Adult MBCT
Registration Contact Form

Participant Agreements

I certify that I have read and understand the entire Adult MBCT webpage.

I agree to participate in a 30-minute individual orientation to be scheduled with an STLDBT therapist who has participated in an MBCT class. I will come to the orientation prepared to ask any questions I have, discuss my expectations for the class and learn more about what the class entails.

I commit to attend all ten sessions, an all-day Saturday retreat and two 30 minute individual consultations for a total of 11 group sessions plus 2 individual consultations over 10 weeks. I understand that each session builds on previous sessions and that any absence affects my progress and the quality of other participants’ experience. 

I commit to practice meditation, mindful activity and noticing a different type of thought daily between sessions.  Home practice will require about 15-20 minutes a day six days a week.  I understand progress hinges on regular practice.

I commit to track the mindfulness skills I use daily on the provided MBCT Diary Card and to bring my completed Diary Card to class each week.

I understand that in-class practice exercises may on occasion cause emotional discomfort.  I understand therapists will minimize emotional discomfort as much as possible but I accept that some discomfort may be unavoidable and useful.

I commit to use coaching calls if/when I have the urge to stop coming to class, skip a class because I had a bad day, when I become dysregulated because of something that occurs in class, when I’m struggling with initiating home practice or if other class-related or mindfulness-related concerns, questions or struggles arise.

I certify I have fully disclosed to the best of my ability my current diagnoses. 

If applicable, I certify that all mental health providers I see are aware of my intent to participate in an Mindfulness-Based Cognitive Therapy class and support my participation. 

If under psychiatric care or in therapy, I commit to continue under care and follow treatment recommendations throughout the 10 weeks of the class.

I have a working computer or device with access to high-speed internet and working camera, speakers and microphone.

I agree to pay a $95 non-refundable registration fee which will cover the cost of the orientation and the last class.

I give St. Louis DBT, LLC permission to bill my credit or debit card for $75/session for 11 sessions, which includes 10 weekly sessions plus a 6 hour retreat. Two partial scholarships are available upon written application. Deadline for a scholarship is 30 days before classes start.

I understand that I am purchasing a full course for a total cost of $920. The cost is prorated over 11 sessions solely for the convenience of participants. Participants may elect to pay in full at any time.

I agree t0 provide credit or debit card details either through St Louis DBT’s client portal or by phone prior to this application being accepted. Credit card details will be saved in ST. Louis DBT, LLC’s secure and private electronic management system, TheraNest.

I understand St. Louis DBT, LLC does not file health insurance forms but that documentation can be provided on request so I can submit for out-of-network reimbursement, if available. I understand insurance providers will not reimburse for missed sessions.