I understand that I will be participating in a single 3-hour integrative workshop provided by Healers Within. This workshop is designed to offer a combination of sound healing, yoga therapy, and group psychotherapy under the guidance of qualified professionals. The specific content and activities of the workshop have been thoughtfully integrated to enhance holistic well-being through group interaction and personal reflection within a structured timeframe. Each component—sound healing, yoga therapy, and psychotherapy—aims to contribute uniquely to the experience, promoting both mental and physical health in a supportive group setting. The group psychotherapy component will be provided by Sophia Pages and Janae Borrego both Licensed Marriage and Family Therapists in the state of California.
Scope of the Workshop
The workshop is a one-time, 3-hour session designed to provide integrative support via group psychotherapy, yoga therapy and sound healing.
The workshop aims to address common themes and issues that can be effectively explored in a group setting. However, it is understood that the brief duration may limit the depth of exploration compared to ongoing therapy sessions.
I understand that the effectiveness of the workshop depends on the participation and engagement of all members, including myself.
Rights and Responsibilities
I have the right to ask questions at any time during the workshop and am encouraged to actively participate in the discussions and activities.
I understand that I may decline to participate in any part of the workshop that makes me uncomfortable.
Regular review of the workshop's progress will be conducted to ensure it meets its objectives.
I am aware that no specific outcomes are guaranteed from my participation in the workshop.
Confidentiality
I understand that confidentiality is a cornerstone of psychotherapy, and this principle extends to the group psychotherapy workshop. What is shared in the workshop stays in the workshop, with the following exceptions:
If there is an imminent risk of harm to myself or others.
If there is suspicion of abuse or neglect of a vulnerable individual.
If a court order mandates the disclosure of workshop proceedings.
I acknowledge that the nature of a group setting means that absolute confidentiality, as might be expected in individual therapy, cannot be guaranteed. However, all participants are expected to respect and uphold the confidentiality of the group discussions.
Potential Risks
Emotional Discomfort: Discussions or activities may evoke strong emotions, such as sadness, anger, or anxiety.
Personal Disclosure: Sharing personal information or experiences could be distressing or triggering.
Lack of Confidentiality: Despite efforts, there's a risk that information shared could be inadvertently disclosed.
Challenging Beliefs: Activities or discussions that challenge beliefs or perspectives could be uncomfortable.
Unforeseen Reactions: Unexpected emotional distress or physical discomfort could arise from workshop content.
Limited Therapeutic Support: The workshop is not a substitute for individual therapy; facilitators provide support but cannot offer personalized therapy.
Group Dynamics: Conflict or tension within the group could impact some individuals' experiences.
Failure to Achieve Desired Outcomes: There is no guarantee that participation will lead to significant changes or achieve specific outcomes.
Psychological Triggers: Topics or activities might trigger distress in individuals with a history of trauma or mental health issues.
Continued Self-Exploration: The workshop may prompt further emotional or psychological stress outside the session.
Consent to Participate
I voluntarily agree to participate in this 3-hour group psychotherapy workshop. I understand that I can withdraw from the workshop at any time, though I agree to discuss my decision with the workshop provider first, if possible. I acknowledge the potential risks involved and accept them. By signing below, I confirm that I have read, understood, and agree to the terms outlined in this informed consent document, including the potential risks. I have had the opportunity to ask questions and have received satisfactory answers.
By completing and signing this form, I hereby agree to the following:
That I am participating in a in-person and or online yoga therapy, yoga class, sound class, workshop, retreat, and or pre-registered yoga session offered by Lizbeth Vázquez, owner of YogicMethods and partner of Healers Within; during which I will receive information / instruction about yoga related practices.
I recognize that some mindbody practices may require some physical exertion, which may be strenuous and may cause physical injury. I am fully aware of the risks and/or hazards involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the yoga therapy, yoga class, sound class, workshop, retreat and or pre-registered yoga session.
I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in any yoga based mindbody therapy, retreat, and/or any yoga related class/program with Lizbeth Vázquez, including sound class and/or a workshop.
I knowingly, voluntarily and expressly waive any claim that I may have against YogicMethods business, its instructors and staff, and its owners, for any injury, death or damages that I may sustain as a result of being in YogicMethods business or as a result of participating in a any yoga therapy or related yoga program; including loss that may be caused by the negligence of the released party.
I release and discharge Lizbeth Vázquez from any, and all liability, claim, demand, or action that I may have related to the loss, theft or damage of any of my personal property while in Lizbeth Vázquez’s session.
I, my heirs, or legal representatives, forever release, waive, and or discharge any negligence or other acts.
I have read the above release and waiver of liability and fully understand its contents. I am 18 years of age or older and voluntarily agree to the terms and conditions stated above.
This form is designed to outline the emergency procedures and collect necessary emergency contact information for participants in the 3-hour workshop hosted by Healers Within. The safety and well-being of all workshop participants are our highest priorities.
Emergency Procedures:
Immediate Response: In the event of an emergency, workshop facilitators will first assess the situation and provide immediate support as needed.
Emergency Services: If the situation warrants, emergency services (e.g., 911) will be called immediately to provide professional medical assistance.
Emergency Contact Notification: The emergency contact provided on this form will be notified as soon as it is feasible. Our team will provide them with all known information and follow their guidance regarding any further steps.
Continued Support: Workshop facilitators will remain with the participant requiring assistance until emergency services arrive or until the situation is resolved.
Please provide your emergency contact information below.