WARRIOR RANCH FOUNDATION HORSE INTERACTION RESEARCH STUDY

PURPOSE 
You are being asked to be a volunteer in a research study.
The goal of this study is to look at how horse interaction affects the emotions of people who may or may not have post traumatic stress.
We hope to better understand effective interventions to reduce symptoms of post traumatic stress. 

PROCEDURES 
If you decide to be in this study, your part will involve: 
Completing 2 assessment forms: BDI takes about 10-15 minutes and the NIH TB Loneliness is probably 3-5 minutes. 

Your participation involves several follow-up assessments including: Day after retreat, approximately 1 week after the retreat, and approximately 1 month after the retreat.
We will also collect de-identified general demographic information. 

RISKS / DISCOMFORTS
The following risks/discomforts may occur as a result of you being in this study:
Discomforts of answering questions may occur.

BENEFITS 
There is no direct benefit expected as a result of you being in this study. However, we hope the knowledge gained from this study will help to increase our understanding of reducing the symptoms of pts. If needed, it will help Warrior Ranch adapt it's program. As well as giving us the validity needed to be awarded grants to continue running our program. This in turn will benefit other Veterans in the future.

CONFIDENTIALITY  
We will take steps to help make sure that all the information we get about you is kept confidential. Your name will not be used wherever possible. We will use a code instead. All the study data that we get from you will be kept locked up. The code will be locked up too. If any papers and talks are given about this research, your name will not be used. 

ALTERNATIVES 
Your alternative to being in this study is to simply not participate. 


YOUR RIGHTS AS A RESEARCH SUBJECT  
• Your participation in this study is voluntary. You do not have to be in this study if you don't want to be.
• You have the right to change your mind and leave the study at any time without giving any reason, and without penalty.
• Any new information that may make you change your mind about being in this study will be given to you.
• You can ask for a copy of this consent form. 
• You do not lose any of your legal rights by signing this consent form.


QUESTIONS ABOUT THE STUDY OR YOUR RIGHTS AS A RESEARCH SUBJECT   
If you have any questions, concerns, or complaints about the study, you may contact Eileen Shanahan 631-887-9529.

CONSENT:

If you sign below, it means that you have read (or have had read to you) the information given in this consent form, and you would like to be a volunteer in this study.

 

Who will be participating?

Adult  Adult and Children  

Parent / Guardian Information

This scale is a self-report measure of anxiety. Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by the symptom during the past month, including today, by checking the numbe rin the corresponding space in the column next to each symptom.










































































































Context: In the past month, please describe how often Responses: 1 = Never 2 = Rarely 3 = Sometimes 4 = Usually 5 = Always































Sign Here

I certify that my answers are true and complete to the best of my knowledge. I authorize a background check through National Center for Safety Initiatives