Sample Participant Consent Form

Purpose

This platform provides interactive, AI-powered simulation training to help counselors, social workers, and students develop skills in military cultural competency, trauma-informed care, suicide prevention, and therapeutic alliance building with service members, veterans, and military families.

What You Will Do

• Engage in realistic simulated counseling sessions with an AI avatar client.
• Practice clinical skills such as risk assessment (C-SSRS), lethal means safety, safety planning, and culturally responsive interventions.
• Receive real-time AI coaching and post-session feedback.
• Optionally participate in faculty-reviewed sessions for educational purposes.

Data Collection & Privacy

• All sessions use fictional client scenarios.
• Transcripts of your conversations with the avatars, your written plans, reflections, and rubric results are stored in the RAPPORT research database under your study ID for analysis by the study team.
• Faculty may review anonymized session data for educational feedback and research purposes.
• We do not collect or store any real Protected Health Information (PHI) at this time. The privacy notice lists every item the platform stores, who processes it, and for how long.
• Your name and session data may be associated with your training record for faculty evaluation.

Voluntary Participation

Your participation is completely voluntary. You may stop at any time, skip scenarios, or withdraw without any penalty.

Risks & Benefits

• Benefits: Safe environment to practice high-stakes clinical skills, receive immediate feedback, and build confidence working with military populations.
• Risks: Minimal. You may experience emotional responses similar to real clinical work. Support resources are available if needed.

Data Use for Research

If MindImmerse undertakes formal research in the future, de-identified data from sessions (for example, skill usage, response patterns, alliance measures) may be used for program improvement and academic research, subject to prior Institutional Review Board (IRB) approval and a separately-executed research consent. No research data is collected under this draft.

Questions or Concerns