Caregiver Workshop Agreement Form:
Welcome to the “Building the Foundation to Support your Teen with Body Image Resilience” Workshop! This will be a live, 2 hour workshop that will be offered on Tuesday, August 24th from 4:00 pm - 6:00 pm PST via Zoom. To give you a better idea of what you can expect from your participation in this workshop, we have included the following informed consent information:
Purposes and goals of this group
To provide information and tools to support participants with helping their teen develop body image resilience when living in a body negative culture.
To define and build awareness around Health at Every Size and the impacts of diet culture and weight stigma.
To provide support on how to build a body positive household.
To walk participants through foundational skills for helping their teen navigate hard body image moments.
Your workshop facilitators and the professional relationship
This workshop will be facilitated by the co-founders of Willow Mind & Body, Kacey Legnitto, MS, RD, CEDRED and Katie Peterman, Psy.D. Kacey is an anti-diet Registered Dietitian, certified intuitive eating counselor, and eating disorder specialist. Katie is a licensed psychologist experienced in working with individuals recovering from eating disorders.
The role of your workshop facilitators
Our primary role as workshop facilitators is to provide you with information and tools to support you in helping your teen with body image resilience when living in a body negative culture. Due to this being a psychoeducational workshop, we will not be in the role of being your therapist or dietitian. The information and inventions we provide will be for educational purposes only and will not be a substitute for psychotherapy or nutrition counseling. This workshop is for informational purposes only and is not a substitute for psychotherapy or nutritional counseling. Participating in this workshop does not constitute a clinician-patient relationship with either Katie Peterman or Kacey Legnitto.
As facilitators, our responsibility is to create an atmosphere of safety and support in order for you to get the most out of the workshop. We will encourage each participant to be honest, open, and respectful about their feelings and observations in the workshop.
Throughout this workshop, you will be invited to share your thoughts and reactions and to ask questions. It is important that you feel comfortable to participate openly. You have the expectation of privacy in this workshop. As a general rule, workshop facilitators will not disclose what you share without your permission. However, there are some exceptions to this rule. In specific situations, in accordance with professional ethics and state laws, your facilitator may disclose information without your permission. Some of the circumstances where disclosure is required by law are:
If you disclose that a child, a dependent person, or an elder adult is being abused
If you are in danger of harming yourself or someone else
Workshop participant’s agreement for confidentiality
All participants will be asked to agree to a high level of confidentiality. This means that each participant agrees not to share any other participant’s identifying and personal information with others. It is appropriate to share your personal reaction and feelings about the workshop with others, but please do not share other people’s information with anyone outside of the workshop.
Additional considerations for creating a safe space
The topics we will be covering in this workshop are sensitive and can feel vulnerable to discuss in a brief workshop setting. In order for all participants to engage bravely and thoughtfully during our time together, we ask that you agree to treating each participant with respect and kindness. We also ask that you participate with your video on, so that we can all see each other and interact (as if we were in person). Please know that you do not need to share anything that you do not feel comfortable disclosing. You also have the right to leave the workshop at any point.
This workshop will be held over Zoom. We want you to be aware that there are potential risks from meeting via a virtual platform, including, but not limited to, the possibility, that: disrupted or distorted by technical failures could happen, and there is the potential of being interrupted by unauthorized persons.
Thank you for the time and attention that you took to read this Workshop Agreement. If you have any questions about any of the items above, please reach out to us at firstname.lastname@example.org prior to signing up for the workshop.
Please note that by signing up for the Workshop, you are indicating that you have carefully read and understand the Workshop Agreements and that you agree to its terms and conditions.