*

3 .

*THE EFFECTS OF DATING ON DEVELOPMENTAL ADJUSTMENT FOR ADOLESCENTS, INFORMED CONSENT DOCUMENT*



1. Taylor Smith, who is a senior undergraduate education student at the University of New Orleans, has requested your participation in a research study at this institution.



2. The purpose of the research is to map the progression of the adolescent romantic relationship in order to learn more about how it impacts learning. By exploring these issues, I hope to help educators and others who work with adolescents understand and facilitate healthy development of social and emotional skills during this stage.



3. Your participation will involve responding to six prompts via the following survey. Participation is voluntary – you may withdraw your consent to participate at any time.



4. There are minimal foreseeable risks or discomforts to you if you agree to participate in this study. The possible risks are:



a. Disclosure of personal information.

b. Harassment or other physical/social risk from peers or former/current romantic partners should personal information be disclosed.



Possible discomforts include:



a. Psychological distress from presentation of questions concerning negative or disturbing events in the course of a romantic relationship.



You may decline to answer any question that causes you undue psychological distress.



The risk of information disclosure will be addressed further in Item 6.



5. Although there may be no direct benefits to you, the possible benefits of your participation in the research are:



a. Addressing of the need for further research into the normal progression of adolescent romantic relationships.

b. Application of this research by educators and counselors to predict which types of adolescents and which types of relationships are most likely to result in negative consequences (e.g. depression or dating violence).

c. Use of the information gained through this research to develop proper interventions for adolescents who may be involved in unhealthy relationships.



6. The results of the research study may be published, but your name or identity will not be revealed. In order to maintain confidentiality of your records, Taylor Smith will convert all correspondence into records, which will be coded and kept on a password protected laptop computer. Neither the computer, nor the password, will be available to others. While quotes may be extracted from the records for inclusion in the published results, all possible identifying information will be omitted and no full copies of the records will be made. Finally, all records will be deleted upon completion of the study.



7. You will not be paid for your participation.



8. Any questions you have concerning the research study or your participation in it, before or after your consent, will be answered by: Dr. Cynthia Ybos; Room 342B, Bicentennial Education Building, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA 70148; (985) 640-8585.



9. If you have questions about your rights as a participant in this research, or if you feel you have been placed at risk, you can contact Dr. Ann O’Hanlon at (504) 280-3990.



10. This form explains the nature, demands, benefits, and any risk of the project. By signing the form, you agree knowingly to assume any risks involved. Remember, your participation is voluntary. You may choose not to participate or to withdraw consent and discontinue participation at any time without penalty. In signing this consent form, you are not waiving any legal claims, rights, or remedies. A copy of this consent form will be offered to you.

