Informed Consent for Social Sprouts
Introduction:
Welcome to our summer social skills series! We're excited to embark on this journey together toward growth of new skills and a chance to connect with peers. Before we begin, it's important for you to understand what participation in this group entails. This document serves as your informed consent, outlining the nature of the group, its benefits, potential risks, and your rights as a participant. Please read through this carefully and feel free to ask any questions you may have.
Nature of the Group:
Purpose: The purpose of this group is to provide a safe and supportive space for kids to explore and address self-esteem, self confidence, relationships and their own social strengths and needs.
Format: The group will meet once a week for approximately 45 minutes for 8 weeks. Sessions may include discussions, psychoeducational activities, skill-building exercises, and group interactions. The structure and content of each session will be tailored to meet the needs of the participants. The groups will be facilitated by an MSW Graduate Student supervised by clinical director Kara Kushnir, LCSW.
Confidentiality: Confidentiality is crucial in maintaining a safe environment for sharing. Everything discussed within the group will be kept confidential by all members, including the therapist, unless there is a risk of harm to oneself or others, or if disclosure is required by law. NOTE: high school peer mentors/volunteers who participate also are expected to uphold confidentiality and receive training ahead of time. However, given the nature of the peer models/mentors being volunteers, we do not assume any liability for the possibility of a breach of confidentiality on their part as we do our best to train them in best practices to mitigate risk.
Benefits:
Support: You'll have the opportunity to connect with peers who may share similar experiences and challenges, offering mutual support and understanding.
Learning: Through group discussions and activities, you'll gain insight into your thoughts, feelings, and behaviors, as well as learn practical skills to manage stress, regulate emotions, and improve communication.
Empowerment: Participating in this group can empower you to take an active role in your mental health journey, build resilience, and work towards your personal goals.
Risks:
Emotional Discomfort: Discussing personal experiences and emotions within the group may evoke feelings of discomfort, sadness, or anxiety. However, the group will be facilitated in a supportive manner to help navigate and process these emotions.
Confidentiality Breach: While confidentiality is a priority, there are limits to confidentiality as outlined above. In the event of a breach, efforts will be made to minimize any potential harm and maintain trust within the group.
Your Rights:
Voluntary Participation: Your participation in this group is entirely voluntary. You have the right to withdraw from the group at any time without consequence.
Informed Consent: By signing this document, you acknowledge that you have been informed of the nature, benefits, and risks of participating in the group, and you consent to engage in the group process. This group is being facilitated by a graduate MSW student supervised by an LCSW.
Privacy: Your privacy will be respected, and your personal information will be handled in accordance with applicable laws and ethical standards.
Agreement:
I have read and understood the information provided in this document regarding the group. I voluntarily consent to participate in the group and understand that I may withdraw my consent at any time without penalty. I understand the importance of confidentiality within the group and agree to respect the privacy of fellow group members. I also understand that the therapist may discuss my progress and participation within the group for professional consultation purposes, while maintaining confidentiality as much as possible.