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Group Therapy Consent

Welcome to Group Therapy.
Before participating in group sessions, it’s important that you understand the nature of group therapy and agree to the guidelines that support a safe and respectful environment. This consent form outlines key information about confidentiality, group expectations, and your rights as a participant. Please read it carefully and sign to acknowledge your understanding and agreement before attending group therapy.

Telehealth Group Consent and Agreement

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This document serves as an agreement between the patient and clinic(s) regarding participation in telehealth substance abuse group therapy sessions led by our counselor(s). By signing this agreement, you acknowledge that you have read, understand, and agree to

the guidelines outlined below.

1. Purpose of Telehealth Group Therapy

Telehealth group therapy provides support and therapeutic interventions for individuals dealing with substance abuse. These sessions aim to foster a safe, confidential, and supportive environment to aid in recovery and personal growth.


2. Confidentiality and Privacy

Confidentiality is a critical component of group therapy. However, due to the nature of group settings, absolute confidentiality cannot be guaranteed. By participating, you acknowledge and agree to the following:

 - Refrain from sharing any personal or identifying information about other group members outside the group.

 - Ensure you are in a private and secure location during sessions to maintain confidentiality.

 - Use headphones if necessary to prevent others from overhearing group discussions.

 - The use of recording devices, screenshots, or screen recording software during sessions is strictly prohibited.

 - While all members are expected to uphold confidentiality, the therapist cannot control what participants do or say outside the group setting.


3. Legal and Ethical Limitations of Confidentiality

There are legal and ethical exceptions to confidentiality where the therapist is required by

law to break confidentiality, including:

 - If a participant expresses suicidal ideation with imminent risk of harm.

 - If a participant expresses homicidal ideation or threats of violence towards others.

 - If there is suspicion or disclosure of child abuse or neglect.

 - If there is suspicion or disclosure of elder abuse, dependent adult abuse, or abuse of

individuals with disabilities.

 - If the therapist receives a subpoena or court order requiring disclosure of therapy records.


4. Group Rules and Expectations

To ensure a productive and respectful group environment, all participants must adhere to the following rules:

 - Attend sessions on time and participate actively.

 - Treat all group members with respect and avoid disruptive behavior.

 - Refrain from using offensive or derogatory language.

 - Remain substance-free during sessions.

 - Follow therapist guidance and interventions.

 - Notify the therapist in advance if you are unable to attend a session.


5. Technology Requirements

To participate in telehealth sessions, you must meet the following requirements:

 - Have a stable internet connection and a working camera/microphone.

 - Use a secure telehealth platform as designated by the therapist.

 - Log in a few minutes before the scheduled session time to address any technical difficulties.


6. Risks and Limitations of Telehealth

While telehealth provides accessibility and convenience, it has limitations, including but not limited to: potential technology failures, limited non-verbal communication, and privacy concerns. If technical issues arise, please attempt to reconnect or contact the therapist immediately.


7. Emergency Protocol

Telehealth is not suitable for crisis situations. If you experience an emergency, including

suicidal or homicidal thoughts, call 911, visit the nearest emergency room, or contact a crisis hotline immediately. The therapist will provide local crisis resources as needed.


8. Consent and Agreement

By signing below, you acknowledge that you have read, understand, and agree to the terms outlined in this agreement. You consent to participate in telehealth substance abuse group therapy and understand the expectations and limitations.


To maintain a safe and supportive environment, all participants must remain free from the influence of alcohol or illicit substances during group sessions. If a participant appears to be under the influence—such as displaying slurred speech, impaired cognition, erratic behavior, or other observable signs of intoxication and/or signs of mental distress—the therapist reserves the right to remove them from the session. Continued violations of this policy may result in dismissal from the telehealth group.

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