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Summary: The purpose of this study is to validate a questionnaire created to measure empathy of those with an addiction reported by the addict or partner. If you agree to participate in this study, you will be asked to complete two surveys online related to your experiences of other people, yourself, and your partner (if applicable). Demographic information will also be requested. The survey should take approximately 20 minutes. Once the survey is completed, your participation in the study is complete.


Criteria for Selection: To participate in this study, you must be 18 years old or older and either undergoing addiction treatment or have a partner who is undergoing addiction treatment.


Your right to withdraw/discontinue: You are free to discontinue your participation at any time without penalty or consequence. You may also refuse to answer any items you do not wish to answer and still continue participating in the study. Your choice to withdraw, discontinue, or refuse to answer does not impact your relationship with your therapist or your treatment plan.


Risks: Risks to participants are kept to a minimum. Some people may experience some mild distress when answering questions about their experiences of other people, themselves, and their partner (if applicable). If your participation in this study causes you any concerns, anxiety, or distress, please contact your therapist as soon as possible. You can also reach out to the 24/7 crisis hotline by dialing 988 on your telephone. If you have any concerns about your experience in the study, you can contact Stevie Hall by email at stevie@arisedallas.com.


Benefits: Participation in this research study does not guarantee any benefits to you. It is hoped that the results from this study will improve the questionnaire, and once tested, it will be released for clinicians to use in addiction treatment to help those in recovery and their partners.


Time commitment: If you agree to participate in the study, it will take approximately 20 minutes to complete the survey.


Confidentiality: There will be no information collected that identifies you. Your name will not be connected to any of the data collected. All reasonable steps will be taken to protect your identity. A completed survey is assigned a random number for identification and data analysis. All data from this study will be accessible only to the researcher and their research team. Data collected online will be stored on a password-protected website and de-identified for analyses. Data transferred to a spreadsheet for data analysis will be kept in a password encrypted file on the researcher’s and research team’s computer and will be destroyed after 3 years. The researcher is not interested in anyone’s individual responses, only the average responses of everyone in the study.

Researcher Contact Information: This research study is being conducted by Stevie Hall, PhD., LPC, CSAT under the supervision of Heartland Institutional Review Board. If you have any questions or concerns about your participation in this research please feel free to contact Stevie Hall at stevie@arisedallas.com. You can also contact Heartland Institutional Review Board at 866.618.4472 or director@heartlandirb.org.


Institutional Review Board: This project has been reviewed and approved by Heartland Institutional Review Board. Questions concerning your rights as a participant in this research may be addressed to: Heartland Institutional Review Board – Phone: 866.618.4472 | email: director@heartlandirb.org

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* Verification of Informed Consent: By clicking “I Agree” below, you are indicating that you freely consent to participate in this research study and attest that you are 18 years old or older.

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