Definition of Group Counseling
Group counseling is a type of psychotherapy that involves a small number of people meeting under the guidance of a professionally trained therapist (or therapist-in-training) that involves a safe and supportive space for sharing personal, relational, and societal experiences.
Consent to Group Counseling Services
I consent to group counseling services provided by Wellness Grove. I understand that these services include a pre-screening process and may include documentation related to my group experience that are deemed necessary by my group facilitator’s professional judgment.
I understand that:
- For group counseling to be most effective, it is important for me to take an active role in the process to include arriving to group sessions on time, being honest with my facilitator(s) and group members, and maintaining ownership of mutually agreed upon goals.
- Group counseling is a confidential process that involves sharing sensitive, personal, and private information that can be accompanied by an array of experiences, thoughts, and feelings.
- All confidentiality protections required by law or regulation will apply to my group experience.
- Group counseling information will be communicated to me by the group facilitator(s) to include, but not limited to: frequency of group sessions, number of group sessions, goals, type of group experience (such as a process or psychoeducational group, a closed or open group), and group rules.
- I am encouraged to regularly discuss progress and review goals with my facilitator(s) and group members, and to address any concerns or questions regarding progress and goals should they arise.
- I can refuse to accept clinical recommendations from my facilitator(s).
- I have the right to refuse, or discontinue, group counseling services at any time without the decision impacting my right to future care or treatment, and without risking any service benefits to which I would otherwise be entitled.
- I will have access to all information resulting from group counseling services as provided by law, and that my express permission is required before my medical information may be shared with a third-party, unless otherwise allowed by law.
- No staff member or group facilitator will discriminate clients on the basis of race, religion, age, sex, sexual orientation, gender identity, ethnicity, physical or mental impairment, financial or social status.
- I have the right to be treated with the upmost respect and courtesy by all Wellness Grove staff members and my group facilitator(s).
Benefits of Group Counseling
I understand that group counseling has numerous benefits. I understand and acknowledge that for many group members, the outcomes of group counseling are positive and can include, but are not limited to: a greater understanding of self, learning effective personal and interpersonal coping strategies, a reduction of mental health symptoms, greater quality of life, and increased happiness and life satisfaction.
Risks of Group Counseling
I understand that there are potential risks with any form of group counseling. I understand that potential risks associated with participation in group counseling can include, but are not limited to: experiencing increased stress or uncomfortable emotions (such as sadness, guilt, anxiety, frustration), relational difficulties, and no change or an increase in problematic symptoms/experiences despite efforts from myself, the facilitator(s), and/or members of the group.
I understand that should any of these risks occur, I will discuss my experienced concerns, discomfort, behavior changes, or questions with my group facilitator(s) who may be able to help me better understand my experience and/or use different methods or techniques that may be more satisfying. I understand that when appropriate my group facilitator(s) may desire to coordinate care with another provider or entity, but only with my written consent. I understand that if my clinical needs exceed the scope of services offered by Wellness Grove, I will be offered appropriate referrals.
Confidentiality
I acknowledge and understand that discussions within the group setting are confidential. I understand that no information concerning my group experience will be released without written consent unless mandated by law. I understand that possible exceptions to confidentiality include, but are not limited to the following situations: danger of harming myself or others, child abuse, elder abuse, animal abuse, criminal prosecutions, suits in which the mental health of a party is in issue, and the filing of a complaint with a licensing board or other state or federal regulatory authority.
I also understand that my group facilitator(s) may disclose my confidential information to any other person or entity of my choice upon receipt of a valid and executed release of information from me.
I also understand that if I am using insurance for group counseling services, Wellness Grove is required to communicate information about my treatment to my carrier such as, but not limited to, my clinical diagnosis for the purposes of reimbursement.
I also understand that group counseling is effective because individuals feel safe sharing personal and private information in a confidential setting. It is important that every member of the group uphold the confidentiality of other group members. My group facilitator(s) will discuss a group or individuals in the group only with professionals at Wellness Grove for supervision or consultation purposes only.
Confidentiality policy for minors (for clients under 18 years of age):
I acknowledge and understand that parent(s)/guardian(s)/legal representative(s) have a legal right to examine a minor’s counseling records should these be kept as part of the group experience. However, in order for many minor clients to feel comfortable in group counseling, it is beneficial for them to talk within the group setting about the group counseling process and to know that what they tell the group will be kept private/confidential except in cases of imminent danger to themselves or others, or in instances when the group facilitator(s) considers the information to be so serious that the parents’/guardians’/legal representatives’ be kept informed to promote the client’s welfare.
By signing this agreement, you are agreeing to this informal waiver of your right to full disclosure of the minor’s records. If you choose not to informally waive this right, please talk with the group facilitator(s) about your concerns prior to signing this form.
Group Facilitator Incapacity or Death
I understand and acknowledge that in the event that my facilitator(s) becomes incapacitated or dies, it will become necessary for another facilitator to take procession of my records, if kept for the group experience, and provide continued services. I understand that I have the right to seek group or individual counseling services elsewhere, and if I should choose to do so my records will be communicated once I complete and sign a release of information.
Group Counseling Records
I understand that my group counseling sessions shall not be audio/video recorded in any way unless agreed to in writing by mutual consent. I understand that my facilitator(s) will maintain a record of the sessions using a HIPAA-compliant electronic health records system should I be attending for clinical reasons. I understand that correspondence via email will also be through a HIPAA-compliant email service.
I understand that upon written request I may review my counseling records. I acknowledge and understand that in order to ensure the information in my records is clearly understood, I will be asked to schedule an appointment with my facilitator(s) or another member of the counseling staff to review the information.
Relationships in Group Counseling
I understand that personal and/or business relationships can undermine the effectiveness of the group therapy experience and cause my group facilitator’s professional judgment to be compromised. I understand that the group facilitator(s) are responsible for monitoring and discussing issues related to professional boundaries with me and are required to ensure that professional boundaries are upheld as ethically necessary.
I understand that I will use relationships in the group therapeutically, rather than socially. I understand that as a group member I need to refrain from engaging in close friendships or dating other members while group is ongoing.
Social Media and Online Engagement
I understand that as a client I am free to share (or not share) about my group counseling experiences at Wellness Grove at any time, in any way, and with anyone of my choosing. I understand that my group facilitator(s), and all clinicians at Wellness Grove, are bound to confidentiality and cannot publicly acknowledge or respond to any inference or possible interpretation of their connection with current or former clients/group members.
I understand the following:
- To maintain confidentiality and keep the clear, professional boundaries in the group counseling relationship, my clinician will not respond to or accept friend or contact requests from current or former group members on any social networking sites to include, but not limited to: Facebook, Instagram, LinkedIn, and Twitter.
- To maintain confidentiality and keep clear, professional boundaries in the group counseling relationship, my group facilitator(s) will not use social media platforms for any direct communication with current or former group members.
- If I wish to share my online experiences with my group facilitator(s) I will do so following a group session where information/experiences can be reviewed together.
- Wellness Grove maintains a social media presence for educational and marketing purposes and there is no expectation for me to access, follow, or like it.
- Should I choose to engage with social media platforms for Wellness Grove, I have a right to do so using my own discretion, and my choice has no bearing on access or utilization of the counseling services available to me.
- My group facilitator(s) does not engage in the practice of looking up group members should they have a social media presence.
Access to Services
I understand that counseling services are generally available during normal business hours. Those hours are: (in Eastern)
Monday through Friday: 7am to 9pm
Saturday: 9am to 5pm
Sunday: CLOSED
Wellness Grove offices are closed on the following designated holidays:
- News Year Day
- Martin Luther King Jr. Day
- Memorial Day
- Independence Day
- Labor Day
- Veterans Day
- Thanksgiving Day
- Christmas Day
Wellness Grove offices close at 5pm on the following days:
- Christmas Eve
- Thanksgiving Eve
- New Year’s Eve
I understand that in the event of experiencing a crisis I can come to the office location at any time during office hours and be worked into a schedule for a brief evaluation. I acknowledge and understand that in the event of experiencing an imminent crisis, I will call 911 or visit my local emergency room.
Group Counseling Attendance
I understand that my group facilitator(s) is responsible for conveying respect by keeping group counseling sessions or contacting me in the case of needing to cancel, or reschedule, a group meeting. I acknowledge and understand that I am responsible for attending group counseling sessions on time and will call in advance in the event that I will be more than a few minutes late or have to miss the session.
I acknowledge and understand that I am responsible for scheduling group counseling sessions and will contact Wellness Grove for all scheduling requests and/or concerns. I further understand that I will receive automated text and phone reminders prior to each scheduled group counseling session and can choose to opt-out at any time.
No-show/late cancellation fees: I acknowledge and understand that prompt arrival for appointments is important for my care. I understand that I will notify Wellness Grove should I be more than a few minutes late or have to miss an appointment. I understand the fee schedule for no-show/late cancellations is as follows:
| Service Item: |
Cost: |
| No-Show (arriving more than 10 minutes after group start time) |
$50.00 |
| Late Cancellation (24 hours or less from group start time) |
$25.00 |
Group Counseling Fees
| Service Item: |
Cost: |
| Group Psychotherapy Non-Family |
$50.00 |
I acknowledge that I have been informed of, and consent to, the fee associated with my group counseling experience prior to my involvement.
I acknowledge and understand that while most insurance companies offer coverage for group counseling services, some do not. I understand that it is my obligation to contact my insurance provider before engaging in counseling services to determine if there are applicable co-pays or fees which I am responsible for. I understand that if my insurance, HMO, third-party payor, or other managed care provider does not cover counseling services, I will be solely responsible for the entire fee of the group counseling session.
I acknowledge and understand that I am responsible for notifying Wellness Grove of any changes to my insurance coverage. I understand that I am responsible for the entire fee of a group counseling session in the event of an insurance change that was not communicated and not reimbursed with the new coverage.
I acknowledge and understand that any fees that I incur on my account must be paid in full before my next scheduled appointment.
For Parents/Guardians/Legal Representatives of Minor Clients Attending Group Counseling for Clinical Purposes
If the client is under 18 years old, I understand that Wellness Grove will need to have a copy of court documents or custody papers that prove I am a legal guardian.
I understand that if there is a shared parenting agreement in my custody agreement, Wellness Grove will need a copy of this paperwork demonstrating my right to make decisions concerning my child’s mental health treatment.
I understand that if I am in a co-parenting arrangement, it is most beneficial for both parents to be involved in my child’s treatment in some capacity. I understand that decisions will always be based upon what is in the best interest for my child.
Wellness Grove Review & Grievance Reporting
I understand that Wellness Grove will periodically send out electronic review requests to the primary email address on file in order to gain feedback for the continual improvement of quality group counseling care. I understand that these requests are optional and should I opt-in to provide a review, my responses will be reviewed by Wellness Grove management and kept confidential.
I acknowledge and understand that I have the right to file a grievance at any time with Wellness Grove should I ever have any issues in my interactions with any Wellness Grove staff member or group facilitator. I further understand that my grievance will be reviewed by management and taken seriously, that my grievance will be investigated fully, and that reporting a grievance will not result in retribution or impact my continuation of care at Wellness Grove.
Termination of Group Counseling Services
I understand that ending group therapy prematurely should not be done casually, although either my group facilitator(s) or I may decide to end group counseling if either of us believes it is in my best interest. I understand that should I wish to stop group counseling at any time, I am encouraged to meet for at least one additional session to discuss my decision with the group, and to receive any recommendations/referrals that my group facilitator(s) believes are important to my well-being.