ACS Survey

Alliance Circumplex Study (ACS) Survey

RESEARCH CONSENT FORM: ALLIANCE CIRCUMPLEX STUDY

This research study is conducted by Robert L. Hatcher, Ph.D., of the University of Michigan Psychological Clinic.

The working relationship between the client and the therapist is known to be a key ingredient in the effectiveness of therapy. We would like to invite you to participate in a study that is intended to help us better understand the working relationship in therapy, often called the therapeutic alliance. We hope that you will help us with this project.

This is an on-line study that involves answering a few a brief demographic questions and completing four questionnaires, which we would ask you to do on one of our computers at the Clinic after one of your sessions. To ensure that you are fully informed about the study, this consent form will be repeated on-line when you begin the study.

Completing four questionnaires should take about 20 minutes. The questionnaires include a newly-devised therapeutic alliance questionnaire that is the focus of our study. This questionnaire contains 44 questions about your experience of your therapist’s role in therapy. It is followed by a 12 item alliance questionnaire that has been in use for a long time; by a questionnaire that you took at the start of therapy, the Inventory of Interpersonal Problems (IIP), and then by a 13 item questionnaire that asks about your progress in therapy.

We expect that you may find it useful and interesting to think about your experience of working with your therapist, and the progress that you have made so far. No one has reported negative effects from participating in studies similar to this that we have conducted with clients at the Clinic, and we do not anticipate that you will experience negative effects. However, please note that you may skip any question if you so wish, and that you may withdraw from this study without penalty.

Please note that your answers to these questionnaires will not be connected with your name or other unique identifying information. You will be asked to create an ID number during the computer session so that we can link your answers to the questionnaires together. This number will not be linked to your name or other unique identifiers. Your responses to these questionnaires will be stored anonymously, and will become part of a larger data set that will allow additional research analysis to be conducted as the number of participants grows. Your services at the Clinic are in no way contingent on your decision whether or not to participate in our study.

If you have any questions or concerns about the questionnaires, please feel free to contact Dr. Robert Hatcher, Principal Investigator, at the University of Michigan Psychological Clinic at any time (734-764-3471).

Should you have questions regarding your rights as a research participant, please contact the Institutional Review Board, 540 East Liberty #202, Ann Arbor, MI 48104-2210, Telephone (734) 936-0933, Fax, (734) 998-7191, e-mail irbhsbs@umich.edu. The eResearch ID number for this study is HUM00013035.

Sincerely,

Robert L. Hatcher, Ph.D.
Director