YWCA Support Group Agreement

By submitting this form you agree to abide by the Support Group Agreement policy herein.

Name
First Last
Email
I agree to begin the 8-week YWCA Domestic Violence Support Group. YWCA Support group facilitators and participants are multi-cultural and mixed gender. Groups are conducted in a safe, small setting where you will get to share your experiences, respond to topics and benefit from the feedback that others express. Lastly, do understand that your participation is voluntary and you have the right to stop attending at any time
- - The YWCA’s support group provides educational and emotional support to survivors of domestic violence. Our groups promote personal empowerment, growth, healing, and above all hope for the future.
- - All groups follow an 8 week curriculum. Once a participants attends all 8 sessions they will be dismissed from the support group. If a participant wishes to complete another 8 week cycle, they will be placed back on the waitlist for the next available opening in the group. This format allows every person to receive the service at least once.
- - Due to the high demand for the support groups, all participants must be aware that any participant who misses two consecutive group meetings will be automatically removed from the group. The participant will need to notify the YWCA if they wish to begin services again.
Commitment: I understand that group attendance is important and I agree to notify YWCA staff if unable to attend a group session.
Punctuality: I understand that meetings will begin and end on time and I will try to notify staff if needing to arrive late or leave group ea If you have to leave unexpectedly, please call the counseling services department and leave a message so that we can ensure you are safe.
Confidentiality: By submitting this document, you are agreeing to keep everything that happens in group confidential, this includes the names and images of other group participants and their information.
- - An intentional breach of confidentiality may lead to removal from the group.
- - For reasons of safety and confidentiality, all facilitators will remove a person from the group if they see that someone has walked into your personal space, if you join the group while driving, or are noticed in a public space where others can hear conversations. You may be able to rejoin the meeting after you have secured a safe, private, and confidential space that is free from distractions.
- - All participants are asked to leave their video cameras on during the whole support group session. This is to ensure everyone is safe and that the confidential information of all participants is maintained. It is recommended that if you are able to utilize headphones that you do so to ensure confidential conversations.
Be Present: I agree to attend all group meetings not under the influence of any drugs or alcohol (excepting prescription medications being taken according to my doctor’s instructions). I understand that if the facilitator determines me to be under the influence, I will be asked to leave the group.
Mutual Respect: I agree to respect others’ feelings, experiences and opinions, to listen without interrupting, and refrain from holding side conversations. I agree to share from my own feelings and experiences and refrain from giving advice unless first asking permission to do so.
Safety: I understand that out of control, violent or abusive behavior by the group attendees is not permitted, and that any group member exhibiting any of these behaviors will be asked to leave the group at the facilitator’s dis If any concerns or questions comes up related to what is happening in the group, please share them with your facilitator or the YWCA clinical director.
Listen Generously: I agree to be sensitive and aware of the amount of time I spend checking in/sharing so that everyone has an adequate amount of time to share.
Right to Pass: I understand I have the right to pass if I do not wish to share during check in or group discussions.
Privacy and Minimizing Interruptions All participants are asked to ensure that they have a private space, free of distractions (including children) to attend group sessions. I agree to silence or turn off my cell phone during group unless it is an emergency. I understand that use of the restroom and preparation of snacks before group insures less interruptions during group. Sometimes it is difficult to predict or control internet interruptions. If you are having difficulty with your internet connection, we ask that you try to reconnect for a maximum of 1 time. If you are still not able to connect or are disconnected, we ask that you wait until the following week to rejoin the group. This will minimize the number of times a facilitator has to stop to re-enter you to the group.
You will be emailed the link to join the meeting via Zoom from the email Therapy@ywcasc.org. The title of the invitation is “YWCA Support Group”. Please double check your Spam and/or Junk mail as the emails are often rerouted to one of these boxes. If you still cannot find the email give the counseling support services a call at (707) 303-8411 so that we can resend.

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