Consent Form
Title of the Study: Exploring Healing Among Genderqueer Individuals: The Role of Mind-Body Techniques
Principal Investigator:
Elizabeth Cerven, LCPC, PhD Candidate
Adler University, DCES
Email: elcerven@adler.edu
Phone: 708-601-4929
Invitation to Participate
You are invited to take part in a research study about how genderqueer individuals experience healing while engaging in mind-body techniques as part of their therapy. This form explains the purpose of the study, what you will be asked to do, and your rights as a participant.
Please read this form carefully and ask any questions before deciding whether to participate.
Purpose of the Study
The purpose of this study is to explore how genderqueer individuals experience healing through mind-body techniques such as mindfulness, yoga, somatic practices, and breathwork within the context of therapy. This research is being conducted as part of a doctoral dissertation in the Counselor Education and Supervision program
What You Will Be Asked to Do
If you agree to participate, you will:
- Participate in a 60–90 minute one-on-one interview with the researcher, either in person or via secure video conferencing.
- Be asked open-ended questions about your experiences in therapy, healing, embodiment, and identity.
- Optionally participate in a follow-up conversation (if needed) for clarification or feedback.
With your permission, the interview will be audio-recorded for transcription and analysis.
Voluntary Participation and Right to Withdraw
Participation is completely voluntary. You may choose not to answer certain questions or to withdraw from the study at any time, without any negative consequences or impact on your current or future care.
Risks and Discomforts
Some questions may feel personal or emotional. You are free to skip any question. A list of LGBTQIA+-affirming mental health resources will be provided in case the interview brings up any discomfort or distress.
Benefits
There are no direct benefits. However, many participants find it meaningful to reflect on their experiences. The study may also contribute to more inclusive and affirming therapeutic practices for gender-diverse individuals.
Confidentiality
Your privacy is a priority. All recordings and transcripts will be stored on encrypted, password-protected devices. You will be assigned a pseudonym, and any identifying information will be removed. Only the researcher will have access to raw data. Quotes from your interview may be used in presentations or publications, but they will be anonymized.
The in-person interviews will be conducted at my office, a private office space used for therapy services. The office has a door which will be closed to ensure privacy.
The virtual interviews will be conducted online via a Zoom session. Zoom has a secure connection and is compliant with HIPPA (Health Information Protection and Portability Act) regulations, meaning that the online sessions are private and secure. To ensure your privacy, it is best that you participate in the interview in a closed room to ensure that what you say during the interview is kept private. I will also participate in the interview from a closed room. If for some reason you are unable to be in a closed room and are in an open area, such as a coffee shop or restaurant, please be advised then that what you share in the interview cannot be guaranteed to be private because of the nature of the public setting.
Compensation
This is a voluntary study. No compensation is offered.
Contact Information
If you have questions about this study, you may contact:
Elizabeth Cerven at elcerven@adler.edu
Sandra Kakacek, Ed.D. at skakacek@adler.edu Dissertation chairperson
Catherine McNeilly, PsyD at cmcneilly@adler.edu Adler IRB Chairperson
If you have concerns about your rights as a research participant, you may contact the Aderl University IRB committee at irb@adler.edu
Consent Statement
By signing below, you indicate that:
- You are at least 18 years old
- You have read and understood this form
- All of your questions have been answered
- You voluntarily agree to participate