Application for Registered Play Therapist - Supervisor membership

This form begins the process for registering to become a Registered Play Therapist - Supervisor member of the Australian Play Therapists Association, Inc. It includes collection of essential personal information, as well as requests for information about your qualifications, training and experience so we can assess your eligibility for membership against our criteria.

Please note all information is stored securely and only used for the purposes of membership with the APTA.

NOTE ON CERTIFYING COPIES OF DOCUMENTS - PLEASE READ

* Indicates required question

Email *

First Name *

Last Name *

Proof of name change

Please attach a copy of proof of name change (e.g. marriage certificate or change by depol) if you have had a change of name and have provided documents with different names.

Upload up to 5 supported files. Max 10 MB per file.

Contact Phone Number *

Postal Address *

Postcode

State/Territory

Practice/Business Name *

Website *

Membership Location

Australian (currently working and have registration in Australia)

International (currently working and have registration in another country)

If International, which country?

How did you hear about us? *

If you heard about us another way, please specify

Mental health qualifications

* Indicates required question

If you are qualified for another profession, please specify

Evidence of your mental health qualification *

Please attach a certified (see APTA’s list of eligible certifiers) copy of professional mental health qualification.

Upload up to 5 supported files. Max 10 MB per file.

Registration with mental health regulatory body

Evidence of your registration with a mental health regulatory body

Please attach a certified (see APTA’s list of eligible certifiers) copy of registration or membership with relevant mental health association/body or board, if applicable to your qualification.

Upload up to 5 supported files. Max 10 MB per file.

Therapy Statutory Declaration *

Please attach a statutory declaration, certified (see APTA’s list of eligible certifiers), stating that you have completed 750 hours of supervised clinical practice in counselling or therapy in your primary mental health profession, following your initial registration in that profession. NOTE: This does not include the 300 hours of play therapy direct practice requirement addressed later in this form.

Upload up to 5 supported files. Max 10 MB per file.

Workplace and Employment

* Indicates required question

Where do you practice play therapy? *

Private practice

Not-for-profit

Medical workplace – private or public hospital or clinic

Public workplace – State or Commonwealth government service

School workplace - private or public; K-12

Educational/University workplace - private or public; instruction, administration, research, etc.

Other:

If other, where else do you practice play therapy?

Details about your current workplace *

Describe your theoretical approach when practising play therapy *

Play therapy training

* Indicates required question

Have you completed 150 hours of APTA-approved play therapy training? *

Yes

Minimum 100 hours face-to-face training and maximum 50 hours of online/distance. Recordings of training sessions are not accepted. Please note the play therapy training requirements listed in full at https://apta.asn.au/training, as well as which play therapy training providers in Australia are currently approved as fully or partially meeting APTA's play therapy training requirements. If your training provider is not on list list, or has only partial hours recognised by APTA as per our website, it is the responsibility of the applicant to demonstrate how their minimum of 150 hours of play therapy training meets APTA's training requirements, which may be through providing copies of course transcripts or curriculum, etc. Training must be completed within a 5 year period and with no more than four different providers. For those who complete training with more than one provider, the responsibility is on the applicant to ensure they can demonstrate, through academic transcripts or copies of detailed course curriculum, the meeting of all of APTA's content-based criteria for play therapy training. Please contact [email protected] for assistance if needed.

Play therapy training certificates and course outlines

Please attach certified (see APTA’s list of eligible certifiers) copies of any Play Therapy Training course certificates/course outlines.

Upload up to 10 supported files. Max 10 MB per file.

Evidence of clinical supervision training *

Provide documentation of either 24 hours of play therapy supervision training OR 22 hours of mental health supervision training plus 6 hours of play therapy-specific supervision training.

Upload up to 5 supported files. Max 10 MB per file.

Play therapy clinical practice

* Indicates required question

In addition to your 750 hours of counselling or therapy practice in your primary profession, have you completed 300 hours of direct clinical practice, under supervision, specific to play therapy? *

Yes

Hours include: Direct play therapy client work with children, parent consultations and any other consultations related to the case. Hours can include face to face and telehealth sessions. Note this is separate to the 750 hours of practice experience required in your primary mental health profession, after your initial mental health training. APTA recognises hours of play therapy clinical practice undertaken after completing your clinical training program in play therapy. If you would like to count play therapy practice hours completed PRIOR to the completion of your play therapy clinical training program, you will need to provide a signed letter from your play therapy supervisor stating your supervisor considered you suitably experienced and qualified in play therapy to commence play therapy practice before completing your play therapy training program.

Play Therapy Statutory Declaration

Please attach a statutory declaration, certified (see APTA’s list of eligible certifiers), stating that you have completed 300 hours of supervised clinical practice specific to play therapy OR attach a letter from your clinical supervisor confirming your client hours.

Upload up to 5 supported files. Max 10 MB per file.

Clinical Supervision

* Indicates required question

Have you completed 50 hours of play therapy clinical supervision with either a Registered Play Therapist or a Registered Play Therapist Supervisor with APTA, APPTA, APT (US) or BAPT (UK)? *

Yes

Statement of Supervision Hours

Please provide a statement of completed hours of play therapy supervision, signed by your Play Therapy supervisor/s including their full name, professional qualifications, mental health association/body or board registration details (including play therapy registrations) and contact details. Please also include the time period over which supervision was completed. If unable to obtain a signed statement from clinical supervisor/s then a signed statutory declaration must be provided, certified (see APTA’s list of eligible certifiers), stating that you have completed play therapy clinical supervision.

Upload up to 5 supported files. Max 10 MB per file.

Working with Children Clearance

* Indicates required question

Do you hold a current Working With Children Check or Police Clearance? *

Yes

Do you hold a current Working With Children Check or Police Clearance lodged and accepted according to legislation within the state/country in which you work in?

Current Working with Children Check or National Police Check

Please attach a certified (see APTA’s lists of eligible certifiers) copy of documentation of a current Working with Children Check and/or National Police Check as required by Australian individual state law.

Upload 1 supported file. Max 10 MB.

Personal Indemnity Insurance

* Indicates required question

Is your Private Indemnity Insurance:

For a private practice, and at a minimum of $10,000,000.00

Provided by a workplace or organisation

Personal Indemnity Insurance Certificate

Please attach a copy of professional indemnity insurance certificate of currency or letter from your workplace

Upload up to 5 supported files. Max 10 MB per file.

Complaints and Legal Matters

Have any formal complaints been made against your professional conduct or have you been involved in legal matters regarding your professional conduct? *

Yes

If yes, what was the outcome?