Page 58 - EMCAPP-Journal No. 10
P. 58

CONFIDENTIALITY:  All  information  obtained  about   Primary Researcher and notify her of the condition. The
             you in this study is strictly confidential unless disclosure   researcher will require a brief explanation of the problem,
             is required by law. The results of this study may be used   and if the problem is correlated with the participation in
             in reports, presentations and publications, but the resear-  the research, will then provide you with a list of approved
             cher  will  not  include  any  identifying  information  that   counselors in your area. You will be required to sign a
             would connect you to the study or specific results.   release of information for the therapist of your choice,
                                                               so the therapist can receive a bill from the therapist, and
             DISCOMFORT AND RISKS FROM PARTICIPATION:          pay for your services directly. The researchers will provi-
             If  you  choose  to  participate  in  this  study,  you  will  be   de full compensation for up to ten individual or family
             asked questions about your sexual attractions, behaviors,   sessions total. As a participant, you have up to six months
             and identities. Answering these questions may bring up   after your direct participation to contact the researchers
             uncomfortable  or  disturbing  emotions  or  thoughts.  In   will such complaints, in order to receive compensation.
             addition, you will be completing two psychological inst-  After that window of time has passed, complaints will no
             ruments. Again, certain questions may create discomfort   longer be considered. You can contact the Primary Re-
             or disturbing feelings or thoughts. If these negative emo-  searcher alyssav@gmail.com or 318-990-2803.
             tions or thoughts become overwhelming and you deter-
             mine that you are not able to complete the survey, you are   APPROVAL OF RESEARCH: This research project has
             free to stop at any time. If you require further assistance   been approved by the Human Subjects Review Commit-
             with emerging disturbance or distress, you may also con-  tee of the School of Psychology and Counseling, Denver
             tact the Researcher who will provide you with some re-  Seminary.
             sources and recommendations for support. And, as with
             any research, there is some possibility that you may be   VOLUNTARY CONSENT: Participation in this research
             subject to risks that have not yet been identified. If you   study is totally voluntary, and your consent is required
             have concerns about your participation in the study, you   before you can participate.
             are encouraged to discuss them with the Primary Resear-  1. I have read this form and understand the above de-
             cher named below.                                 scription of this study and its risks and benefits. I have
             EXPECTED BENEFITS: Each family will receive $50.00   had an opportunity to ask questions and have had them
             in the form of cash, for participating in the research to   all answered. I hereby acknowledge the above and give
             completion. Should you have to drop out at anytime, for   my voluntary consent for participation in this study.
             any reason, this monetary compensation will not be gi-  2. I also understand that if I participate, I may withdraw
             ven. After completing the interview, should you ask for   at anytime without penalty.
             your results to be withdrawn from the study, the mone-  3. I also understand that I must be 18 years or older in
             tary compensation will be recouped at that time. Other   order to participate in this study, or have the consent of
             possible rewards for participating in this research could   my guardian if I am under the age of 18.
             be  the  possible  benefit  of  knowing  that  you  have  con-  4. I understand that should I have any questions about
             tributed to the advancement of the understanding of a   this research I should contact the following:
             child’s attachment to his/her caregiver and its effect on   Primary Researcher:    Alyssa Voglewede       alyssa.
             the moral development in children.                voglewede@my.densem.edu

             FREEDOM  TO  WITHDRAW:  You  may  choose  to  not   Secondary Researcher: Brooke Vincent  brooke.vincent@
             participate or to stop participation in this study at any   my.densem.edu
             time without penalty. Even if you say YES now, you are
             free to say NO later by contacting the Primary Resear-  Participant’s Signature  __________Date: ____________
             cher.
                                                               Participant’s Signature___________Date: ___________
             COMPENSATION FOR ILLNESS AND INJURY: If you       RESEARCHER’S STATEMENT: I certify that I have exp-
             agree to participate in the research, your consent to this   lained the nature and purpose of this research, including
             document does not waive any of your legal rights. How-  benefits, risks, costs, and any experimental procedures. I
             ever, in the event of any adverse effect occurring, neither   have described the rights and protections afforded to hu-
             Denver Seminary nor the researchers are able to give you   man subjects and have done nothing to pressure, coerce,
             any money, insurance coverage, free medical care, or any   or falsely entice this subject into participating. I am aware
             other compensation for such injury. In the event that you   of my obligations under state and federal laws, and pro-
             suffer injury as a result of participation in this research   mise compliance. I have answered the subject‘s questions
             project, you may contact the Primary Researcher at alys-  and have encouraged her to ask additional questions at
             sav@gmail.com or 318-990-2803.                    any time during the course of this study.
             COMPENSATION  FOR  EMOTIONAL  DISTUR-             Researcher’s Signature __________Date: ____________
             BANCE: If you agree to participate in this research, and
             feel participating caused you or your family emotional
             disturbance that requires help, you are able to contact the

                                                           56
   53   54   55   56   57   58   59   60   61   62   63