Group Confidentiality Agreement

When you join a psychotherapy group you will be required to accept and sign the below confidentiality agreement:

CONFIDENTIALITY is a trust of privacy or secrecy of communication and information that is special in a group setting because it is the shared responsibility of all group members and their therapist. Although the therapist will not disclose client communication or information except as provided by law or in other limited circumstances, group members’ communications and information are not protected. Thus, this agreement is an attempt to provide you and your fellow group members with as much confidentiality as possible.  

WHAT IS NOT PERMISSIBLE: I will 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 description, biographical information, and specific of content of interactions with other group members.

WHAT IS PERMISSIBLE: I understand that I am free to disclose to people I choose the fact that I am a group member and attending this group. By my choice, I also may disclose personal information about myself with respect to group experience. This includes my personal reactions (feelings and thoughts) to my group experience, feedback from other members concerning myself, and any personal information about myself such as new skills I have learned and changes I have made.

By my signature below, I indicate that I have read carefully and understand this agreement and that I agree to its terms and conditions. I have asked and had answered any questions I have concerning the agreement and am aware that signing of the agreement is required for my membership in the group. I am also aware that my refusal to sign this agreement will exclude my participation in the group, and that if I breach confidentiality I may be asked to leave the group. I have obtained a copy of this agreement for my records.