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Informed Consent for Group

Welcome! We are so excited to meet you! 

Please read through the information below and feel free to ask your questions about our sessions and/or anything about us. Once you are ready to participate, please sign this informed consent form below so we will have on our records that you have read the information and that you have been properly informed about  therapy, groups, and workshops.


Group Therapy & Support groups are a unique environment where a group of people who are likely experiencing similar challenges in the period of their lives gets together to share their difficulties which as a result give and at the same time, receive help from each other. 


Group Therapy is centered around a group of people experiencing similar situations, but this treatment option is more structured than a support group. These sessions often have a fixed timeframe, say meeting once a week for 6-8 weeks. The therapist leading the sessions will offer guided programs as the group works through the issues together. Group therapies often are centered around mental health issues many people struggle with, such as depression or grief. Due to state license limitations, we can only provide group therapy to residents of: NY, CT, MA, NJ, FL AND CO.

Support groups and Workshops are made up of people who are all working through a similar mental or emotional health situation, such as grieving a loved one, substance abuse (their own or a loved one’s), depression and so on. These groups usually meet regularly, and have an ongoing schedule. They are usually facilitated by mental health professional, but not guided through a particular program. The mental health professional might suggest additional, individual treatments which would happen outside of the group. These are not limited based on the state in which a participant resides, and are open to anyone.

Each group is different, so you may be signing up for (1) an interactive group which will allow participants to share, or (2) Non-interactive group which consists of the group facilitator teaching or guiding you through activities or a particular topic.

We make sure to maintain a safe environment that is conducive both for sharing and accepting each other where each can grow and trust one another and where each and everyone will feel respected and valued.



We respect each and everyone's right to privacy and confidentiality and we shall make sure to maintain it that way. However, please understand that this is not absolute and is limited to provide for by law. Certain limitations are as follows:

  • Threatening one's self or another that may result in physical harm;

  • An act of physical or emotional abuse against a child or any person;

  • Sexual abuse against a child where the child is living with the abuser;
    Whenever we are summoned by court order to disclose information against a participant. However, we shall notify you and let you exercise your privilege in the right to deny the disclosure of your records with us.

  • Your prior written consent to release records.


For the safety it is necessary that the following is required to be complied with by its members:

  1. Discussions made within the group session are not allowed to be discussed outside with anyone and should maintain the practice of confidentiality in order to build trust with fellow members;

  2. Members should maintain positivity and not induce disrespect among others;

  3. Members should not be drunk, nor they are allowed to take alcohol or take drugs before or after therapy;

  4. Maintain conduct that brings respect to fellow members' thoughts, emotions, or behavior.

  5. Refrain from having a relationship with a fellow member other than therapeutic while engaged in the session.


The therapists should maintain a professional relationship with the participants all the time and no more than that. Any relationship with a participant may result in a "dual relationship" and may affect the goals of the session.


For INTERACTIVE GROUPS: The sessions consist of processing on the issues that a member is involved where the others will give their feedback and reaction towards the said issue. This helps each member understand the issue from a different perspective in order to understand others. This also helps with one's reflection about his or her situation which can then help for insight and personal growth.


For NON-INTERACTIVE GROUPS: The sessions consist of the facilitator either teaching you new skills, or providing psychoeducation on a particular topic. You will not need to show your video or unmute yourself. You can use the "raise hand" button on ZOOM or use the chat box if something comes up for you.



I agree to adhere to the norms and expectations for group therapy, support groups, and workshops as indicated above. I acknowledge that I have had the opportunity to ask questions and such questions were answered clearly and to my satisfaction.

I acknowledge that there will be other individuals who have been invited to attend this group.

Confidentiality is not guaranteed, however, it is one of the values and rules to maintain a safe space. I acknowledge and agree to maintain confidentiality.

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