Grief Education, Training, Treatment Utilization, and Clinical Readiness Among Independent Licensed Clinical Social Workers

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Consent for Research Study Participation

Title:  Grief Education, Training, Treatment Utilization, and Clinical Readiness Among Independent Licensed Clinical Social Workers.

UTK IRB:  20-05974-XM
Researcher: Amy Jo Payne, LCSW, University of Tennessee, Knoxville
You are invited to participate in a research study, the purpose of which is to better understand factors associated with providing more effective grief counseling.

In order to determine if you are eligible for this study, you will first be asked to read this consent statement and then, if you agree, click the “I Agree to Participate” button at the end to consent to participate in the study.  
In order to determine if you are eligible to participate in this research study, you will be asked questions about your age, job responsibilities, educational background, professional certifications and licensure, and practice location.  Your responses to these questions will determine if you are eligible to participate in this study.

Eligible participants must:
Be an independent licensed clinical social worker;
Have access to a device capable of displaying an online survey;
Be at least 18 years old;
Be fluent in the English language; and
Practice in the United States.

If you agree to participate in the study and are determined to be eligible to participate, your total time estimated for this study is 15 minutes.

As a part of your participation in this study, you will complete a brief questionnaire with questions related to your demographic information, treatment expertise, knowledge of treatments for grief therapy, attitudes towards providing grief therapy, and practice behaviors related to providing grief therapy. This questionnaire will take about 3 minutes to complete.

After completing the questionnaire, you will be presented with survey questions related to your experience and training in providing grief therapy.  This second survey will take about 2 minutes to complete.

Lastly, you will complete a survey with questions related to your personal experience with grief.  This survey will take about 10 minutes to complete.
Sometimes answering questions about grief makes people distressed, although this is very rare. You can leave the study at any time you wish.  If the study were to reactivate some of your own personal grief, a list of grief resources for clinicians will automatically be made available upon your exit from the survey.

We do not expect you to gain any direct benefits from being in this study. However, your participation will allow the Primary Investigator to assess whether there is a gap between clinicians’ knowledge of grief theories and their actual grief therapy utilization. This research will also help better understand factors which contribute to attitudes and practice behaviors for treatment of grief. It is hoped that the knowledge gained from this study will benefit others in the future.

There is no compensation for your participation in this research study.

The information from this study will be kept confidential. All of your answers will be identified by a study ID number, not your name, and will be stored in a locked research office. All information collected will be stored in an electronic password-protected file.  Since your identity will never be known, if information from this study is published or presented at scientific meetings, your name and other personal information will never be known to be disclosed.

There are times when others may need to see the information we collect. These include:
People at the University of Tennessee, Knoxville who oversee research to make sure it is conducted properly;
Government agencies (such as the Office for Human Research Protections in the U.S. Department of Health and Human Services); and
others responsible for watching over the safety, effectiveness, and conduct of the research. 
If a law or court requires us to share the information, we would have to follow that law or final court ruling.  

If you have questions at any time about the study or the procedures, (or you experience adverse effects as a result of participating in this study) you may contact the researcher, Amy Jo Payne, LCSW at and (859) 361-2022. If you have questions about your rights as a participant, you may contact the University of Tennessee IRB Compliance Officer at or (865) 974-7697.
Your participation in this study is voluntary and you may decline to participate. Your decision will not affect your relationship with the researcher or the University of Tennessee.  If you withdraw from the study before data collection is completed, we will only use the data that you completed in our research. If you would like your incomplete data to be destroyed, you may contact the Primary Investigator using the information listed above.  Please note that you will need to provide the date and time that you participated in the study to enable us to destroy your incomplete data since we do not collect identifying information.

I have read this form, been given the chance to ask questions and have my questions answered.  If I have more questions, I have been told who to contact.  By clicking the “I Agree” button below, I am agreeing to be in this study.  I can print or save a copy of this consent information for future reference.  If I do not want to be in this study, I can close my internet browser.