Mental Health Counseling - Psychology

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consentform1PYCL0586.doc

ORAL DATA COLLECTION PROTOCAL

Instructions:

(1) Informing your Participant:

When an individual is approached to be interviewed, either with or without electronic recording, it is important that you explain to them very clearly who you are, what the project is about, why you are doing it, what risks it poses to them, who will benefit, and what will become of the materials. This makes for “informed consent,” meaning they truly understand what they are getting involved in. You can read the materials to them, and you may also give them the option of reading the description themselves.

(2) The Agreement to Interview Form

The Agreement to Interview form is a very good and appropriate way to insure that your participants know what they are getting into. After you have read the project description to them, and explained clearly what the project is about, why you are doing it, and what will become of the interviews and other materials.

You may then, if you feel it’s appropriate, ask them to sign the Agreement to Interview form, and give them a copy. Keep the other copy in a safe place.

Alternatively, you can obtain their consent “on tape,” in the actual interview.

(3) Final Consent Form

(a) Draft Review: Before obtaining final consent, it is absolutely essential that the participants be given the opportunity to look over any final product(s) that you produce from the interviews, and they should have the opportunity to request changes (which you should then make). Remember, this is their words you are using, and those words are their intellectual property. It is important that you respect their requests to have their words read as they want them to.

The final consent form is designed so that you can get their signature in advance, providing that you will make the changes that they request. They may also want a family member or other third party to edit their materials, and the form also allows for this.

(b) Final Consent: this form allows you to go ahead and publish their words in whatever form is appropriate to your project. Note that there are also places where they can choose to be identified. If they do not sign these, but request to remain anonymous, you must respect that and protect their identities from being released.

Informed Consent:
[Name of the Project]

[Your Contact Information]

Project Description: [insert]

Procedure and Risks:

We would like to record the interview, if you are willing, and use the tapes to write our materials. We will record the interview only with your written consent, and will ask that no personal identifiers be used during the interview, to ensure your anonymity. Please feel free to say as much or as little as you want. You can decide not to answer any question, or to stop the interview any time you want. The tapes and transcripts will become the property of project.

If you so choose, the recordings and recording-transcripts (or copy of notes taken) will be kept anonymous, without any reference to your identity, and your identity will be concealed in any reports written from the interviews.

There are no known risks associated with participation in the study.

Benefits:

It is hoped that the results of this study will benefit the community through providing greater insight into the culture and history of our area.

Cost Compensation:

Participation in this study will involve no costs or payments to you.

Confidentiality:

All information collected during the study period will be kept strictly confidential until such time as you sign a release waiver. No publications or reports from this project will include identifying information on any participant without your signed permission, and after your review of the materials. If you agree to join this study, please sign your name on the following page.

INFORMED CONSENT FOR INTERVIEWS

I, _____________________________________, agree to allow myself and my child to be interviewed for a Master’s Level Psychology course at ____________________________.

I certify that I have been told of the confidentiality of information collected for this project and the anonymity of my participation; that I have been given satisfactory answers to my inquiries concerning project procedures and other matters; and that I have been advised that I am free to withdraw my consent and to discontinue participation in the project or activity at any time without prejudice.

I agree to participate in one or more electronically recorded interviews for this project. I understand that such interviews and related materials will be kept completely anonymous, and will only be shared with the course professor, Dr.______________________.

I agree that any information obtained from this research may be used in any way thought best for this study.

________________________________________ Date ________________________

Signature of Interviewee

Final Consent Form

Dear Participant:

This form gives us final authorization to use material from your interview.

I, _________________________________________________, hereby grant the right to use information from recordings and or notes taken in interviews of me and/or my child, for a Master’s Level course at University. I understand that names will be changed to assure anonymity and the interview records will be kept by the interviewer, and that the information contained in the interviews will not be used in materials to be made available to the general public. The information will only be shared with the professor, Dr. Wilkins.

____________________________________________ Date:__________________________

Signature of Interviewee

____________________________________________ Date:__________________________

Signature of Interviewer