Research Study Consent Form

 

Study Title: Effects of Mindfulness Practice

Researchers: David Rockman Master's Student, Department of Psychology

Faculty Sponsor: Prof. Jack Mearns, Department. of Psychology, (657) 278-3514

 

You are being asked to take part in a research study carried out by David Rockman, a master's student in the Department of Psychology at California State University, Fullerton, under the direction of Prof. Jack Mearns. This consent form explains the research study and your part in it if you decide to join the study. Please read the form carefully, taking as much time as you need.

This research study examines psychological relationship between mindfulness and mood regulation. If you are an individual the age of 18 or older, you are eligible to take part in the study, which will take less than 20 minutes.

If you take part in the study, you will complete questionnaires about feelings you experience and your history of mindfulness practice if any.

Your responses in this study are anonymous. Neither the researchers nor anyone else will be able to link data to you. Your anonymity will be protected to the full extent of the law.

Benefits: There is no direct benefit to you from being in this study.

Cost and payment: There is no financial cost or payment to participants for participating in this study.

Risks: Some questions within this study inquire about potentially sensitive topics such as negative thoughts and feelings. If you experience significant distress or discomfort while participating in this study, you may stop participating at any time.

If you are experiencing severe negative emotion, please contact a counselor. A database for finding counselor referrals can be found at https://arc.mhanational.org/find-an-affiliate 

If you are experiencing suicidal thoughts, please contact support at 1-800-273-8255 or through https://suicidepreventionlifeline.org/

If you have questions about this study or the information in this form, please contact the researcher, David Rockman, at davidrockmancsufullerton@gmail.com. You may also contact Jack Mearns, the faculty sponsor, at (657) 278-3514. If you have questions about your rights as a research participant, or would like to report a concern or complaint about this study, please contact the Institutional Review Board at (657) 278-7719, or e-mail irb@fullerton.edu

Your participation in this research study is completely voluntary. You may choose not to be a part of this study. There will be no penalty to you if you choose not to take part. You may choose not to answer specific questions or to stop participating at any time.

I have carefully read this consent form. By clicking on the I AGREE button, I agree that I am at least 18 years of age and choose to participate in this project. You may stop your participation at any time, even after you have agreed to participate.