GROUP PARTICIPATION AGREEMENT

Dr. Stacey Shelby, Ph.D., RCC

Structure of the Group

This is a closed group of up to eight participants that will meet once per month for two hours on Zoom.

The cost of participation is $150 per month, and enrollment requires a six‑month commitment. The closed structure is intended to foster trust, psychological safety, and depth within the group.

New members are not added once the group begins.

Nature of the Group

This group is a consultation and reflective support circle. It is not psychotherapy or mental health treatment, and participation does not establish a therapist‑client relationship.

Participants are responsible for their own wellbeing and may seek individual therapy or clinical services elsewhere if needed.

Confidentiality

Confidentiality is essential to maintaining a safe and respectful group environment.

Participants agree to respect the privacy of others in the group and not share personal stories, identities, or experiences of other members outside the group.

Identifiable information about other members should not be discussed with colleagues, friends, or on social media.

While all members are expected to uphold confidentiality, it cannot be absolutely guaranteed in a group setting. Each participant therefore shares at their own discretion.

Recording

Group sessions will be recorded for participants who cannot attend live. Recordings are for private use by enrolled members only and may not be shared, copied, or distributed.

Attendance and Commitment

Because the group is closed and designed to build trust over time, consistent participation is important for the integrity of the circle.

All efforts should be made to attend sessions live. If attendance is not possible, the recording will be available.

Participants agree to notify the facilitator in advance if they are unable to attend.

Missed sessions are not refunded.

Payment and Commitment Policy

Participation in the group requires a six‑month commitment.

Payment of $150 per month will be charged monthly for the duration of the six‑month term.

If a participant withdraws before the end of the commitment period, remaining payments for the six‑month term will still be due.

This policy helps preserve the stability and continuity of the group.

Respectful Participation

Participants agree to contribute to a respectful and supportive environment.

Members are encouraged to speak from personal experience, listen without interruption or judgment, allow space for all voices, and maintain professional and ethical conduct.

The facilitator reserves the right to remove a participant if their behavior significantly disrupts the safety or functioning of the group.

Limits to Confidentiality

Although this group is not psychotherapy, there are rare circumstances in which confidentiality may need to be broken, consistent with professional ethical obligations.

These circumstances may include a credible threat of harm to oneself or another person, information indicating the abuse or neglect of a child, or a legal subpoena or court order requiring disclosure.

Technology and Online Participation

This group is conducted via Zoom. Participation in online meetings carries inherent privacy risks associated with internet-based communication.

While reasonable measures are taken to protect confidentiality and security, absolute privacy cannot be guaranteed when using online technology.

Participants agree to join sessions from a private location and to take reasonable steps to ensure that others cannot overhear the conversation.

Commitment and Payment Responsibility

Because the group is closed and seats are limited, each participant’s commitment is important for maintaining continuity and trust within the group.

Payment obligations remain in place regardless of attendance, including missed sessions or schedule conflicts.

By enrolling, participants reserve a place in the group for the full six‑month term.

Electronic signatures are accepted and considered legally binding for the purposes of this agreement.

Agreement

By signing below, I acknowledge that I have read and understood the above guidelines and agree to participate in the group according to these terms.