Counselling Placements

There are a number of opportunities within each of the services that the Counselling Team provides which allows our students to have a comprehensive experience of working with clients with varying presentations.

What do I need to apply?

We offer placements to students who are studying Counselling or Psychotherapy at Level 4 or on a Level 5/6 or degree program. We do not accept students who are doing Psychology Degrees.

What we need from you

In addition to being on an appropriate course we need you to commit to working with us either as a student (or once qualified) for two years for a minimum of three hours a week. You must be a student member of the BACP/BPS/UKCP and complete an enhanced DBS check.

What we offer you

We offer you monthly Supervision, clients that have been assessed by a Clinical Lead prior to allocation, Student Reports and access to both online and in person training (including MHFA Training) and workshops.

Application

If you are interested in applying for a placement within the counselling team please complete the application form below and our Clinical Lead will contact you about the next steps in your application.

Application Form

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Voluntary Student Placement Application Form

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Title:

Surname:

Forname(s):

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Tel No (Home):

Email address:

First line of address: *

Second line of address:

Mobile No:

Date of Birth:

Town: *

Postcode:

Please state previous names (If applicable):

Are you related to any member or employee of Hillingdon Mind?

Please indicate who, and state relationship:

Course Currently Studying

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School/College/University

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Subject - Level (Dip, Degree)

Year (first, second etc.)

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School/College/University

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Subject - Level (Dip, Degree)

Year (first, second etc.)

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School/College/University

Subject - Level (Dip, Degree)

Year (first, second etc.)

Education & professional qualifications

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School/College/University

Examinations Taken Subject

Result Grade achieved

Add another entry?

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School/College/University

Examinations Taken Subject

Result Grade achieved

Add another entry?

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School/College/University

Examinations Taken Subject

Result Grade achieved

Add another entry?

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School/College/University

Examinations Taken Subject

Result Grade achieved

Add another entry?

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School/College/University

Add another entry?

Examinations Taken Subject

Result Grade achieved

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School/College/University

Examinations Taken Subject

Result Grade achieved

Add another entry?

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School/College/University

Examinations Taken Subject

Result Grade achieved

Please list any other relevant course attended or qualifications achieved (with dates):

Relevant experience, interests and voluntary activities:

Inclusion Monitoring

How do you identify?

Female
Male
Non-Binary
Another / prefer to self-describe
Prefer not to say

Please describe:

What is your sexual orientation?

Bi
Gay/lesbian
Heterosexual/straight
Another/prefer to self-describe
Prefer not to say

Please describe:

Have you ever identified as trans?

Yes
No
Prefer not to say

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Ethnicity:

Asian or Asian British
Black or Black British
Mixed
White or White British
Other ethnic group

Please specify:

Bangladeshi
Chinese
Japanese
Indian
Pakistani
Another Asian background

Please specify:

African
Caribbean
Another Black background

Please specify:

Black African & East Asian
Black African & South Asian
Black African & White
Black Caribbean & East Asian
Black Caribbean & South Asian
Black Caribbean & White
East Asian & White
South Asian & White
Another mixed background

Please specify:

White British
White Irish
Eastern European
Another White background

Please specify:

Arab
Gypsy or Traveller
Another background

Please specify:

(it’s a requirement of our funders that we gather this information – failure to complete this section means we won’t be able to take you onto the free service)

Disability Discrimination Act 1995

Do you consider yourself to have a disability under the Disability Discrimination act?

Please list any adjustments which you will require if shortlisted for an interview:

Rehabilitation of Offenders Act 1974

This post is subject to an Enhanced DBS Check and is regarded as exempt under the Rehabilitation of Offenders Act 1974.

References

Names and addresses of two referees, one of whom should be your Tutor or Superviser, and one from a relevant referee e.g. past Tutor or Employer

Reference 1

Name:

Email Address:

Address:

Position:

Tel No:

Relationship to you:

May we make contact prior to the interview:

Reference 2

Name:

Email Address:

Address:

Position:

Tel No:

Relationship to you:

May we make contact prior to the interview:

Declaration

I declare that the information given is true and correct. I give my consent to my referees being contacted as indicated. I confirm that I have the right to work in the UK. I understand that canvassing in relation to this post will lead to the disqualification of my application.

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Signed:

Date:

Please note that failure to disclose relevant details or a deliberate attempt to falsify information may lead to dismissal.

GDPR 2018:

The use of information provided on this form will comply with the requirements of the above act. It may be processed for operational, managerial information and associated purposes relevant to the maintenance of Hillingdon Mind administrative systems. Such data may be used to produce depersonalised statistics.

Once you are happy with your application form please press submit

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