CONSENT TO PARTICIPATE IN A RESEARCH STUDY
Title of Study: Mapping cross-cultural counseling competence, colorblindness, and general interpersonal communication abilities onto counselor broaching skillsets

Principal Investigator: Kelly King, PhD, LPCA, NCC
                                    Department of Allied Professions
                                    700 Cecil Street
                                    North Carolina Central University
                                    Durham, NC 27707
                                    (919) 530-5049
                                    kking52@nccu.edu

You are being asked to participate in a research study. To join the study is voluntary. If you decide to be in this study, you will be one of approximately 100 people who will participate. Details about this study are discussed below. It is important that you understand this information so that you can make an informed choice about whether you want to participate in this research.

Background and Purpose:
The purpose of this research is to understand how beliefs, personal identities, and communication skills impact counselor broaching and ultimately their multicultural counseling competence. To participate you must be a counselor in training who is currently seeing clients as part of practicum/internship OR a practicing counselor AND at least 18 years of age or older.

Duration and Location:
You can access this study by selecting the ‘next’ arrow button on this page and continuing in this online form. The duration of the survey is approximately 10 minutes. 

Procedure:
In this study you will be asked to complete a survey with questions about your attitudes about race, communication skills, and multicultural counseling competence. Your responses will be anonymous and analyzed as part of the whole group of responses we receive. Your anonymous responses will be securely stored on a password-protected file on the researchers’ computers.

Risks and Discomforts:
There are no anticipated risks or discomforts involved in this study. If you do experience unpleasant emotions while participating, you are welcome to pause or discontinue your involvement in the survey. 

Benefits and Payment:
Research is designed to gain new knowledge that will be beneficial to society. By participating in this research, you will be contributing to society’s understanding of how counselor’s attitudes and skills impact broaching and multicultural counseling competence. At the completion of the survey you can choose to enter a drawing for one $50 Amazon gift card. In order to enter you will be redirected to a separate survey form where you can input your email contact information. This will not in any way be connected with your survey responses. 

Right to Refuse or Withdraw from the Study:
Your participation in this study is voluntary. You may refuse to participate, or may discontinue your participation at any time without penalty. The Investigator has the right to stop your participation at any time. 

Use of Research Results:
The data obtained in this study will assist counselor educators in training more culturally responsive counselors. The data may be used in publications or for teaching purposes in an anonymized form.
Privacy and Confidentiality:
The researchers commit to maintaining your privacy and confidentiality. We are not collecting any identifying information from you with your responses to the main survey. The responses to the survey will be stored without any identifying information in an electronic, password-protected file on the researchers’ laptop computer for 5 years following completion of the study. Should survey information be breached, survey data cannot be linked to you because we will not have any identifying information connected to your responses. All information obtained in this study is strictly confidential unless disclosure is required by law. Participants will not be identified in any report or publication.

Questions about the Study:
If you have any questions, complaints or concerns about this study, you may contact the Principal Investigator listed on the first page. This study has been approved by the Institutional Review Board (IRB) at North Carolina Central University. If you have questions about your rights as a research participant, you may contact the IRB Administrator, DeWarren K. Langley at irb@nccu.edu or 919-530-5105 or the Director of Research Compliance, Undi Hoffler at uhoffler@nccu.edu or 919-530-5140.

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Title of Study:Mapping cross-cultural counseling competence, colorblindness, and general interpersonal communication abilities onto counselor broaching skillsets

Principal Investigator: Kelly King, PhD
                                
Participant’s Agreement:
By selecting the ‘next’ arrow below on this consent form, you are agreeing that you read, or it has been read to you, and you fully understand the contents of this document and are openly willing consent to take part in this study. All of your questions concerning this study have been answered. By signing, you are also agreeing that you are a counselor in training who is seeing clients as part of practicum/internship OR a practicing counselor AND 18 years of age or older and will participate in this study described to you by Kelly King. 
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