Uploaded by Gemma B

Consent Form

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CONSENT TO PARTICIPATE IN RESEARCH
PROJECT: Improving Mental Health Among Franciscan University of Steubenville Students.
PURPOSE OF THE STUDY: The primary goal of this study is to research the effectiveness of positive based group
support therapy on reducing rates of depression and/or anxiety among FUS students and improving their well-being.
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PROCEDURES: All participants will first take two screening assessments: the Patient Health Questionnaire 9 (PHQ 9) and
the General Anxiety Disorder 7 (GAD 7). Those who score on the mild to moderate range of either depression or anxiety
will be asked to participate in the study. Any who score on the moderate to severe range on either scale will be advised to
seek professional help from the Baron Counseling Center.
Participants who are selected will then answer a few questions related to demography (name, gender, etc.) and past
experience with counseling and/or medication to manage their mental health.
Those who agree to participate in the study from the invitation of Baron Counseling Center staff after requesting help from
the Center will be in Group #1.
All other participants will be divided, using randomized assignments, into one of two sets of groups: a control group (#2)
and, an experimental group (#3). Participants will then be assigned to a discussion/support group made of 8-12 participants
led by a trained facilitator.
This study will NOT utilize no-treatment control groups. All participants will have the benefit of therapy.
At the outset of the study, during its mid-point, and the conclusion participants will take several quantitative measures
related to well-being. Participants should allot for 45 minutes of time for each of these three testing periods. Participants in
Group #3 (experimental group) will also be invited to take additional steps (all safe and positive) related to their well-being.
These steps will be described to participants once they are selected to Group #3.
POTENTIAL RISKS AND DISCOMFORTS: we anticipate no risk connected with the research. Some students will
experience a bit of social anxiety when asked to share their fulfillment stories, but experience shows that this anxiety
usually dissipates quickly when they get into the flow of listening to and sharing fulfillment stories.
WITHDRAW: participants may withdraw at anytime with no questions asked. If you wish to withdraw from the study
please contact Gemma Bernstein: gbernstein001@student.franciscan.edu
CONFIDENTIALITY: All responses will be held in confidence.
Date of IRB approval:
IRB number:
I understand the information described above. I agree to participate in this study.
Printed name of Participant
_______________________________
Date ________________________
Application for IRB Review of Research Involving Human Subjects
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