill level: This event is appropriate for mental health professionals of all skill levels.

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Workshop Schedule:

Registration: 8:15-8:45 am

Continental Breakfast: 8:15-8:45 am

Workshop Session: 8:45-10:15 am

Break: 10:15-10:30 am

Workshop Session: 10:30-12:00 pm

Lunch: 12:00-1:00 pm

Workshop Session: 1:00-2:30 pm

Break: 2:30-2:45 pm

Workshop Session: 2:45-4:15 pm

End of the Workshop: 4:15 pm


Continental breakfast, lunch and snacks are included in registration fee.

DIRECTIONS: From the East - Take I-94 east to U.S. 23 north. Exit U.S. 23 at exit 37B (Ann Arbor). Traveling west on Washtenaw Avenue, after approx 1.5 mi, stay right on Washtenaw at the “Y”, heading into town. Church is located on the left shortly after you cross Hill Street. From the West - Traveling on I-94 west, take State Street exit and turn left, following State St north past the athletic campus and into town. Turn right onto Hill Street at the light, then left onto Washtenaw Ave. The church is nearly immediately on your left, before the light for South University: 1432 Washtenaw Ave.

CANCELLATION POLICY: All cancellations must be requested in writing and received no later than May 6h, 2016. Cancellations are subject to $25 processing fee. Substitutions may be made in writing for no additional cost. No refunds are given due to inclement weather. ADA/ Section 504: For special accommodations, please contact Robin Bell via email at: mymiapt@gmail.com or call: (517) 489-1468.

OVERVIEW:

This is an experiential workshop where you will learn therapeutic Interventions with families and dyads using Sandtray Worldplay. Interwoven in this workshop will be a practical understanding of how the brain reacts and why this tool is so effective in facilitating change.



LEARNING OBJECTIVES: As a result of this workshop, participants will be able to...

  1. Define Sandtray

  2. Identify clientele for which Sandtray has proven effective

  3. Demonstrate a basic understanding of neurobiology and how it informs the efficacy of SandtrayWorldplay

  4. Describe the use of SandtrayWorldplay with families and family dyads

  5. Explore additional techniques of using sandtray for therapeutic interventions

  6. Identify common difficulties in the use of Sandtray and explore resolutions

 

BIOGRAPHICAL INFORMATION:

Marta "Dikke" Hansen LICSW, MSW

Dikke is currently the Director of Behavior Health at Outer Cape Health Services in Provincetown, Massachusetts. Additionally she maintains a private psychotherapy practice. Dikke is a co-founder of Growing Edge Adventures, LLC. She has had 35 years of experience as a clinical mental health therapist and administrator in social service agencies. Her extensive knowledge of Sandtray/Worldplay is thanks to 16 years of study and training with Gisela Schubach DeDomenico, PHD; creator of SandtrayWorldplay.



Christina Johnson, MA, LPC

Tina has a full-time private practice in Wellfleet, MA as well as working as an adoption consultant. She is a co-founder of Growing Edge Adventures. LLC. Tina has 12 years of experience as a social service agency administrator and has worked as a mental health therapist for 30 years. Additionally, she has had 16 years of study and training with Gisela Schubach DeDomenico, PHD; creator of SandtrayWorldplay.




Sandtray: Therapeutic Interventions – Neurobiology



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