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RCA Mental Health Consultation-Line
Participation is voluntary and confidential
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Name of RCA Member
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First
Last
The need is about:
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Rabbi
Spouse
Couple
Child(ren)
Wider Family
Community Member
Who will be at the session?
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Self
Spouse
Couple
Child(ren)
Family
Other (if other, please explain)*
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The Challenge is
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Acute
Ongoing
Emergency
RCA Mental reach
Best email to reach interested party about the session
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Best mobile phone to reach interested party about the session
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Issue(s) about which you would like to receive guidance
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Mental Health & Emotional Well-Being
Crisis Situations in Family & Marriage:
Professional & Community Challenges:
Boundary and Ethical Challenges:
Mental Health and Emotional Well-Being
Acute Stress & Anxietry
Burnout & Exhaustion
Depression & Low Mood
Panic Attacks
Grief & Loss
Trauma & PTSD
Anger Management
Addictive Behaviors
Crisis Situations in Family and Marriage:
Marital Issues
Mental Health Issues with Family Members
Parenting Challenges
Severe Family Conflict/Estrangement
Professional and Community Challenges:
Congregational Conflict
Harassment or Attacks
Community Tragedy/Trauma
Boundary and Ethical Challenges:
Confidentiality Dilemmas
Boundary Struggles
Best times for the consultation (click all that apply):
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Weekdays - Days
Weekdays - Evenings
Weekends
Preferred Volunteer
First Choice
Second Choice
Third Choice
Custom Captcha
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