StableMind Wellness, LLC

Adult Virtual Group Processing
Informed Consent & Participation Agreement

Virtual Grief Therapeutic Processing Group

Facilitator: Breanne Vanderbilt, LPC
Eligibility: Adults ages 18 and older
Format: Virtual Group Psychotherapy
Schedule: Tuesdays at 6:00 PM Eastern Time
Program Dates: November 24, 2026 – February 9, 2027
Session Fee: $35 per session

Practice Contact Information

StableMind Wellness, LLC
Phone: (484) 519-1805
Email: stablemindwellness@gmail.com
Website: www.stablemindwellness.org

1. Purpose and Nature of Group Processing

The Virtual Grief Therapeutic Processing Group is a clinician-facilitated service designed to provide adults experiencing grief and loss with a supportive environment for emotional processing, reflection, connection, and development of healthy coping strategies.

Group sessions may incorporate therapeutic discussion, psychoeducation, emotional processing, mindfulness, and coping skills.

Participants may explore experiences related to bereavement, changes in relationships, significant life transitions, and other forms of loss.

This group is designed as a supportive, clinician-facilitated space for processing grief, sharing experiences, and developing healthy coping strategies, rather than a structured psychotherapy group focused on individualized diagnosis, treatment planning, or clinical interventions.

Participation does not guarantee specific therapeutic outcomes or symptom improvement.

2. Eligibility and Clinical Appropriateness

Participation is limited to individuals who are at least 18 years old.

StableMind Wellness reserves the right to conduct an intake or screening assessment before approving enrollment to determine whether group psychotherapy is clinically appropriate.

Individuals experiencing acute psychiatric instability, imminent safety concerns, or symptoms requiring more intensive intervention may be referred to individual psychotherapy, crisis services, or a higher level of care.

Enrollment is subject to clinical appropriateness and facilitator approval.

The facilitator may recommend additional services or discontinue an individual's participation when clinically necessary.

Participation in this group does not automatically establish an individual psychotherapy relationship with the facilitator.

3. Potential Benefits and Risks

Potential benefits of group psychotherapy include:

  • Increased emotional awareness and understanding of grief

  • Development of healthy coping strategies

  • Reduced feelings of isolation

  • Increased emotional expression and self-compassion

  • Connection with others experiencing loss

  • Improved adjustment to life changes

Participants acknowledge that discussing grief, loss, trauma, and emotionally difficult experiences may result in temporary increases in sadness, anxiety, distress, or other uncomfortable emotions.

Participants may encounter differing perspectives or experiences that evoke emotional reactions.

Although the facilitator will work to maintain a supportive therapeutic environment, emotional discomfort and interpersonal challenges may occur.

Participants understand that progress varies and cannot be guaranteed.

4. Confidentiality and Its Limitations

StableMind Wellness and its clinicians maintain confidentiality in accordance with applicable federal and state laws, including HIPAA and relevant professional ethical requirements.

However, group psychotherapy involves additional confidentiality considerations because multiple participants are present.

Each participant agrees to respect the privacy and confidentiality of all other group members.

Participants agree not to:

  • Disclose the identity or participation of other group members

  • Share another participant's personal experiences or disclosures outside the group

  • Record, photograph, screenshot, livestream, or reproduce any portion of group sessions

  • Share meeting links or access credentials with unauthorized individuals

  • Discuss identifying information about other participants with individuals outside the group

Important Confidentiality Limitation

Although participants are required to respect group confidentiality, StableMind Wellness cannot guarantee that other group members will maintain confidentiality.

Participants acknowledge that other group members may disclose information despite the group's confidentiality expectations.

The facilitator will discuss confidentiality expectations and limitations during group orientation.

Confidentiality may also be limited when disclosure is required or permitted by law, including circumstances involving suspected abuse or neglect, serious threats to safety, court orders, or other applicable legal obligations.

5. Virtual Participation

All sessions will be conducted through a virtual platform selected by StableMind Wellness.

Participants agree to attend from a private, secure location where conversations cannot reasonably be overheard by others.

Participants must:

  • Be physically located in a state where the facilitator is legally authorized to provide psychotherapy services

  • Provide their current physical location when requested for emergency planning

  • Use a private device and secure internet connection when reasonably possible

  • Keep their camera enabled unless otherwise approved by the facilitator

  • Use headphones when needed to protect confidentiality

  • Refrain from attending while driving or operating a vehicle

  • Ensure that no unauthorized individuals are present or listening

  • Avoid participating from public locations where privacy cannot be maintained

  • Refrain from recording, photographing, or distributing group content

Participants understand that virtual services carry potential risks, including technological interruptions, unauthorized access, and limitations in the facilitator's ability to respond to emergencies remotely.

StableMind Wellness will use reasonable safeguards to protect confidential information but cannot guarantee the security of every participant's device, internet connection, or physical environment.

If a participant's privacy becomes compromised, they agree to notify the facilitator promptly.

The facilitator may ask a participant to relocate, temporarily disconnect, or discontinue a session when privacy or safety cannot be maintained.

6. Group Participation Expectations

Participants agree to contribute to a respectful, supportive, and emotionally safe environment.

Participants are expected to:

  • Treat others with dignity and respect

  • Allow others to speak without unnecessary interruption

  • Respect differences in beliefs, identities, experiences, and grief responses

  • Avoid judgment, harassment, discrimination, threats, or intimidation

  • Refrain from unsolicited advice or attempts to direct another participant's healing process

  • Respect each individual's right to decline sharing personal experiences

  • Avoid graphic or unnecessarily detailed descriptions that may overwhelm other participants

  • Refrain from attending while impaired by alcohol or other substances

  • Follow facilitator guidance regarding discussion boundaries and group activities

Participants are encouraged to engage meaningfully but are not required to disclose personal information beyond their comfort level.

The facilitator may redirect discussions, establish boundaries, or limit participation when necessary to maintain a therapeutic environment.

Repeated or significant violations of group expectations may result in removal from the program.

7. Interpersonal Boundaries Outside the Group

Participants acknowledge that group psychotherapy may create feelings of connection and shared understanding.

However, relationships between participants outside the therapeutic setting may affect group dynamics, confidentiality, and emotional safety.

Participants agree not to pressure other members to exchange personal contact information, communicate outside sessions, or establish relationships beyond the group.

Any communication outside group sessions is voluntary and occurs independently of StableMind Wellness.

Participants agree not to disclose information about other members through social media, public posts, or private conversations.

StableMind Wellness is not responsible for independent interactions between group members outside scheduled sessions.

8. Attendance and Program Commitment

The group is scheduled to meet weekly on Tuesdays at 6:00 PM Eastern Time between November 24, 2026, and February 9, 2027.

Consistent attendance is encouraged because continuity supports therapeutic relationships, group cohesion, and emotional processing.

Participants agree to make reasonable efforts to attend scheduled sessions on time.

Participants who anticipate missing a session should notify StableMind Wellness as soon as possible.

Late arrivals may be admitted at the facilitator's discretion to minimize disruption.

StableMind Wellness reserves the right to review continued participation when repeated absences interfere with therapeutic continuity or group functioning.

Participation is voluntary, and participants may withdraw from the group at any time, subject to applicable financial obligations disclosed in the registration agreement.

9. Session Fees and Financial Responsibility

The fee for group psychotherapy is $35 per session.

The group is offered on a self-pay basis. Insurance is not directly billed for participation unless StableMind Wellness expressly confirms otherwise in writing.

Participants are financially responsible for applicable session charges.

Payment arrangements and the timing of payment will be communicated during registration.

Any applicable cancellation fees, missed-session charges, refunds, or prepayment requirements must be disclosed and accepted before enrollment.

Participants understand that insurance reimbursement is not guaranteed and that self-pay group participation does not automatically qualify for reimbursement through an insurance plan.

Participants may request information regarding applicable Good Faith Estimate rights under federal law.

Cancellation and Missed-Session Policy

The following terms must be finalized by StableMind Wellness before enrollment:

  • Payment due: Before Each Session

  • Cancellation notice: 24 Hour Notice Requested Prior to Each Group

  • Late cancellation or no-show fee: $35

  • Refunds or credits for practice-canceled sessions: Sessions canceled by the practice will be offered in a make up format or refunded

No cancellation or missed-session fee will apply unless the relevant terms have been disclosed to and accepted by the participant in advance.

10. Clinical Emergencies and Crisis Limitations

This group is not designed to provide crisis intervention, emergency psychiatric care, or continuous clinical monitoring.

The facilitator is not available for immediate support outside scheduled sessions through this group.

Participants experiencing an immediate emergency should call 911 or seek emergency medical assistance.

Individuals experiencing a mental health crisis may contact the 988 Suicide & Crisis Lifeline by calling or texting 988.

Participants understand that virtual psychotherapy may limit the facilitator's ability to provide immediate in-person intervention.

For safety planning, StableMind Wellness may request participants' current physical location, emergency contact information, and other clinically relevant information.

If a participant presents an immediate safety concern during a session, the facilitator may take appropriate steps consistent with professional obligations and applicable law, including contacting emergency services or disclosing necessary information to protect safety.

11. Communication and Technology

Group access information and relevant administrative communications will be provided through channels designated by StableMind Wellness.

Participants agree not to distribute virtual meeting links, passwords, or access information.

Participants are responsible for having a functional device, internet access, and a reasonably private environment.

In the event of a technological disruption, the facilitator may provide instructions for reconnecting, rescheduling, or concluding the session.

Participants understand that ordinary email and text messaging may not provide the same level of security as a designated patient portal.

Sensitive clinical information should be communicated through channels approved by StableMind Wellness whenever possible.

12. Clinical Documentation and Privacy Practices

StableMind Wellness may maintain clinical documentation of group participation, attendance, therapeutic interventions, and clinically relevant information in accordance with applicable professional and legal requirements.

Participants understand that information shared during sessions may be reflected in clinical records when appropriate.

Clinical documentation will be maintained in accordance with applicable recordkeeping and privacy requirements.

Participants acknowledge receipt of, or access to, StableMind Wellness's Notice of Privacy Practices, which explains how protected health information may be used, disclosed, and protected.

Requests for records, amendments, or other privacy rights will be handled according to applicable law and practice policies.

13. Voluntary Participation and Right to Withdraw

Participation in this group is voluntary.

Participants may choose not to answer specific questions, disclose certain experiences, or participate in particular therapeutic exercises.

Participants may withdraw from the group at any time.

StableMind Wellness may recommend alternative services or discontinue participation when the group is no longer clinically appropriate, when safety concerns arise, or when significant participation expectations are violated.

Any outstanding financial obligations remain subject to the terms agreed upon during enrollment.

14. No Guarantee of Outcomes

Grief is an individual process that varies in intensity, duration, and expression.

Group psychotherapy may support emotional processing and adjustment, but no specific outcome, reduction in symptoms, or timeline for healing is guaranteed.

Participation does not replace medical treatment, psychiatric care, individual psychotherapy, or other services that may be clinically indicated.

15. Acknowledgment and Informed Consent

By electronically signing or affirmatively accepting this agreement, I acknowledge that:

  1. I am at least 18 years of age.

  2. I have read and understand the nature, purpose, benefits, and potential risks of group psychotherapy.

  3. I understand the limitations of confidentiality within a group setting.

  4. I agree to respect the privacy and confidentiality of other participants.

  5. I understand that confidentiality among group members cannot be guaranteed.

  6. I agree not to record, photograph, screenshot, or distribute any portion of group sessions.

  7. I agree to participate from a private location and follow virtual participation requirements.

  8. I understand that the group is not an emergency or crisis service.

  9. I understand the $35 per-session fee and agree to the separately disclosed financial and cancellation terms.

  10. I understand that participation is voluntary and that I may withdraw, subject to applicable financial obligations.

  11. I understand that participation is subject to clinical appropriateness and facilitator approval.

  12. I acknowledge receipt of, or access to, StableMind Wellness's Notice of Privacy Practices.

  13. I have had the opportunity to ask questions and obtain clarification before consenting.

  14. I voluntarily consent to participate in the Virtual Grief Therapeutic Processing Group facilitated by Breanne Vanderbilt, LPC, through StableMind Wellness, LLC.

Electronic Consent: Selecting the required consent checkbox and submitting the registration form constitutes my electronic acknowledgment and consent to the terms of this agreement, provided the registration system records my affirmative agreement, identity, date, and applicable document version.

StableMind Wellness, LLC
(484) 519-1805
stablemindwellness@gmail.com
www.stablemindwellness.org

This agreement is intended to support informed consent and does not replace individualized clinical assessment, applicable legal requirements, or other required practice notices and authorizations.