Form CBT-E Clinical

We would like to create a community of CBT-E clinicians and researchers throughout the world. This will enable professionals to seek out others for possible collaboration and to share knowledge. If you wish to add yourself to our list please complete the following form:

    Your name/your centre's name and your location/location of your centre:

    Contact details that will appear on the CBT-E website:
    (e.g. website address, email address, postal address, telephone number)

    Professional Role(s) and qualifications (if relevant):
    Please briefly detail your profession and/or the professions of those in your centre (e.g. Clinical Psychologist, Psychiatrist)

    Training in CBT-E (if relevant):
    Please detail any training in CBT-E that you and/or your members have attended (training website, workshops etc.). Please include names, dates and locations of any training attended

    Clinical Practice and Supervision (if relevant):
    Please provide a brief description of your clinical interests, activities and experience, and please say if you offer clinical supervision in CBT-E

    Research (if relevant):
    Please provide a brief description of your research interests, activities and experience and, if you wish, any publications

    Email address: (required)
    (Only for use by website staff, in case we require further information from you)

    Photo:
    Please provide a photo or image if possible of yourself/your group/centre