Informed Consent & Participation Agreement

A Life In Balance DBT Skills Training Group

Format: Virtual Group Skills Training

Program Length: 24 Consecutive Weeks (unless otherwise specified)

This document provides informed consent for participation in a therapist-led DBT Skills Training Group and outlines expectations for participation, attendance, and engagement. Please read carefully. Participation in the program requires acknowledgment and agreement to the terms below.

1. Nature of Group-Based Service

I understand that this program is provided in a group-based format, meaning:

• Sessions are attended by multiple participants simultaneously.

• Learning occurs through skills instruction, discussion, observation, and shared practice.

• Other participants may share personal experiences related to skill application.

I acknowledge that group-based services differ from individual therapy and require shared responsibility for maintaining a respectful, safe, and collaborative environment.

2. Scope of Services: DBT Skills Training Only

I understand and agree that:

• This program provides DBT skills training only.

• This is not comprehensive DBT treatment.

• Services are limited to psychoeducation, skills instruction, and structured group process.

This program does not include:

• Individual DBT therapy

• Phone coaching

• Crisis or emergency services

• Case management or trauma processing

I acknowledge that the facilitator’s role is limited to skills training within the group context.

3. Requirement for Concurrent Individual Therapy

Add your textI understand that:

• Ongoing individual therapy is required concurrently while participating in this DBT Skills Training Group.

• Individual therapy is necessary to address personal history, individualized treatment goals, crisis support, and emotional processing outside the scope of group skills training.

• The group facilitator does not assume responsibility for individual clinical care beyond this program.

4. Attendance, Commitment & Engagement Agreement

I understand that DBT skills training is cumulative and depends on consistent participation. By enrolling in this program, I affirm my agreement to:

• Attend weekly sessions for 24 consecutive weeks

• Arrive on time and remain present for the full session

• Participate respectfully and follow group norms

• Remain engaged (camera on, attentive, not multitasking)

• Commit to the cumulative learning and practice of DBT skills

I acknowledge that:

• Regular attendance is essential to my progress and the integrity of the group.

• Repeated absences, late arrivals, or disengagement may interfere with treatment effectiveness.

• Excessive absences or failure to meet participation expectations may result in removal from the program without refund.

5. Benefits of Group Participation

I understand that potential benefits of participation may include:

• Learning evidence-based DBT skills for emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness

• Increased self-awareness and coping capacity

• Normalization and support through shared group experience

• Opportunities to practice skills in a structured, relational setting

I acknowledge that benefits are not guaranteed and vary by individual.

6. Potential Risks of Group Participation

I understand that possible risks include:

• Emotional discomfort or activation during skills practice or discussion

• Feeling triggered, overwhelmed, or emotionally vulnerable

• Risk of confidentiality breaches by other group members, despite clear expectations

I acknowledge that I may discuss concerns with the facilitator and that participation is voluntary.

7. Confidentiality & Limits of Confidentiality

I understand that:

• The facilitator is legally and ethically bound to maintain confidentiality in accordance with professional standards and applicable law.

• Confidentiality in a group setting cannot be guaranteed, as other participants are not legally bound in the same manner.

I agree to:

• Respect the privacy of all group members

• Not disclose personal or identifying information shared in group outside of sessions

I understand that confidentiality may be broken by the facilitator if required by law, including:

• Risk of serious harm to self or others

• Suspected abuse or neglect of a minor, elder, or dependent adult

• Court orders or other legal requirements

8. Crisis Services & Safety Limitations

I acknowledge that:

• This program does not provide crisis services or emergency intervention.

• Phone coaching between sessions is not included.

• If I experience suicidal thoughts, urges to self-harm, or emotional instability beyond my ability to manage safely, I am responsible for seeking immediate support through:

  
  

  • My individual therapist

  • Emergency services (911)

  • Crisis resources such as the 988 Suicide & Crisis Lifeline

    
    

I understand that the facilitator may recommend a higher level of care if clinically indicated.

9. Voluntary Participation & Right to Withdraw

I understand that:

• Participation in this program is voluntary.

• I may choose to withdraw at any time.

• Withdrawal does not eliminate financial obligations outlined in the Program Terms & Policies.

• The facilitator reserves the right to recommend withdrawal or terminate participation if group participation is no longer clinically appropriate or group safety is compromised.

10. Acknowledgment & Consent

By signing below, I confirm that:

• I have read and understand this Informed Consent & Participation Agreement.

• I have had the opportunity to ask questions and receive clarification.

• I understand the nature, benefits, risks, and limitations of this program.

• I voluntarily consent to participate under the conditions described above.