Group Agreements Form - Counseling And Psychological Services

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Group Agreements
Counseling and Psychological Services
Confidentiality agreement: You have the right to confidentiality and privacy by the group
leaders and other group members. Confidentiality within the group setting is a shared
responsibility of all members and leaders. While group leaders may not disclose any client
communications or information except as provided by law, group members’
communications are not protected. As such, confidentiality within the group setting is
often based on mutual trust and respect.
CAPS adheres to professional, legal, and ethical guidelines of confidentiality established by
professional organizations and state law. Legal and ethical exceptions to confidentiality
include: a clear or present danger to harm yourself or another, knowledge of the abuse or
neglect of a minor child or incapacitated adult, or responses to a court subpoena or as
otherwise required by law.
As a member of this group, I agree to not disclose to anyone outside the group any
information that may help to identify another group member. This includes, but is not
limited to, names, physical descriptions, biological information, and specifics to the content
of interactions with other group members.
Additional group agreements:
 I agree to come each week, stay the entire session, and to be punctual. Group will
start and end on time.
 I agree that if I am going to miss a session I will let the group members and/or
leaders know in a timely fashion.
 I understand that a minimum commitment of 3 sessions is required.
 I understand that it is my responsibility to discuss my therapeutic goals and reason(s)
for attending. Also, I understand that no one is going to force me to talk or reveal
difficult material before I am ready to do so.
 I understand that any form of physical contact is not permitted within the group
setting.
 I agree that as long as I am a group member, I will not subgroup with other
members outside of group time (e.g. hang out, date)
 I understand that drinks are allowed, but food may not be.
 I agree that all cell phones will be turned off during group time.
 I understand that group sessions may be videotaped for training and supervision
purposes. They will not become a part of my clinical record. These recordings are
for the counseling center internal use only.
 I understand that during post-processing all members are encouraged to stay and
listen. I agree to be silent during this time and if I have any reactions or comments
about the post-processing, I will bring them back to the next group session.

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