Application for the Self-Help Group

What is your name, and preferred pronouns?

What is your mobile phone number (if you are happy to be contacted via phone or text)?

Your email (if you are happy to be contacted via email)?

Are you on WhatsApp and happy to be contacted through WhatsApp?

What years and boarding houses were you in at CH?

Have you been in therapy before? Y/N?

How was it helpful or not to you?

Have you been in a self-help group? Y/N

On average, how often in a month do you feel upset (triggered)

How do you think/feel/behave when you are remembering the abuse you sustained?

What would you like to accomplish by being in this group?

Do you have anyone safe to talk to about what you are learning in this self-help group if you find yourself distressed?

Do you have any concerns about meeting that you would like Duncan or Penny to be aware of?

Any additional message (optional)


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