Informed Consent for Participation in a Grounded Theory Study

Welcome to the study!

Hi, my name is Vanessa Black. I am a doctoral candidate at Pacifica Graduate Institute. I will be conducting this study as partial fulfillment of the doctorate for the degree of Doctor of Philosophy in Depth Psychology Specialization in Somatic Studies requirements at Pacifica Graduate Institute. Please read through the information below. Feel free to reach out if you have any questions. Once you are ready to participate, please sign this informed consent form below, so I will have a record that you confirm that you have read the information and that you consent to participation.

Inclusion Criteria

I understand that in order to participate in the study, I must confirm that:

• I am 18 years of age
• I work in a dyadic practice
• I am not in a personal relationship with the researcher
• I am not in the internship phase of my clinical work
• I am willing to participate in a 60-90 minute Zoom interview
• I have access to reliable WIFI 

What to Expect

The interview will be conducted and recorded on the Zoom platform. I understand that the researcher will transcribe the recorded sessions and provide me with a summary of their findings for my review. At that time, I will have the opportunity to further comment upon, correct, edit, or add any additional information to the findings. I understand that the dissertation will be published by Pacifica Graduate Institute and may be publicly available. I acknowledge that I will not be paid for my participation.

 

Risks, Safeguards, Confidentiality, & Benefits

Risks

I understand that my participation in this study may be psychologically activating. As with any psychological study, or any exploration of psychological material, difficult or confusing feelings, thoughts, or somatic symptoms may arise. I understand that my participation in this study may produce a range of thoughts, feelings, and emotions of varying intensity or duration. I further understand that maintaining self-care is my responsibility.

Safeguards

At any time before, during, or after the completion of this study, if I become
uncomfortable, I can (a) decline to answer an interview question, (b) choose to opt out of the study, or (c) ask the researcher for referrals to therapy or counseling resources to process material arising from participation. I understand that my participation in this study precludes the researcher from acting as a therapist. This would create a dual relationship and is prohibited. Thus, the researcher will provide at least three referrals in the event that I need therapeutic support, but I will be responsible for paying any counseling fees.

Confidentiality

I understand that every effort will be made to ensure my anonymity, and that my confidentiality will be protected at all times. My name and any other information that could potentially be used to identify me will be changed or omitted. These same protections will be extended to my clients, patients, colleagues, mentors, and supervisors who may be mentioned during the interviews.

All recorded materials will be stored on password-protected devices, and/or devices that are stored in locked containers. At no time will any recorded material be made available on the internet, or placed in a situation where confidentiality could be compromised in any way. All written records will be stored in a secure location. If analyzed on a computer, all data will remain password-protected on a local non-networked laptop. All documents, recorded materials, and identifying data from this study will be destroyed three years after the study is published.

Benefits

By participating in this study, I may find some benefit in an in-depth exploration of the dyadic relationships I have been a part of. I also understand that this exploration may give me the opportunity to engage in a reflexive process. Possible benefits from participating in this study is that I may explore find a new ways of thinking about the practitioner-client relationship and the intersubjective field.

 

Participation is Voluntary

I understand that I am voluntarily participating in a qualitative grounded theory psychological study conducted by Vanessa Black in partial fulfillment of requirements for a doctoral degree at Pacifica Graduate Institute. This study is concerned with how biopsychosocial and historical factors influence contemporary practitioners in their professional dyadic relationships. I understand that my participation in this study will consist of one 60-90 minute recorded Zoom interview.

Contact Information
The information about this study has been provided to me by the researcher, Vanessa Black. If I have further questions, I may contact the researcher via email at vanessa.black@my.pacifica.edu or by calling (661) 203-6190. I may also contact the faculty member at Pacifica Graduate Institute who is supervising this research study, Dr. Juliet Rohde-Brown, jrohde-brown@pacifica.edu.

CONSENT

I have read and understood this Informed Consent notice, and with my signature
below, hereby give my informed consent to be a willing participant in this psychological study under the terms and conditions listed above. I understand my confidentiality will be protected in the use of any and all materials.