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Consultant Reporting Form

Consultant’s Reporting Form

This form is to be used in combination for certification or recertification. You can also download the form in PDF format if desired.

"*" indicates required fields

MM slash DD slash YYYY
MM slash DD slash YYYY
Certification Type*

(Needs to be completed within 2 years after Phase 2)



NEUROEXPERIENTIAL MODEL

Theory*
Practice - Frame Setup-Process
MM slash DD slash YYYY

GUIDELINES FOR BRAINSPOTTING CERTIFICATION WITH CONSULTANT

  1. Basic connection, overview of the consultation and how to use the pointer (Exploration of the basics)
  2. Review from 1st session (Focus on Dual Attunement, W.A.I.T and not knowing/uncertainty; staying in tail of comet, review the terms, exploring how we use in session and giving case examples).
  3. Work on going from dysregulation to regulation (Review from Phase 1) and how to use psychoeducation of the brain.
  4. Continue to Review case(s), listening to consultee, consultee perspective, review set-ups, review with consultees strengths and challenges with consultee. Clearly articulate any issues/gaps and what needs to happen for improvement. Have consultee practice on consultant.
  5. Review of the consultation process, wrap up anything that needs to be finished, review additional case material (something more specific, additions, child work, performance, parts work).
  6. Have Consultee practice Brainspotting on Consultant to assess dual attunement, etc. Review all items. If Consultee needs more sessions before deemed ready, then discuss and make a plan.

The Brainspotting Certification Standard Committee has accepted and voted upon the following standards, which will be implemented starting March 15, 2019.

Brainspotting CERTIFICATION:

  • Minimum of 6 individual Brainspotting consultation sessions 60-minute hour with the same Brainspotting Consultant
  • Recommendation of at least 2 Brainspotting consultation hours after Phase 1 and a minimum of 2 after Phase 2.
  • Brainspotting Phase 1 and 2 training in-person/online – videos are for additional learning not for certification
  • Document at least 50 Brainspotting sessions using the Brainspotting Session Documentation form.
  • Check list form from Brainspotting Consultant
  • Upon completing certification process with Brainspotting Consultant the following documents get submitted to Brainspotting Trainings, LLC (David Grand)
  • Application and all supporting documents (Brainspotting Session Documentation Form, Brainspotting Consultant’s Report with a positive recommendation for Brainspotting certification, copy of liability malpractice insurance.)
  • Payment of $150.00 USD

Brainspotting RE-CERTIFICATION:

Every two years to keep certification you need a minimum of:

  • Document at least 100 Brainspotting sessions using the Brainspotting Session Documentation form.
  • 1 Individual Brainspotting Consultation 60-minute hour (evaluating Brainspotting Consultee competency; review original standards for certification)
  • Upon completing recertification process with Brainspotting Consultant the following documents get submitted to Brainspotting Trainings, LLC (David Grand)
  • Application and all supporting documents (Brainspotting Session Documentation Form, Brainspotting Consultant’s Report with a positive recommendation for recertification, copy of liability malpractice insurance.)
  • Payment of $100.00 USD
  • Individual exceptions will be determined by Brainspotting Consultant and BT, LLC
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