Attestation Statement

I attest to the following:

I have satisfied all required application criteria set forth by Global Council for Clinical Sandtray Therapy to earn its Certified Clinical Sandtray Therapist (CCST) or School Based Certification in Sandtray Therapy (SB-CST) credentials.

The information, statements, and documents in this application or renewal are accurate and reflect my true experience, education, training, and expertise. Such information, statements, and documents are solely my responsibility and GCCST shall not be responsible or liable for the consequences of any inaccurate or misleading information.

To the best of my knowledge, there are no outstanding complaints against me.

I have read, understand, and hereby confirm that I will abide by the code of ethics, standards of practice, and all other legal standards required by those organizations from which I have been granted a license or certification.

I agree to support the GCCST mission statement, refrain from aiding or engaging in any conduct that is prejudicial to the purpose, interests, effectiveness, reputation, or image of the sandtray therapy profession and/or GCCST.

I acknowledge that my credentialing application or renewal may be denied, suspended, or revoked, if I: a) have a disciplinary action taken against me by the applicable licensing authority that results in the suspension or revocation of my license; b) am convicted of a crime related to the provision of mental health services or a crime that would adversely affect the interests, effectiveness, reputation, or image of GCCST; c) falsify, by inclusion or omission, information on the credentialing application or renewal or any supporting documents; d) fail to complete the CCST/SB credentialing application or renewal requirements in a timely manner; e) represent my CCST/SB credential as my primary credential or mental health qualification; or f) voluntary relinquish my license.

I agree to immediately notify GCCST by email if I: a) have any disciplinary action taken against me by the applicable licensing authority; b) have my license suspended or revoked; c) am convicted of a crime related to the provision of mental health services or a crime that would adversely affect the interests, effectiveness, reputation, or image of GCCST; or d) voluntary relinquish my license.

I have read and am familiar with Best Practices created and endorsed by GCCST and displayed on its website. GCCST BEST PRACTICES

GCCST shall have no responsibility or liability for the impact that the delay or rejection, for any reason, of a CCST/SB application for, or renewal of, a CCST/SB credential may have on my professional standing or employment status.

GCCST and its Advisory Board have reserved the sole right to resolve any and all filed complaints regarding my CCST/SB credential. GCCST reserves the right to place my CCST/SB credential on probation, or temporarily suspend or permanently revoke it, after notice and review of any complaints filed.

I acknowledge and agree that a designation as CCST/SB by GCCST does not certify, imply, or affirm my knowledge or competency in my profession or otherwise and that such designation only confirms that the education and training requirements of GCCST have been satisfied. I have not and will not use either the CCST/SB designation as my only or primary credential. I understand that on all professional documents, communications, and advertising the CCST/SB credentials must be accompanied by the degree or the license in a mental health field that establishes the type of mental health services I am qualified to offer.

I hereby indemnify and hold harmless GCCST from and against any and all claims, losses, actions, costs and expenses, including attorneys’ fees, incurred by GCCST as a result of or arising out of: a) my acts or omissions in my treatment of patients; b) my failure to abide by the code of ethics, standards of practice and legal standards and requirements promulgated by my primary licensing authority; c) any falsification, including by omission or inclusion, of information on my CCST/SB application or any supporting documents; d) my conduct or actions that are prejudicial to the purpose, interests, effectiveness, reputation, or image of sandtray therapy and/or GCCST and e) any other action or omission relating to my CCST/SB credential.

GCCST reserves the right to revise its credentialing program and its criteria, process, and other aspects. It further reserves the right to request additional information to review and process applications.

I fully understand and agree to abide by the terms and conditions of this agreement and the above attestation by which GCCST may confer a CCST/SB credential to me. I attest that I am an individually licensed mental health professional or certified school based mental health provider by the licensing/credentialing authority in the state of my residence or practice and that all information herein is true and correct to the best of my knowledge.