Group Confidentiality Agreement

A Life in Balance DBT Skills Trainiang Group

A skills group works only when members can trust that what is shared in the room stays in the room. This agreement describes your responsibility to protect the privacy of other group members, and it explains the limits of confidentiality in a group setting. Please read it carefully before signing.

1.  Why this matters

In group, you will hear other members’ names and may hear them share personal experiences. Each member is trusting the group with information that is private to them. Protecting that trust is part of being a member of this group, and it is something every member owes to every other member.

2. My commitment as a group member

I agree that I will:

• Keep the identities of other group members private. I will not tell anyone outside the group who attends, or that a particular person is a member.

• Not repeat, share, or describe what other members disclose in session — including their stories, struggles, or any identifying details.

• Not discuss other members, by name or by identifying detail, with anyone outside the group, including family, friends, or other clients.

• Not post about the group or its members on social media or any other public platform.

• Not record, screenshot, photograph, or save any portion of a session (see the Telehealth & Virtual Session Consent for recording terms).

• Protect privacy in my own setting — attending from a private space and using headphones when others might overhear.

3. The limits of confidentiality in a group

I understand that:

• Confidentiality among members cannot be guaranteed. Other participants are not licensed clinicians and are not legally bound by HIPAA in the way the facilitator is.

• The facilitator is legally and ethically required to protect my privacy, but the facilitator cannot control what other members choose to do.

• Even with this agreement in place, a breach of privacy by another member remains a possible risk of group participation, and I accept that risk as a condition of joining.

4. What the facilitator may be required to disclose

Separately from member-to-member confidentiality, the facilitator may be required by law to disclose certain information — for example, when there is a risk of serious harm to me or others, suspected abuse or neglect of a child, elder, or dependent adult, or a court order. These limits are described in full in the Limits of Confidentiality & Mandatory Reporting disclosure.

5. If this agreement is broken

I understand that breaking this confidentiality agreement is a serious matter and may result in my removal from the program, and that it may also carry consequences outside the program depending on the circumstances.

6, Acknowledgment

By signing below, I confirm that I have read and understand this Group Confidentiality Agreement and agree to protect the privacy of every member of my group.