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  • Informed Consent for Art Therapy Group

  • This art therapy group uses visual art tools, techniques, and activities to facilitate positive therapeutic outcomes related to emotional functioning and mood. Activities will incorporate two- and three-dimensional art-making, including drawing, painting, collage, and sculpture. Art-making has been found to facilitate deeper expression of thoughts, feelings, and experiences, and the group environment invites for interpersonal connections, reflections, and artistic inspiration. Participants design and create individual art pieces with therapeutic intent, engage in dialogue around their own and others’ artworks, and reflect on the art-making process and impacts on mood and self-expression.

    SCHEDULE/FEES

    Wednesdays 5:00-6:30pm

    April 12th – May 31st (9 weeks)

    $1800 total ($200/session) paid in full in advance

    SAFETY/CONFIDENTIALITY

    A safe environment is created and maintained by the facilitators of the group, the children participating in the group, and their parents. While the Art Therapy Group has a structured approach and curriculum, children and their parents sometimes share sensitive and private information with the facilitators and/or other group members and parents. Wolff Child Psychology and your group facilitators are legally bound to maintain confidentiality. Along these lines, we request group members and parents maintain others’ privacy and confidentiality.

    LEGAL LIMITS OF CONFIDENTIALITY

    The information provided by and to you as a client of the Art Therapy Group is legally confidential and generally cannot be released without the client’s consent. There are exceptions to this confidentiality, which are listed in the Notice of Privacy Practices you were provided. For instance, if we are directed by a judge in a court of law to reveal information, then we must do so. Additionally, if you provide us with information about child abuse or neglect, abuse or neglect of the elderly, or abuse or neglect of a compromised adult, we must report that information immediately. If you tell us that you intend to harm someone else or yourself, we are required by law to reveal that information to the authorities and to the individual who may be harmed. In addition, we are required to work with you closely to preserve your safety. If a legal exception arises during the group, if feasible, you will be informed accordingly. 

    RECORDS

    Records may be released with your written permission. Records will include only the child’s personal progress in group—not information about other group members.

    PROFESSIONAL CONSULTATION

    Facilitators may consult with other professionals at WCP regarding group interactions. This allows a freedom to gain other perspectives and ideas concerning how best to help you reach individual and group goals. No identifying information is shared in such consultations unless a release has been obtained from you as a group member.

    ATTENDANCE

    Your child’s presence in group is highly important. A group dynamic is formed that helps create an optimal learning environment. We ask that you make this commitment a top priority for the duration of the group. It is understood that occasionally an emergency may occur that will prevent you from attending group. If you are faced with an emergency or sudden illness, please contact your facilitator before group begins to let them know you will not be present.

     

    Alexandra Manion, Ph.D.

    Dr. Alexandra Manion is a current post-doctoral fellow in clinical psychology. She received her Ph.D. in Child, Family, and School Psychology from the University of Denver, as well as her M.A in Educational Psychology from the University of Colorado. Her experience and expertise represent a blend of both clinical and school-based delivery, with a focus on neuropsychological assessment and evidence-based intervention. Dr. Manion completed pre-doctoral training in pediatric neuropsychology at Children’s Hospital Colorado, in addition to completing an APA-accredited pre-doctoral internship in neuropsychology at Henry Ford Health System in Detroit, MI. Her assessment and intervention experience includes infants, children, and adolescents with learning disorders, Autism Spectrum Disorder, ADHD, trauma, emotional and behavioral concerns, as well as complex medical presentations. Alexandra Manion's work is supervised by Nikki Pond, Psy.D. Dr. Nikki Pond is an employee of Wolff Child Psychology in the position of Psychologist. She received her M.Ed. in Prevention Science and Practice from the Harvard Graduate School of Education and her M.A. and Psy.D. in Clinical Psychology from the University of Denver. She completed pre-doctoral training in assessment at National Jewish Health, as well as training in therapy and assessment for children with complex trauma, depression, and anxiety at Denver Children's Home. As a pre-doctoral intern, she completed an APA-accredited one-year internship training program in child and adolescent psychology at Denver Children's Home through the DU Graduate School of Professional Psychology Internship Consortium. She is currently licensed as a Psychologist in the State of Colorado. Her license is #5344.

     

    Danielle Mohr, Ph.D.

    Dr. Danielle Mohr is a Licensed Clinical Psychologist. She earned her M.S. and Ph.D. in Counseling Psychology from Colorado State University. Her graduate training focused on assessment and treatment of children and adolescents with ADHD, learning disorders, Autism Spectrum Disorder, and mood and behavioral concerns. Dr. Mohr completed her pre-doctoral internship at Community Reach Center, in Adams County, Colorado, and a post-doctoral fellowship in clinical child psychology at the University of California at Davis Medical Center. Dr. Mohr has served as the Assessment Coordinator for Aurora Mental Health Center, supervising doctoral students in psychological assessment and diagnosis, and has worked in a private practice setting. Dr. Mohr sees assessment as a collaborative process to help children and families learn about strengths and find the support they need. She is currently licensed as a Psychologist in the State of Colorado. Her license is #4528.

  • How to reach Drs. Danielle Mohr and Alexandra Manion

    You can reach us by calling our confidential phone line and voicemail at (303) 500-3407 or e-mailing us at danielle@wolffchildpsychology.com and alexandra@wolffchildpsychology.com.  Because we do not provide an emergency response system, we may not return your call promptly. On weekdays, we usually check voicemail at least twice per day (i.e., in the morning and before the end of the business day). On the weekends and on holidays, we check voicemail at least once per day. We do not carry pager or work cell phones.

    E-mail is an acceptable form of communication with us; however, as with any form of communication, we cannot completely ensure its confidentiality. You should not email uswith urgent concerns or to tell us about self-injurious thoughts or actions. Rather, you should call 911 or contact your nearest emergency room if you are in imminent danger of hurting yourself or someone else. If there is time for you to safely leave a message on our voicemails indicating you are in a state of emergency after you call 911 or go to an emergency room, please do that as well. You may also contact 1-800-273-TALK for immediate 24-hour services if you are thinking of hurting or killing yourself.

  • I have read the preceding information, it has also been provided verbally, and I understand my rights as a client or as the client’s responsible party. I have received a copy of this form for my own records.

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