Informed Consent for Psychoeducation via Video Conference Call
Welcome and thank you for your interest in our psychoeducation group. The following includes information about your rights as a participant and it is important that you read the following in its entirety.
Fee for Service
There is a cost associated with this group and payment is due before the start of any session. Full payment for the entire series is due before attending any sessions. It is your responsibility to make an informed decision about your ability to attend this group before submitting payment. Space is limited and your spot in the group is reserved for you upon receipt of payment. Early withdrawals or missed sessions are non-refundable.
Psychoeducation vs. Psychotherapy
The psychoeducational group you have registered for is purely educational in design and purpose and is not therapeutic or a replacement for psychotherapy. In these psychoeducational group sessions, the facilitator will present to attendees evidence-based material that has been found to be useful for people wishing to address concerns related to the group topic. Time is allowed for discussion and opportunities for you to share how concepts relate to your personal life are built into the curriculum. If issues arise that are not suitable for this educational experience, you may benefit from formal psychotherapy.
Risks of Psychoeducation
Psychoeducation has been shown to have many benefits, including improved insight,
increased understanding, and affirming support. However, since psychoeducation may involve
discussing many parts of your life, including, at times, the unpleasant aspects, you may also
experience uncomfortable feelings. You should be aware that psychoeducation may or may not
lead to direct improvements in your life. You should also be aware that if psychoeducation
induces change in your life, these changes may disrupt your accustomed manner of living and
your relationships with others.
Video conference calling allows for improved accessibility for this group. However, there are some factors that are important for you to understand. We make an effort to protect sensitive information but there are inherent risks to conducting business using the internet, computers, and other technology including unauthorized access. Disruptions of signals and problems with the internet’s infrastructure may cause broadcast and reception problems.
To maintain confidentiality, sharing the meeting link with anyone unauthorized to attend the group and any type of recording (video, audio, etc.) of sessions is strictly forbidden.
Your facilitator will make every effort to be present and prepared for each group as it was originally scheduled. However, unforeseen circumstances such as internet disruption, issues with necessary technology/computer equipment, and illness may lead to the cancelation of groups. Depending on the nature of the disruption, advance notice may or may not be possible. Someone will reach out to you when communication capabilities are restored.
We keep electronic records for all group participants. Records include identifying information and contact details such as phone numbers and email addresses. We also make note of participant engagement in sessions and keep records of what participants share during sessions. A professional assessment may also be included.
Security breaches may result in unauthorized access to identifying or sensitive information. In the unlikely event of a security breach, you will be notified of the nature of the breach and what information may have been accessible to an unauthorized party.
You may request a copy of your records and are responsible for any costs incurred. If you would like records to be sent to someone other than yourself, you must provide a Release of Information detailing your consent.
You have the right to confidentiality under federal and state laws relating to the receipt of services.
There are some Limits to Confidentiality. All of our providers are mandated reporters and have a Duty to Warn and Protect:
If you disclose a plan or threat to harm yourself, your facilitator must notify legal authorities. In addition, if you disclose a plan to harm another person, your facilitator is required to attempt to warn the possible victim and notify legal authorities.
Abuse of Children and Vulnerable Adults
If you disclose, or it is suspected, that there is abuse or harmful neglect of children or vulnerable adults (i.e. the elderly, disabled), your facilitator must report this information to the appropriate state agency and/or legal authorities.