Thank you for agreeing to present at SBCNA's Conference. Please complete the form below. One form must be completed for each session.

Please email your most recent CV and photo for CE credit approval and promotional purposes to presenters@sebiofeedback.org.

Speaker Information

Speaker Biography

Your bio should be 100-150 words, please do not ask us to edit your CV or type "see attached".

Additional Speaker(s)

For additional speakers, please provide all information requested above for each speaker including name, title, degree(s), affiliation, phone number, email address, mailing address and biography.

Session Information

(if more than one speaker, this section should be an overview of entire session)

WRITING BEHAVIORAL LEARNING OBJECTIVES

• Learning objectives, or learning outcomes, are statements that clearly describe what the learner will know or be able to do as a result of having attended an educational program or activity.
• Learning objectives must be observable and measurable.
• Learning objectives should (1) focus on the learner, and (2) contain action verbs that describe measurable behaviors.
• Verbs to consider when writing learning objectives: list, describe, recite, write compute, discuss, explain, predict apply, demonstrate, prepare, use analyze, design, select, utilize compile, create, plan, revise assess, compare, rate, critique
• Verbs to avoid when writing learning objectives know, understand, learn, appreciate, become aware of, become familiar with

Example of well-written learning objectives:

This workshop is designed to help you:

• Summarize basic hypnosis theory and technique;
• Observe demonstrations of hypnotic technique and phenomena;
• Recognize differences between acute and chronic pain;
• Utilize hypnosis in controlling acute pain;
• Apply post-hypnotic suggestions to chronic pain; and
• Practice hypnotic technique in dyads.

REFERENCES

UTILITY/VALIDITY

SPEAKER DISCLOSURE FORM

• In order to ensure independence, objectivity and scientific rigor in all activities and in accordance with the ACCME, ANCC and ACPE Standards for Commercial Support; all those in a position to control the content of an educational activity are required to disclose their relevant financial relationships. This includes indicating that you have nothing to disclose. Your disclosure will be distributed to the activity attendees.
• Government organizations and non-profits are NOT commercial organizations, so we are not interested in those relationships.
• * Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. 'Contracted research' refers to research funding in which an institution receives a grant and manages the grant funds and an individual(s) is the principal or named investigator on the grant. Relevant financial relationships are those in which an individual (including the individual's spouse/domestic partner/business partner) has/has had a personal financial relationship (in any amount) occurring in the last 12 months with a commercial entity producing health care goods or services and that individual also has control over educational content (planning or presenting) about the products or class of products of the commercial interest.

If yes, please indicate the following information:

NBCC Presenter Qualification Form

In order for a provider to offer and issue NBCC continuing education credit, the program must satisfy the following requirements: the subject matter must be directly and primarily related to an NBCC content area, and the presenter of the program must qualify as a presenter for the subject matter presented.

Qualifying programs must be taught or authored by presenters who possess appropriate qualifications, as required by the NBCC Continuing Education Provider Policy. Qualified presenters and authors are classified by three (3) specific categories. The following categories identify the relevant education and/or experience requirements for a presenter to qualify to present/author programs that are offered for NBCC continuing education credit.

1. Category 1 Presenter Qualifications. In order to qualify as a Category 1 Presenter, the individual must:
   (a). Hold a graduate degree in a mental health field from a regionally accredited educational institution; and,
   (b). Be qualified by appropriate education, experience, and/or training to present/author the particular subject matter, or author the publication concerning the subject matter.
2. Category 2 Presenter Qualifications. In order to qualify as a Category 2 Presenter, the individual must:
   (a). Hold a graduate degree from a regionally accredited educational institution directly related to the subject matter presented; and,
   (b). Be qualified by appropriate education, experience, and/or training to present/author the particular subject matter, or author the publication concerning the subject matter.
3. Category 3 Presenter Qualifications. In order to qualify as a Category 3 Presenter, the individual must:
   (a). Be qualified by appropriate education, experience, and/or training to present/author the particular subject matter, or author the publication concerning the subject matter.
4. Additional Presenter Requirements and Restrictions.
   (a). Each program presenter must qualify under this Policy to teach the particular subject matter presented by that individual.
   (b). Honorary academic degrees must not be used to qualify a presenter to present or author programs offered for NBCC credit.
   (c). Individuals who have received academic degrees outside the United States may or may not be qualified to present programs for NBCC credit. Such foreign degreed individuals may be required to submit the results of an international degree equivalency evaluation. NBCC will determine whether the individual qualifies as a presenter under this Policy.

In order for a provider to offer and issue NBCC credit, the program subject matter must be directly and primarily related to one (1) or more of the NBCC Content Areas identified below, and as required by the NBCC Continuing Education Provider Policy. The following categories identify the NBCC Content Areas. The relevant content area(s) must be identifiable in the program objectives.

Approved General Topic Areas
See http://www.nbcc.org/Assets/NBCC-cont-ed-policies-procedures.pdf for full description of the following general topic areas and presenter category requirements.

1. Counseling Theory/Practice and the Counseling Relationship
2. Human Growth and Development
3. Social and Cultural Foundations
4. Group Dynamics and Counseling
5. Career Development and Counseling
6. Assessment
7. Research and Program Evaluation
8. Counselor Professional Identity and Practice Issues
9. Wellness and Prevention

A curriculum vitae, résumé or other documentation to verify education, experience and/or training must be submitted in addition to the following form for each presenter.

Presenter Education:

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