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VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY
Informed Consent for Participants in Research Projects Involving Human Subjects

Title of Project: Couple and family therapy clients’ perspectives of how productive change processes impact intended retention: A common factors informed mixed method analysis.

Investigators: Carissa D’Aniello, M.A., Fred Piercy, Ph.D., Megan Dolbin-MacNab, Ph.D., Department of Human Development, Virginia Tech, Jeana Rae Alvarado, Ericka Hulbert, Sarah Elashmawy, Sean Miller.

I. Purpose of this research
The purpose of this research study is to obtain survey responses from current therapy clients about what was helpful or unhelpful about therapy, and what influenced them to stay in therapy, or to stop therapy before reaching their goals. Almost half the clients who begin therapy stop therapy before they meet their goals. Little is known about how helpful change processes (things that happen in therapy sessions that contribute to change) help people stay in therapy and meet their goals. The purpose for collecting survey responses is to develop a detailed understanding of the process by which clients decide stay in therapy until their goals are met, or to stop therapy. The results of this research study will be presented as a doctoral dissertation, publication and conference presentations.
II. Procedures
Participants will be asked complete a 15 minute online survey about what was helpful or unhelpful about therapy, and what influenced them to stay in therapy, or to stop therapy before reaching their goals.

III. Risks
A potential risk of participating is that you may feel unduly influenced by your agency or therapist to participate. Your participation is voluntary, you may choose not to participate without impact on your therapy treatment. Another risk is that you may feel concerned about the confidentiality of your responses. Your responses are confidential, and no information linking your identity to your responses will be collected.

IV. Benefits
A potential benefit of participation in the study is the positive feelings associated with sharing your therapy experience, and helping therapists increase their understanding of what helps clients stay in therapy and meet their therapy goals. No promise or guarantee of benefits has been made to encourage you to participate. Results are available after data analysis is complete upon your request.

V. Extent of Anonymity and Confidentiality
Survey responses are collected using a web-based format and contain no identifying information.

VI. Compensation
To thank you for the time and effort involved in participating, you will receive a $5 Amazon gift card.

VII. Freedom to Withdraw
Participation is voluntary and you may choose to stop participation at any time without penalty or impact on your therapy treatment.

VIII. Subject’s Responsibilities
You voluntarily agree to participate in this study. You have the following responsibilities: (a) sign consent form presented; (b) complete a 15-minute questionnaire.

IX. Subject’s Permission
I have read the Consent Form and the conditions of this project. I have had all my questions answered. I hereby acknowledge the above and give my voluntary consent:

Should you have pertinent questions about this research or its conduct, and research subjects’ rights, and whom to contact in the event of a research-related injury to the subject, you may contact:

Carissa D'Aniello, M.A.
Ph.D. Candidate
Virginia Tech
203-605-0390
[email protected]

Megan Dolbin-MacNab, Ph.D.
Associate Professor, Marriage and Family Therapy
Clinical Training Director, Family Therapy Center
540-231-6807
[email protected]
Fred P. Piercy, Ph.D.
Professor, Marriage and Family Therapy
Virginia Tech
[email protected]

David M. Moore
Chair, Virginia Tech institutional Review
Board for the Protection of Human Subjects
540-231-4991
[email protected]

 
 
 
 
 
Age:
   
 
 
Ethnicity
 
Native Hawaiian/Pacific Islander
 
American Indian/Alaska Native
 
White
 
Middle Eastern
 
Black/African American
 
Hispanic or Latino
 
Mixed Race
 
Asian
 
 
Gender
 
Male
 
Female
 
Transgender
 
Prefer not to answer
 
Other
 
 
 
1. What is your current relationship status?
 
Single
 
Committed relationship
 
Live with my partner
 
Married
 
Separated
 
Widowed
 
Divorced
 
Other
 
 
 
2. How many sessions have you had with your current therapist?
 
Between 1 & 4 Sessions
 
Between 5 and 8 Sessions
 
9 or more Sessions
 
 
3. What type of therapy are you currently receiving?
 
Couple therapy
 
Family therapy
 
Individual therapy
 
 
Before your current therapist, did you have a previous therapist?
 
Yes
 
No
 
 
 
If yes, why did you stop seeing that therapist?
 
I was not making progress
 
Therapist left agency
 
I moved out of the area
 
Other
 
 
 
4. Since starting therapy with your current therapist, the problem you came here for is:
 
Much better
 
Somewhat better
 
About the same
 
Somewhat worse
 
Much worse
 
 
5. Overall, how helpful has your current therapy been in achieving the change you want to make?
 
Very helpful
 
Somewhat helpful
 
Somewhat unhelpful
 
Very unhelpful
 
 
6. Considering your responses to the questions above, are you more likely to:
 
Continue therapy until you make the change you want to make
 
Stop therapy before you make the change you want to make
 
Does not apply. Please explain:
 
 
 
7. Select the category that best describes how you feel about continuing therapy:
 
I will stop therapy because I've made change
 
I will continue coming to therapy because I'm making good progress toward change
 
I will continue coming to therapy, but I am not making good progress toward change
 
I will stop therapy because I am not making progress toward change
 
None of these apply to me. Explain:
 
 
Relationship With Your TherapistDirections: Choose the response that describes the way you feel about your therapist most of the time.
Always Very Often Fairly Often Sometimes Seldom
1. Because of therapy sessions, I am clearer as to how I can change.
2. Therapy gives me new ways of looking at my problem.
3. I believe my therapist likes me.
4. My therapist and I collaborate on setting goals for my therapy.
5. My therapist and I respect each other.
6. My therapist and I agree on the goals we are working on.
7. I feel that my therapist appreciates me.
8. We agree on what is important for me to work on.
9. My therapist cares about me even when I make mistakes.
10. The things I do in therapy help me accomplish the things that I want.
11. My therapist and I understand the changes I want to make.
12. I believe the way we are working with my problem is correct.
13. How important is your relationship with your therapist in your decision to continue therapy?
 
 
Section Three: Helpful Change Events
Directions: Select the response that best describes how helpful the event was in contributing to the overall change you made so far in therapy. If the event described did not happen in the course of your therapy, please select "Does Not Apply". Response categories in gray correspond to the items in gray.
Very Helpful/Important Somewhat Helpful/Important Somewhat Unhelpful/Unimportant Not Helpful/Unimportant Does Not Apply
1. I notice small changes early in therapy.
1a. How important was this in your decision to continue or to stop therapy?
2. Our therapist helps us clarify our therapy goals.
2a. How important was this in your decision to continue or to stop therapy?
3. Something helpful happens in each session.
3a. How important was this in your decision to continue or to stop therapy?
4. We revisit an important topic several times.
4a. How important was this in your decision to continue or to stop therapy?
5. Subtle changes happen gradually.
5a. How important was this in your decision to continue or to stop therapy?
Very Helpful/Important Somewhat Helpful/Important Somewhat Unhelpful/Unimportant Not Helpful/Unimportant Does Not Apply
6. Our therapist is fair to both of us.
6a. How important was this in your decision to continue or to stop therapy?
7. Our therapist makes us feel safe and comfortable.
7a. How important was this in your decision to continue or to stop therapy?
8. Our therapist's pace is comfortable for us.
8a. How important was this in your decision to continue or to stop therapy?
9. Our therapist helps us feel hopeful that we can reach our goals.
9a. How important was this in your decision to continue or to stop therapy?
10. Our therapist slows down when we need to.
10a. How important was this in your decision to continue or to stop therapy?
Very Helpful/Important Somewhat Helpful/Important Somewhat Unhelpful/Unimportant Not Helpful/Unimportant Does Not Apply
11. Our therapist senses when to challenge us and when not to.
11a. How important was this in your decision to continue or to stop therapy?
12. We can talk to our therapist if therapy isn't working.
12a. How important was this in your decision to continue or to stop therapy?
13. We talk about the problem after therapy sessions.
13a. How important was this in your decision to continue or to stop therapy?
14. Changes in me lead to changes in our relationship.
14a. How important was this in your decision to continue or to stop therapy?
15. We talk about the problem that brought us to therapy in sessions.
15a. How important was this in your decision to continue or to stop therapy?
16. Life events challenge us to use the skills we learn in therapy.
16a. How important was this in your decision to continue or to stop therapy?
17. Our therapist encourages us to talk to each other, not only to him/her.
17a. How important was this in your decision to continue or to stop therapy?