Diploma in GSRD Therapy Application Form - Pink Therapy CPD and Training

Have you already completed at least your initial training in your occupation, whether that is a Diploma in Counselling or Psychotherapy, Clinical or Counselling Psychologist, Medical Doctor, etc.? *

Yes
No

Have you secured the funding for the training? Course fees are £3,700, which comprise a £500* deposit payable on the offer of a place and the rest in instalments (*or equivalent in €)? *

Yes
No

Do you have a minimum of three GSRD clients in ongoing therapy? Irrespective of the presenting issues, you need to have a reasonably stable flow of GSRD clients as this course has a strong clinical component? *

Yes
No

It begins with a two-week online intensive, which will very likely be in the last two weeks of July 2025 (excluding the weekend). Teaching hours are typically 9am-1pm UK time daily Mon-Fri, and we highly recommend you take the whole two weeks off as there will be homework, online meetings with your peers etc. Will you be able to make yourself available to attend the last two weeks in July 2025, i.e. 21-25 July and 28 July-01 August 2025? *

Yes
No

The Module Webinars and Case Discussion Group Tutorials (two hours) will generally be on a Friday evening (6 or 7 pm UK time) or on a Saturday morning (9 or 10 am UK time). Can you make these times? *

Yes
No

There is much reading and writing for this programme (assignments are 2k words for each of the eight modules) on a regular timescale of submissions. We estimate our students spend around a day or so per week on their studies for the course duration; previous students who are not native English speakers tell us this is an underestimate for them. Do you have the time and ability to meet this? *

Yes
No

Date of Application *

BASIC INFORMATION

Student Name *

First

Middle

Last

Birthdate

How do you identify your gender? *

Is it the same gender you were assigned at birth? *

Yes
No
Prefer not to say

What are your pronouns? (She/Her, He/Him, They/Them, etc ...) *

How do you identify your sexuality? (Ace, Bi, Gay, Kink, Lesbian, Pan, Queer etc) *

YOUR CONTACT DETAILS

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Mobile Phone *

Work Phone

Company

If relevant

EXPERIENCE

Job Title *

Therapy Qualifications

Date *

Qualification *

Training Provider *

Clinical experience of working with GSRD clients *

Approximately how many GSRD-identified clients are you working with at present? *

Experience of personal therapy? *

What motivates you to undertake this course? Write a personal statement of 300-500 words and include your lived and professional experience where relevant. *

Upload your CV here. *

Click or drag a file to this area to upload.

Please upload one file in one of these file formats .docx, .pptx, .pdf

SUPERVISOR'S REFERENCE

Required as part of the Selection Procedure.
This can be the supervisor of your generic practice if they are familiar with the range and standard of your work. Please ask them to complete a short form to support your application. Please send them the link to the form together with a copy of your application

SUPERVISOR'S REFERENCE FORM

Your Supervisor's Details

Please ask your supervisor to complete the reference on your suitability for the course.

Name *

First

Last

Email *

Mobile Phone *

Landline Phone

Do you wish to pay the course fee in GBP or Euros? *

GBP (£)
Euro (€)

Pink Therapy has always had a commitment to capacity-building in disadvantaged groups who may be underrepresented in the counselling field. We will, therefore, be offering two of the 15 available places on the course at a 30% discount. There will be a bursary for a therapist who identifies as Trans and/or Non-Binary and another bursary for a Black, Asian or Minority Ethnic (BAME) therapist. Should you wish to apply for one of the two Bursary places, please email us a personal statement about yourself and the impact you think the course will have on your career and contribution to the field. Please also write something about your financial situation. We will award the Bursaries to those we deem to have the greatest need.
You can upload your bursary application below if you meet the requirements.

Upload your BURSARY APPLICATION here.

Click or drag a file to this area to upload.

Please upload one file in one of these file formats .docx, .pptx, .pdf

Diploma in GSRD Therapy Application Form (2025 intake)

You must be able to answer “yes” to all six of the following Essential Criteria Questions to be considered for the interview shortlist: