Participant Waiver (please read and sign below)
Kelsey Sawyer is a Board Certified Dance Movement Therapist and Yoga Teacher who specializes in Grief. Due to state to state licensing laws, Ripples of Courage is a grief support group and is not considered therapy. I understand that this group is not therapy and is not a subsitute for psychiatric care, psychotherapy, or medical treatment.
Instead, this group is a supportive environment where participants can connect and share about their grief experience openly and honestly through creativity and expression. Though sharing is encouraged, it is not required.
Group Guidelines:
- I will respect confidentiality
- I will practice non-judgement towards myself and others
- I will be mindful of the time and energy I am taking from the group, to ensure everyone has the opportunity to share and be supported
- I will not give advice or tell others what they "should" do
- I will use inclusive language and be open minded
- I will practice self care throughout the 6 weeks
Confidentiality: I agree to respecting other members confidentiality and will not share any identifying information about the other members, or anything that was discussed in group regarding their stories, with anyone outside of the group. I understand that I may share about my own experience and contributions to the group, but not what other members have shared.
Privacy: I understand that a third party video conferencing platform (Zoom) will be used to facilitate these meetings. These meetings have been encrypted to protect privacy, and I have read and accepted the security of the facilitating platform.
These meetings will not be recorded and members are prohibited from recording these meetings in any way.
Emergency Protocol: If at any point in the series I feel like harming myself or someone else, I will let the group leader know or inform my individual therapist and or psychiatrist. If I am unable to reach them, I will call 911 or go to my local emergency room and ask for Mental Health Services.
Movement Agreement:
I understand that this group will involve gentle movement, breath, and yoga poses to explore grief in a more embodied way.
During this practice I agree to listen to my body and the yoga instructor, Kelsey Sawyer of Riverbend Grief Movement LLC. If there is ever any pain or discomfort physically, I will pull back and rest to take care of my body. I have the freedom to stop doing any technique and exercise that doesn’t feel right to me in my body.