Support Group Intake Form

Your communications with Hope Redefined are confidential. The leadership will not release any information without your signed written release. You should also be aware that under some circumstances, your confidentiality may be waived. These circumstances include: threats or acts of harm to yourself or others and abuse of a child in any way. A special clarification for group work is also necessary.

Confidentiality of group members’ communications and information by other group members is not protected by law. However, each group member must be committed to confidentiality to make a safe environment to share openly. We commit to creating a safe place for those who come to share their story. When you leave at the end of each session and upon completion of the group, who you have seen here and what you have heard stays here. Don't talk about it. Period. No exceptions.

Additional steps to ensure confidentiality for all group member is:

• To please wear earbuds or headphones during the calls or while listening to a recorded call. This is to ensure that only YOU can hear the group conversations and not by standers or house guests.

• Please do not provide an email address that is shared in your home. We ask for communications within the group to be held confidential and private as well. If you need to change your email address to a private email address, please contact the facilitator prior to group. (This applies to those who might share an account with a spouse, children, or family email account).

I understand that I am not to disclose to anyone outside the group (especially my spouse, friends, coworkers, pastors, etc.) any information that may identify another group member. This includes, but is not limited to, names, physical description, biographical information, and specifics of content of interactions with other group members. I understand that I am free to disclose to people I choose the fact that I attended the intensive retreat and/or am a part of a Hope Redefined support group. i.e. “I am participating in a support group on Tues nights with Hope Redefined.”

ONLINE ONLY:

Our groups are recorded. These recordings are stored in a protected online google doc and destroyed once the group is complete. If you have a concern about our calls being recorded, please contact the group facilitator ahead of time. We will discuss alternate options.

OUR AGREEMENT WITH ONE ANOTHER:

1) It’s About Me: Keep your focus on your thoughts and feelings. We work in 1st person (I, me). We DO NOT husband bash. (Let no corrupt talk come out of your mouths, but only such as is good for building up, as fits the occasion, that it may give grace to those who hear [Ephesians 5:29].) This is a safe place to do healthy venting, but we cannot permit slander or bashing of another person.

2) Blessed are the Brief: We are committed to respect, mutual support, being safe, and genuine sharing. We desire to include all group members, so please limit sharing to 3 minutes so that everyone gets a chance to participate

3) Trust the Wonderful Counselor: We are here to support and encourage one another as we each seek God’s direction for our lives and marriages. We are NOT here to “fix” one another. Please avoid offering advice and solutions to others. Empathy is welcome, but we aren’t the Wonderful Counselor—the only One who can fix broken relationships.

4) Practice Active Listening: There should be no crosstalk, please. Crosstalk includes interrupting, asking prying questions, or engaging in any back-and-forth conversations while a member is in the process of sharing.

5) Safety First:

• If we are concerned that you are at risk of hurting yourself or others, we will approach you and will advise outside counsel of the situation.

• If we are concerned that others might be hurt around you (not because of you) we are required to report this to appropriate authorities. However, we will not do this without discussing with you first.