Monthly Group Terms

Monthly Resilience Gathering – Participant Information

The Monthly Resilience Gathering is a free community support group offered by the Lyme Resilience Collective. Each session includes:

• A structured 1-hour facilitated group portion led by Sami Kirschbaum
• An optional 30-minute unstructured community time to connect with others who understand the chronic illness journey

Our goal is to provide a safe, supportive, and confidential space for connection, nervous system regulation, and shared learning.

Important things to know before joining:

• This service is free of charge
• Group opportunities may include Brainspotting experientials, guided visual meditations, and nervous system regulation exercises
• Members are expected to follow group rules of confidentiality, respect, and no solicitation
• Late arrivals will not be admitted, and participants may be removed at the facilitator’s discretion if group safety or integrity is disrupted
• This group is not a substitute for medical or psychological treatment

To participate, please complete the consent form linked below. This form covers group rules, telehealth use, privacy practices, policies, informed consent, and basic demographic information.

Group Consent & Participation Form

Section 1: Group Purpose, Rules, and Non-Compete

Purpose
Our support group provides a safe, confidential, and supportive environment for individuals living with chronic illnesses. Members share experiences, receive mutual support, and learn practical tools for nervous system regulation through mindfulness and skill-building.

Each monthly gathering includes:

• A structured 1-hour facilitated portion led by Sami Kirschbaum
• An optional 30-minute unstructured community time for participants to connect with each other

Group Rules

• Confidentiality: What is shared in group stays in group.
• Respect: Kindness and empathy are expected at all times. Harassment, discrimination, or disrespect will not be tolerated.
• Participation: Sharing is encouraged but not required. Saying “I pass” is acceptable.
• Punctuality: Late arrivals may not be admitted. Leaving early should be done quietly, with a private message to the facilitator.
• Listening: Practice active listening, without interruption or criticism.
• Non-Judgment: This is a judgment-free zone.
• Advice: Only give advice if requested.
• Attendance: Members may come and go monthly depending on health and ability to join.
• Conflicts: Bring any issues directly to the facilitator.
• Self-Care: Step away if overwhelmed.
• No Solicitation: Promotion or selling of products or services is prohibited.

Non-Compete and Intellectual Property

All group methods, language, frameworks, and practices are the intellectual property of Lyme Resilience Collective LLC. By signing this form, you agree not to replicate, reproduce, or use these materials for commercial or public purposes, including facilitation of similar groups or services, during your participation and for two (2) years after your last attendance. Violations may result in removal and/or legal action.

Consent
I agree to abide by the group rules and understand that this group is not a substitute for professional medical or psychological treatment.

Section 2: Consent for Telehealth Group Services

• I understand group sessions will be conducted through Zoom.
• Benefits include convenience and accessibility; risks include technical difficulties and potential confidentiality breaches.
• Zoom is not an emergency service. In case of emergency, I will call 911.
• I will not share group Zoom links with anyone not authorized.
• I understand either I or my consultant may end a session if the connection is inadequate.

Section 3: Privacy Practices

• My information is confidential and will only be disclosed with my permission, or when required by law (e.g., safety concerns, abuse reports, court orders).
• My consultant may keep notes on goals and progress, stored securely.
• Group confidentiality: participants may not share personal information about others outside the group. Violating this may result in removal.

Section 4: Group Practice Policies

• Service: The Monthly Resilience Gathering is provided free of charge to community members.
• Structure: Each gathering includes 1 hour of facilitated group time and an optional 30-minute unstructured community portion.
• Closed Group: Only approved participants may join. Links may not be shared.
• No Late Entry: Late arrivals are not admitted to protect the flow of the group.
• Facilitator Discretion: Membership and participation are a privilege. Members may be removed at any time at the discretion of the facilitator to protect the integrity and safety of the group.
• Communication: All scheduling questions, absences, or administrative needs should be directed to our Care Coordinator at Support@lymecollective.com.
• Social Media: I may follow business accounts; my identity will not be disclosed without consent. Testimonials are optional and anonymous unless I approve otherwise.
• Electronic Communication: Email/text may be used for scheduling only, not for emergencies. Confidentiality cannot be guaranteed.
• Termination: The consultant may end participation if terms are violated or intake forms are incomplete two days before the group start date.
• Emergencies: For crises, I will call 911 or go to the nearest ER.

Section 5: Informed Consent for Brainspotting and Wellness Consulting

• Nature of Services: Brainspotting is a brain-body coaching process, not psychotherapy or medical treatment. Consulting does not qualify for insurance coverage.
• Possible Effects: Sessions may trigger strong emotions, memories, or somatic reactions. Clients should not drive or operate machinery for 30 minutes after sessions.
• Group Opportunities: Group experiences may include Brainspotting experientials, guided visual meditations, and nervous system regulation exercises. These practices can support emotional processing and nervous system healing, and participants may choose their level of involvement.
• Confidentiality: Information is confidential except in cases of safety concerns, suspected abuse, or legal subpoenas.
• Consultant Role: My consultant provides support and coaching but does not treat clinical diagnoses. Clients needing psychotherapy will be referred.
• Emergency Procedures: I understand my consultant is not an emergency contact. For crises, I will call 911 or 988.

Liability Waiver
By e-signing your initials on the sign up form, I waive the right to hold Lyme Resilience Collective LLC liable for any claims, injuries, or damages resulting from sessions.