Informed Consent for Group Services

Informed Consent for Group Sessions

  • MM slash DD slash YYYY


  • Welcome to the Transformations Psychoeducation Group Services. . The purpose of this group is to provide education, support, and skill-building in a safe and confidential environment. The following document outlines the expectations, risks, and your rights as a participant. Please read through this information carefully, and do not hesitate to ask questions if anything is unclear.


    1. Group Purpose and Structure:
    The psychoeducation group is designed to provide education on various psychological topics, coping strategies, and tools for personal growth. Group sessions will include discussions, activities, and interactive exercises led by the facilitator. Topics covered may include emotional regulation, stress management, communication skills, and other mental health-related subjects.

    2. Confidentiality:
    Confidentiality is essential for creating a trusting and respectful group environment. As a participant, you are expected to respect the confidentiality of your fellow group members and the information shared within the group.

    Limits to Confidentiality:
    While confidentiality is a priority, there are legal and ethical limits to confidentiality. The licensed professional counselor is required to breach confidentiality if: There is a reasonable belief of harm to yourself or others (e.g., risk of suicide, self-harm, or harm to others). There is a suspicion of child abuse, elder abuse, or neglect. A court orders disclosure of information. You provide consent to share information with another party, such as a family member or another professional.

    3. Group Participation and Expectations:
    By attending the group, you agree to participate in good faith, respecting the group rules and expectations. These include: Active participation and engagement in the activities and discussions. Listening with respect and without judgment. Keeping the discussions within the group confidential. Being open to receiving feedback from others. Following the guidelines for appropriate behavior, which will be explained at the beginning of the first session.

    4. Potential Benefits and Risks:
    Benefits of participation in the group may include: Increased knowledge about psychological topics and coping strategies. Enhanced emotional regulation and communication skills. Opportunities to connect with others in a supportive environment. Risks of participating in the group may include: Emotional discomfort or distress while discussing personal issues or experiences. The possibility of encountering differing opinions or perspectives that may challenge your beliefs. The potential for feeling overwhelmed during or after certain discussions or activities. If you feel distressed at any point, please inform the group facilitator, who will provide support or help you access additional resources.

    5. Voluntary Participation:
    Participation in this group is entirely voluntary. You may choose to discontinue your participation at any time without any penalty or loss of services. If you choose to leave the group, please inform the group facilitator so they can assist with transitioning your care.

    6. Fees and Payment:
    The fee for participating in the psychoeducation group and all of our services are available for your review.  If you have any questions about payment or fees, please discuss them with the facilitator before the group begins as you are financially responsible for any fees and charges that are not covered by your insurance plan.

    7. Consent to Participate:
    By signing below, you acknowledge that you have read and understood the information provided in this informed consent. You voluntarily agree to participate in the psychoeducation group, recognizing that you have had the opportunity to ask questions and clarify any concerns you may have.

  • Click here for Fees and Service Description
  • Clear Signature
  • MM slash DD slash YYYY