Count50: A Depression & Anxiety Support Programme

Application

Welcome to the pilot of Count50, a 7-Week Depression & Anxiety Support Programme.

This is a structured programme to support you in managing depression and anxiety. Please note that all sessions are educational and peer-support based and are not a substitute for medical advice, therapy, pastoral care or professional counselling.

Please note that this is a pilot programme, which is still in development, and your participation is greatly appreciated. By taking part, you will be contributing to the improvement and future development of the programme for others.

The programme will run on Tuesday evenings from 14 October to 25 November (18:30 to 20:30). The pilot will be hosted by Rosebank Union Church. It is expected for participants to commit to attending all sessions in-person for the full duration of the programme.

To help us prepare and ensure the programme is the right fit for you, kindly complete the application form below.

Personal Details

Untitled checkboxes field

I am 18 years or older

Emergency Contact Details

Participation & Availability

I am willing and available to commit to attending the in-person sessions from 14 October to 25 November (Tuesday evenings, 18:30 to 20:30) barring any personal or family emergencies.

Participation & Availability

Yes, I am willing and available!

History of Depression and/or Anxiety

Approximately how long have you suffered with depression/anxiety?

Are you currently taking medication for depression/anxiety?

Yes

Sometimes/Intermittently

In the past, but not currently

Are you currently undergoing professional therapy/counselling for depression/anxiety?

Yes

Sometimes/Intermittently

In the past, but not currently

Please provide a short history and description of your depression/anxiety:

Confidentiality & Safety

I accept and understand that participation in this programme may involve myself or others sharing personal or sensitive information. I agree to keep such information in the strictest confidence and to not disclose or share this information outside of the group. This is for the safety and protection of yourself and other participants.

I understand that the programme leadership will keep all your personal information, details and disclosures in the strictest confidence. The only exception is where a participant’s wellbeing or safety (or that of others) may be at immediate risk. In such cases, information may be shared with the appropriate authorities, Church Eldership, and/or a medical professional for the sole purpose of ensuring the safety and protection of the individuals concerned.

Confidentiality & Safety

Yes, I accept and understand

Physical Exercise

I accept and understand that this programme includes guidelines to participate in regular physical exercise and movement. I accept that it is my responsibility to ensure I have received clearance from a medical professional before engaging in such activities. I will communicate any questions, concerns, or personal limitations to the programme leadership.

Yes, I accept and understand

Disclaimer

By checking "Accept" below, I understand and accept that this support group is intended for informational and educational purposes only. It does not provide medical advice, diagnosis, treatment, therapy, or counselling. Participation is not a substitute for professional medical, psychological or psychiatric care. If you are experiencing a mental health crisis or require medical assistance, please contact a qualified healthcare professional or your local emergency services immediately.

Disclaimer