HEALTH CARE PROFESSIONALS - ASCA QUESTIONNAIRE



Are you interested in contributing to the work ASCA is doing with
adult survivors of child abuse?

ASCA is a national organisation working to improve the lives of adult survivors of child abuse throughout Australia. Our long-term goal is to ensure that adult survivors of all forms of child abuse and neglect in Australia are able to access any service needed to ensure their health, well-being and meaningful engagement within their communities.

ASCA’s strategy is 3-fold:
1. National Awareness Campaign highlighting the long-term impacts of childhood trauma;
2. Comprehensive and responsive first line services through its website www.asca.org.au and its 1300 line 1300 657 380;
3. Network of ASCA-accredited services, provided by individuals and organizations.

ASCA (Adults Surviving Child Abuse) is building its referral database to create new possibilities for adult survivors of child abuse.

We are seeking:

1. Trained and experienced health care professionals skilled in providing services to adult survivors of childhood trauma with complex needs
2. Programs and services provided by health care agencies
3. Current or prior research relevant to information and service delivery to  adult survivors of child abuse
4. Expressions of interest for future ASCA training opportunities (We are seeking contact with experienced trainers in the field as well as those seeking training)

ASCA operates with professionalism, ethical integrity and strong duty of care principles. ASCA has a responsibility to ensure that the professionals/services on its database demonstrate an appropriate level of professional training, qualification and competence. We take that responsibility seriously. With this in mind, we ask that you complete the following ASCA Questionnaire to register your interest. 

ASCA's Clinical Advisory Committee will review your questionnaire responses. Those health practitioners requesting assessment for endorsement who are endorsed by ASCA's Clinical Advisory Committee will be added to ASCA's database of ASCA-endorsed service providers. Those listed will also be available from ASCA’s 1300 counsellors and can be accessed by calling 1300 657 380 or emailing endorsements@asca.org.au.You will be able to update your information at any time.

 

First Name:

Last Name: 

Email:

A. About You

Please enter your preferred contact telephone number including area code.
Preferred format example:  03 9949 1234.

Phone:

Please enter your mobile contact number (optional)

Mobile:

Enter your personal Postal Address line 1 where ASCA will send you material

Postal Address:

Enter Practice Address line 2 for your place of practice (This address will be given out to callers)

Work Address:

Enter the suburb for you most common place of practice

Suburb:

Enter the state for your practice address

State:

Enter the postcode for your practice

Postcode:

If you have a website for your practice please enter the web address (optional)

Website:

Please enter your Qualifications as follows, one per line: Qualification, Institution, Year Attained (or In Progress)
e.g. 1. B.Psych, UNSW, 1987
       2. M.Psych, USYD, 2002

Qualifications:

Please provide the Organisation Name, category of membership, the number of years you have been associated and your registration or membership number for each Professional Body that you belong to, e.g. for the following organisations:  APS, CAPA, AASW, PACFA, ACMHN, RANCZP, or other (please state)
e.g. 1.  APS, Clinical Member, 5 Years, Reg No: 5875A
        2. CAPA, Associate Member, 3 Years, Reg No: D73651

Professional memberships:

Please enter your gender

Gender:

Testimonials

“Extremely well presented. Covered salient points in trauma work. Very credible presenter, obviously knows the subject matter well, is clear, informative, and was careful to ensure participant's expectations were met.”

E. HUTCHING Relationships Australia

“It was wonderful training given that all my questions and issues were addressed. It felt like 2 days of supervision.”

SYLVIA ACEVEDO Clinical and Private Practitioner

“I found the training very informative and a window to many therapies and skills to focus on in the future. The presenter was excellent and certainly demonstrated a well informed knowledge of various modalities and therapies.”

ROBERT DORAN Sydney

“The presenter did an excellent job! The information was interesting, profound and very relevant. The information was very clear, stimulating and I will find it very helpful when working with clients.”

WENDY METRA Counsellor/Psychotherapist

“Absolutely fantastic workshops! It was great to discuss, hear and walk away with real practical strategies and techniques to assist my clients in becoming more body aware. Excellent resources given.”

KERRIE THOMPSON Newcastle

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Testimonials

“Blue Knot Foundation has a key role to play in the building of community capacity in care provision to those who have experienced childhood abuse and trauma in any environment.”

NIALL MULLIGAN Manager, Lifeline Northern Rivers

“I think Blue Knot Foundation is a fantastic support organisation for people who have experienced childhood trauma/abuse, for their families/close friends and for professionals who would like to learn how to more effectively work with these people.”

Psychologist Melbourne

“It's such a beautiful thing that you are doing. Helping people to get through this.”

ANONYMOUS

“It was only last September when I discovered the Blue Knot Foundation website and I will never forget the feeling of support and empathy that I received when I finally made the first phone call to Blue Knot Helpline, which was also the first time I had ever spoken about my abuse.”

STEVEN

"At last there is some sound education and empathetic support for individuals and partners impacted by such gross boundary violations.”

TAMARA

Contact Us

Phone: 02 8920 3611
Email: admin@blueknot.org.au
PO Box 597 Milsons Point NSW 1565
Office Hours: Mon-Fri, 9am-5pm AEST

Blue Knot Helpline
Phone: 1300 657 380
Email: helpline@blueknot.org.au 
Operating Hours: Mon-Sun, 9am-5pm AEST

For media comment, please contact:
Dr Cathy Kezelman AM
0425 812 197 or ckezelman@blueknot.org.au

For media enquiries, please contact: 
Christine Kardashian, Group Account Director
0416 005 703 or 02 9492 1007 or christine@launchgroup.com.au