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Coping Agreement and Informed Consent
This is a psycho-educational experience. This means that you will be experiencing interplay between education, and personal processing and growth. This process is presented as a 10 week group. Participation in this experience can result in a number of benefits to you, including improving your relationship with yourself, your interpersonal relationships, and resolution of the specific concerns that led you to seek attendance at a psycho-educational process. During the psycho-educational process, you may also encounter unpleasant feelings or thoughts. You may also make decisions about changes you would like to make in your behaviors and/or relationships. This experience may result in changes that were not originally intended. During the course of this Intensive, Workshop or Weekly Group, I will draw on my professional experience in this area. Attending a psycho-educational process is not a substitute or alternative for individual psychotherapy, or inpatient psychotherapy. If you are in need of names of counselors before, during or after the psycho-educational process, I would be happy to provide you with a list of providers. While this is a psycho-educational experience and not a substitute for therapy, as a licensed clinician, I am still mandated to report serious occurrences such as threat or danger to self, danger to others, or physical, sexual or severe emotional abuse as mandated in accordance with California law. All other information is held in highest confidentiality. I understand and agree that these reportable exceptions are rules set forth to keep children and people safe. I understand that I am agreeing to participate in a psycho-educational experience that carries with it the potential for positive benefits and/or unpleasant feelings. I understand that I may experience both expected and unexpected change. I understand that this is not a substitute or alternative for individual/couples counseling, and that I am free to participate in my own counseling during, or after this experience. I also agree to practice self-care while I participate in this group. If I am feeling overwhelmed, I will slow down, or take a break and step away. I understand that I am free to participate to whatever degree is comfortable for me, and I will not push myself beyond that to meet any perceived expectations of myself or others.