University of St. Thomas
Counseling and Psychological Services
INFORMED CONSENT FOR TAO
Therapist Assisted Online (TAO)
· TAO is a seven-ten week, interactive, web-based program for common problems.
· TAO is based on well-researched and highly effective strategies.
· Each of the weeks, you will watch videos, complete exercises, and meet with a counselor either in person or via electronic means such as videoconference or phone.
· Weekly exercises take approximately30-40 minutesto complete.
· Daily homework can be completed on a smart phone, tablet, and computer, or on paper. These take about 1-2 minutes per entry and the treatment is most effective if you make an entry 2 or more times per day.
TAO provides you with the skills and tools to help overcome your difficulties, with some on-going support and help. You will need to schedule time to complete TAO each week. Before each session with your counselor you will need to complete a 20 item questionnaire (BHM-20), asking about your experience that week. Your counselor will be able to review your results and track your progress. At times your counselor may want to share the results with you and talk about how you are responding to this treatment. You will be required to complete the outcome measure prior to your therapist appointment each week. It is important that you find a quiet, confidential space in which to do your videoconference or it will need to be rescheduled.
To participate in TAO, you will need a computer or laptop, with a camera for videoconferencing and speakers. You will need a good internet connection. In addition, it is helpful to have a tablet or smart phone for the homework. While TAO is very effective and well liked by most users, some people do not feel comfortable with technology and with remote treatment. If you find that this just is not working for you, please talk with your counselor about this and we will help you to transfer to another mode of therapy.
TAO will have some identifying information while you are in treatment so that we can provide technical support and to facilitate interaction with your counselor. Identifying information includes your name, e-mail address, and phone number. Once you have completed the treatment this identifying information will be deleted; however, we will keep most of your entries in TAO. This information is used to continue evaluating and improving TAO.
In any mental health treatment or counseling a small number of people do not respond or improve. We depend on you to follow the procedures below, if you are in crisis:
After hours, if you live in a Residence Hall, please contact your RA or Hall Director.
If you live off campus, please contact Crisis Connection (612) 379-6363; available 24/7 or text LISTEN to 741741.
To get help in person, you can go to Urgent Care for Mental Health, 402 University Ave E, St. Paul (651-266-7900) or HCMC's Acute Psychiatric Services, 701 Park Ave, Minneapolis (612-873-3161).
To monitor and respond to anyone who might be struggling or deteriorating, we review your results on the BHM-20 once weekly. If we are concerned about you or we lose contact with you, or if you fail to show for a scheduled videoconference, we will contact you by phone or email to check on your well-being. Please note: If you do not show for 2 scheduled video-conferences, any remaining scheduled video-conferences will be canceled and you will lose eligibility to schedule further TAO appointments for this academic year.
I have been informed about the purpose, expectations, possible benefits, risks, and crisis procedures and I agree to participate in TAO. I consent to participate in on-line treatment with TAO. I hereby authorize the collection and use of my data for program evaluation purposes.
Signature of Person Consenting to Treatment Date
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Counseling & Psychological Services, October 2015