Statement of Informed Consent

CONSENT TO ACT AS A PARTICIPANT IN A RESEARCH STUDY

PRINCIPAL INVESTIGATORS:    

Geoffrey Keller, MA
Doctoral Candidate, Counseling Psychology
(412) 508-7579; kellerg@upmc.edu ; gtkeller@carlow.edu

Why is this research being done?
We are examining aggression as it relates to burnout in mental health professional.   Burnout can be defined as “the end in coping with chronic stress” (Jennett, Harris Mesibov 2003) and is particularly relevant in high intensity high energy environments. Specifically, we are interested in collecting data from mental health professionals who work on specialized care units designed for individuals with Intellectual Disability (ID) and Autism Spectrum Disorders (ASD). We collect data through a brief survey that takes between 5 and 10 minutes to complete.  

Who is being asked to take part in this research study?
All staff members who work directly with individuals with ASD or ID and engage in patient care, which includes but is not limited to Behavioral Support Staff, Psychiatric Assistants, Student Behavioral Assistants, Safety Specialists, Social Workers, Counselors and Psychologists, and Nurses.

What procedures will be performed for research purposes?
If you decide to take part in this research study, you will participate in a brief multiple choice survey that should take roughly 5-10 minutes to complete.

What are the possible risks, side effects, and discomforts of this research study?
This is a minimal risk study with several risks identified. Some survey questions ask about experiences with violence and aggression, which may cause participants to experience stress or negative emotions. Additionally, there is the possibility that participants may experience boredom as they may not find the survey content interesting.

What are possible benefits from taking part in this study?
You have the option of being entered into a raffle where every 10th participant (a 1 in 10 chance) will be emailed an online gift card to amazon worth $25.  

You will likely receive no other direct benefits from participating in this study. The only potential benefit may be feelings of satisfaction for having helped and contributed to academic research.

Who will know about my participation in this research study?
Any information about you obtained from this research will be kept as confidential (private) as possible.  All records related to your involvement in this research study will be stored in a locked file cabinet.  You will not be identified by name in any publications.

Is my participation in this research study voluntary?
Your participation in this research study is completely voluntary.  Your decision to consent or not consent to participate in this research study will have no effect on your current or future relationship with Carlow University or this researcher. 

Question Title

* 1. If you wish to be entered into to the raffle for a chance to win a $25 gift card to amazon please type your email address for contact.  If not not, type in "N/A." 

Provided email addresses will only be kept in order to send electronic cards and will be deleted from record post raffle selection.

T