You will be asked to participate in a discussion group led by Holly Sullivan, a psychology student from Saint Mary's College. During the discussion, Holly will ask questions about what you expected to happen as a result of your treatment at the ILC. You will also be asked whether you thought your treatment was helpful and asked to describe how you know whether it was helpful. Holly will also be sharing with you some of the methods that we use to measure progress at the ILC, and she will ask you what you think of these methods. We ask you to answer honestly because we are very interested in your honest opinion.
Because we want to learn from what is said by each person in the group discussion, the discussion will be tape recorded. This tape recording makes sure that we are able to take every comment into consideration. After the discussion is over, the comments people have made will be typed up into a report, and the tape recording will be destroyed. In the typed report, no one's name will be revealed. Each person will be assigned a number, and the identity of those who made comments will not be revealed. Only Holly, Margaret Sak, O.T.R. (clinical manager of the ILC), and Catherine Pittman, Ph.D. (a psychology professor from Saint Mary's College) will know your identity. When a report of the findings of this study is given to the professionals at the ILC, all the comments you have made will be anonymous. No information about you that would reveal your identity will be disclosed.
Discussing the process of rehabilitation and how you have changed since your illness or injury may be uncomfortable or upsetting, and Holly is available to provide support should you feel upset during the discussion. Furthermore, you are free to stop participating in this study at any time.
The whole procedure should take approximately two hours. If you have questions about this study, please ask Holly. She will be happy to answer them. Margaret Sak and Catherine Pittman are in charge of this study. If you have any questions or comments for them, please contact them at 289-0122.
You are making a decision about whether or not to participate. Your signature on the other side of this sheet indicates that you have read this information and have decided to participate in the study. You may withdraw at any time should you choose to do so, and, if you withdraw, your comments will not be included in the report. Withdrawing will not in anyway affect your health or treatment. You will be given a copy of this form to keep.
I agree
to participate in this study. The purpose of the study has been explained
to me. I understand that the information obtained about me will be
confidential. I have been told the benefits and drawbacks of participating.
I know whom to contact for further information. I understand the
procedure may take up to two hours. I know that my participation
is voluntary, that refusal to participate will involve no penalty, and
that I may withdraw at anytime.
| ____________________________________
Signature of Participant |
__________________________
Date |
| ____________________________________
Signature of Group Facilitator |
__________________________
Date |
Last updated: January, 2003
If you have any comments or suggestions about this web site, please send them to wsvelmoe@sainmarys.edu.
This site was authored by Dr. Catherine Pittman and Zhou Zhu as the product of a faculty / student special project.