An Examination of Positive Mental Health Outcomes in Former Recipients of Foster Care


Informed Consent

This survey will take approximately 25 to 30 minutes to complete, and will be conducted anonymously online. The purpose of this survey is to collect relevant information regarding psychological well-being, caretaker bonding, and other mental health factors in persons who were previously in foster care.

Participating in this study has the potential benefit of collecting valuable information that may be relevant to more effective counseling of former foster care recipients as well as to gain a better understanding of positive mental health outcomes in former recipients of foster care. I understand that participating in this study may involve the possible risk of discomfort as a result of exploring such topics as self-efficacy, psychological well-being, caretaker bonding, and substance use.

I understand that my participation is entirely voluntary and that I may decline to enter this study or may withdraw from participation at any time without consequence. I understand that a list of counseling resources will be provided at the end of this survey.

To be eligible for this study, I understand I must be between 21 and 45 years of age and have previously resided in foster care for at least 1 year. By indicating my consent below I agree to participate in the study conducted by Karly Mertz, a MA candidate in Counseling Psychology at Humboldt State University who is supervised by Professor William M. Reynolds.

I understand that the results from surveys submitted online will be stored electronically in a password-protected filing system, and identifying information (such as name, phone number, e-mail or IP address, etc.) will NOT be obtained or requested of me. My responses, therefore, will be anonymous to the researcher.

If I have any questions regarding the survey and/or my participation I can contact Karly Mertz graduate student in Psychology, at or William M. Reynolds, PhD HSU Psychology Professor at I understand that I will be asked for non-identifiable demographic information and that this information along with my survey responses will be stored electronically in a password-protected filing system. If you have any concerns regarding this project, or any dissatisfaction with any part of this study, you may contact the IRB Chair, Dr. Ethan Gahtan, at or (707) 826-4545. If you have questions regarding your rights as a participant, you may report them to the IRB Institutional Official at Humboldt State University, Dr. Rhea Williamson, at or (707) 826-5169.

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