Image as described above

Informed Consent Document for SupportNet Study
University of Colorado Colorado Springs
PROTOCOL No. 13-217

TITLE OF STUDY: SupportNet for Frontline Providers: Internet Support System for Secondary Trauma and Burnout.

SPONSORSHIP: This study is funded through the Department of Defense Telemedicine and Advanced Technology Research Center.

FOR QUESTIONS ABOUT THE STUDY, CONTACT: Charles Benight Ph.D., 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, (719) 255-4180.

PURPOSE: We invite you to take part in a study of job burnout and secondary trauma among mental health providers working with military personnel. Specifically, we are testing the effectiveness of an intervention for mental health providers who treat military trauma survivors. We are asking you to take part because you provide mental health treatment to military members (active or retired). Your participation is completely voluntary.

DESCRIPTION: We will recruit about 90 providers who work with active duty or retired military members into the study. If you decide to take part, you would begin by answering a set of questionnaires on a website. These questions focus mostly on job burnout, secondary trauma, and ability to cope with the demands of work. The items talk about the challenge of working with combat trauma patients. We ask you to answer the survey within 2 weeks.

Depending on your answers to the survey, we will assign you to one of the following groups:

  • Group A: You would get coaching and access to the SupportNet online platform right away. We describe the coaching process and the SupportNet platform below.
  • Group B: You would get the same coaching and access to the SupportNet online platform as people in Group A, but the start will be delayed until we complete the process for Group A (about 8 weeks).
  • Group C: You would have access to the online SupportNet platform only. Access will begin right after Group assignment.
  • Group D: You would be allowed to access the SupportNet platform, but will you won’t be followed as part of the study.
  • Group E: (Mentors): You would be excluded from the study itself, but we will ask you to serve as a ‘Mentor’ for Participants in Groups A and B.

Coaching Element:

  • Participants in Groups A and B will be given an online account for the SupportNet platform. The answers to the questionnaires will be automatically loaded into the self-assessment module of the online system.
  • During the study period, coaches will encourage Participants to do various activities online, including using online information resources, being part of online discussions, setting self-care goals, and taking self-assessments. The Coach will have access to all online information.
  • Coaches will interact with each Participant in Groups A and B for about 6 one-on-one sessions either in person, by telephone, or using tele-health capabilities. Sessions will take place over an 8-week period and will focus on using the website to set and achieve life balance goals, improve self-care, improve awareness of secondary traumatic stress and burnout, improve social supports, reduce stress, and increase work engagement. COACHING WILL BE AVAILABLE FOR 8 WEEKS.


SupportNet Coaching: If you are chosen to take part in the Coaching Element, we will assign you a Coach who will help you create strategies to address and prevent negative work outcomes, including secondary traumatic stress and job burnout, as well as to increase positive work outcomes like work engagement.

Web-Based User and Social Support Element:
You will have the chance to enter basic information like Name, Photo, Email address, Cell Phone, Location, Position, Areas of Interest, and Qualifications. You may also choose to provide more information to set up social and professional support networks, including personal and professional interests, needs, and your availability to give mentoring or supervisory support using the network.

After the 8-week period, you will be asked to answer another set of questionnaires (“POSTTEST”) which contains the same assessments as the first questionnaires, and includes a questionnaire measuring satisfaction with SupportNet, and with your assigned Coach.

About 8 weeks after answering the second questionnaire, if you were in Groups A, B and C, we will ask you to answer another questionnaire which includes all the measures in the second set except for the satisfaction questionnaire (“FOLLOW-UP”).

You are free to not answer these questionnaires. If you choose to answer the questions you are voluntarily consenting to do so. Completion time is about 20 minutes.

Technical Requirements:
Access to a computer is necessary to participate in the SupportNet study. However, there is no limit on the type of computer system used. Technical support is available by calling the Trauma, Health & Hazards Center at (800) 990-8227 or (719) 255 3315.


Groups A and B:

  • About 20 minutes to answer the Pretest assessment. You will be asked to answer it now, at the end of the coaching and in 2 months for a total time of 1 to 1.25 hours.
  • About 60 minutes for the first and 30 minutes for each later coaching session, for a total of about 3.5 hours over an 8-week period.
  • Coaching “homework” between coaching sessions will take about 30 minutes a week.
Group C:
  • About 20 minutes to answer the Pretest assessment. We will ask you to answer it now, at the end of the first 8 weeks and in 2 months for a total time of 1 to 1.25 hours.
Group D:
  • About 20 minutes to answer the Pretest assessment.
Group E:
  • About 20 minutes to answer the Pretest assessment.

There should be little to no impact on your work as a result of your participation. You can complete your individual SupportNet activities anywhere and anytime. Coaching session times should be coordinated with your Coach.

There is also little to no risk of loss of confidentiality, providing you protect your password and ID, and ensure others do not have access to your Coaching sessions or online actions.

ALTERNATIVE: Because this study is designed to collect information for research, your alternative is to not participate.

BENEFITS: You might benefit directly from the study. You will have access to the SupportNet online system. People in Groups A and B will get coaching, in addition to access to the SupportNet platform and resources.

The results of this study may provide valuable information about the effect of working with traumatized military members for mental health providers. Results will provide important information that will help plan support services to these providers.

RISKS: There is a chance you will feel some emotional discomfort from answering questions related to how you are currently coping with your work. If you have disturbing thoughts or distress while you complete this survey or during the course of this study, please call the Trauma, Health & Hazards Center at (800) 990-8227 or (719) 255 3315, and you will be put in touch with someone who can help you. There are no physical risks involved in this study.

PAYMENTS: There will be no payment for participation in this study.

COSTS: There will be no cost to you for participating in this study.

CONFIDENTIALITY: All study data will be stored on secure servers with extensive security features and backup systems. All information about this study is kept confidential and used only by designated members of the research team.

Representatives from the University of Colorado at Colorado Springs and/or the U.S. Army Medical Research and Materiel Command (or the DOD) are authorized to review research records as part of their duty to protect human participants involved in research. Your data will be given a participant identification number. Your email identification will not be attached to any data but is necessary for us to link your information. All computerized data will be password protected so no one but the research team will have access to these data. The computerized data will be stored on a secured server at the university for 7 years. Published data will only refer to group comparisons and never to you individually.

Health Insurance Portability and Accountability Act (HIPAA). No private medical information will be collected in this study.

RIGHT TO WITHDRAWAL: Your participation in this study is completely voluntary. You are free to withdraw at any time. If you refuse to participate there will not be any penalty or loss of benefits, and you can withdraw any time without penalty or loss of benefits.

DO I HAVE TO ACCEPT THIS AUTHORIZATION FORM? At the end of this form you will have the choice to ‘Accept’ or ‘Decline’. You do not have to ‘accept’ this authorization form. But if you do not, you will not be able to participate in this study.


PARTICIPANT’S RIGHTS: You are free not to participate in this study. Your choice whether or not to participate will not affect your job status. If you wish to participate in this study, you must show at the end of this form that you want to go ahead by clicking “I accept”. If you decide to participate, you are free to withdraw your consent and to stop participating at any time without prejudice to you. If you decide to withdraw, please notify Dr. Benight in writing and let him know you are withdrawing from the study. His email address is:

QUESTIONS: If you have any questions about your participation in this study, concerns or complaints about the research, or if you want information about the results of the study, please contact Dr. Charles Benight at (719) 255-4180 or use our toll-free number (800) 990-8227 and ask for extension 4180. You may also contact the IRB point of contact, the Research Compliance Coordinator at (719) 255-3903 or via email at for questions about your rights as a research participant or if you have questions, concerns or complaints about the research. The IRB is the Institutional Review Board; at UCCS and for every research organization that uses one, the Board provides review, approval, and oversight of all research activities involving human participants. Their job is to ensure fair and ethical treatment of all participants.

We suggest you print a copy of this form for your records.

Prof. Charles Benight, PhD
Trauma, Health, and Hazards Center
University of Colorado at Colorado Springs
Image as described above
Valerie Anderson, PsyD
Military Trauma Specialist
Clinical Director
Trauma, Health, and Hazards Center
University of Colorado at Colorado Springs
Image as described above
Thank you. We appreciate your help with this research study.


After reading the informed consent form, do you want to take part in the study?
If you accept participation in this study, please provide a valid email address below.