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Training Registration Form

Psychosis REACH (Recovery by Enabling Adult Carers at Home)

Trainers: Doug Turkington, MD; Kate Hardy, Clin.Psych.D; Sarah Kopelovich, PhD; and Akansha Vaswani-Bye, PhD

Event Description:

Psychosis REACH (Recovery by Enabling Adult Carers at Home) is a training for relatives and close friends of individuals with psychotic disorders that aims to provide concrete skills to improve the quality of interactions between family members. The training supports larger efforts to make Cognitive Behavioral Therapy-an evidence-based treatment for psychosis-more widely available worldwide.

As part of this training you will learn:

Key caring principles
Normalizing and making sense of psychosis
Communication practices
Relapse prevention strategies
Working with medication
Evidence-based coping strategies

Your First Name

* must provide value

Your Last Name

* must provide value

Primary e-mail address

* must provide value

Please confirm primary e-mail address

* must provide value

Secondary e-mail address (if applicable)

What is your gender identity?

Non-binary

Female

Male

None of the above describe me

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If none of the above describe you, what is your gender identity?

Which of the following best describes you (select all that apply):

Black or African American

Asian or Asian American

White/Caucasian

Native American or Native Alaskan

Native Hawaiian or other Pacific Islander

Prefer not to say

I do not identify with any of the above options

Please self-describe:

Are you of Hispanic, Latinx, or Spanish origin?

Yes

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What is your age?

What is your mailing address?

In which country do you live?

If applicable, in which state or province do you live?

What is your postal code?

* must provide value

Please indicate the highest grade of formal education you have completed.

Some high school

GED/high school graduate

Business or technical training beyond high school w/o college degree, including military training

Some college

Associates degree

Bachelor's degree

Some graduate or professional school

Master's degree

Doctoral degree

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Please indicate your marital status.

Single

Married

Separated

Divorced

Widowed

Prefer to self-describe

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Prefer to self-describe:

Do you have a loved one with psychosis?

* must provide value

Yes

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What is your relationship to your loved one with psychosis? They are my...
(If you have more than one loved one with psychosis, please respond to the following questions with the loved one you interact with most often in mind)

child

parent

sibling

grandparent or great-grandparent

aunt or uncle

niece or nephew

spouse or significant other

friend

cousin or other relative

other

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If other, how is your loved one related to you?

What is your loved one's primary diagnosis?

How long ago did your loved one receive their diagnosis? (Please specify months or years)

(If your loved one does not currently have a diagnosis, how long ago did they first begin exhibiting symptoms of psychosis?)

How old was your loved one when they were diagnosed?

(If your loved one does not currently have a diagnosis, how old were they when they first began exhibiting symptoms of psychosis?)

Have you been involved in any of your loved one's treatment sessions?

Yes

My loved one is not receiving any services.

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If no, why were you not involved in your loved one's sessions?

I did not wish to be involved.

My loved one did not want me to be involved.

It was logistically too difficult for me to attend.

Other:

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Other reasons:

How did you hear about this training?

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Please briefly describe what you hope to get out of this training.

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What question(s) do you have about applying cognitive behavioral techniques with your loved one with psychosis?

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