Dvd Review Session Form printable pdf download

Dvd Review Session Form

SE™ Professional Training Beginning Module I

DVD Review Session Form

Participant name:________________________________________

Provider name: __________________________________________

Prior to admittance into the Beginning II SE training module, participants taking the SE Professional Training Beginning Module I by

DVD must complete a mandatory, complementary, 2-hour review session with an approved Review Session Provider. This form is to

be used by the Review Session Provider to assess the participant’s comprehension of the Beginning 1 course material. This signed

and dated form will also serve as an invoice to the SE® Trauma Institute for session compensation.

The concepts and skills listed below are those that the participant is expected to have learned in the Beginning 1 SE training module.

For each of the listed skills or concepts, if the participant does not have at least a basic understanding, or feel at least somewhat

proficient in being able to apply those skills, she/he should consider focusing more specifically on those topics in her/his

consultations with faculty or approved consultation providers. Each module builds upon the knowledge gained in previous modules,

so it is useful to have a working knowledge of the material before moving on to the next module.

PART 1: Assessing Conceptual Comprehension

Review/discuss with participant the key concepts presented in the Beginning 1 training module as listed on the following two tables.

Please circle the number that best correlates with your assessment of the participant’s comprehension of each topic.

Don’t Understand

Still Unclear on Some Aspects

Basic Understanding

Good Understanding

Understand Well

Key Concepts: Physiology of Trauma

Cycles of the ANS (sympathetic and parasympathetic)

Healthy nervous system response

Traumatic stress and ANS dysregulation

Basic symptoms of traumatic stress

Basic concepts of self-regulation

SE™ Trauma Institute: Beginning I DVD Review Session Form

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Dvd Review Session Form