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Release of Liability and Informed Consent

This is only a preview of the release. You will receive an email following each booking with a link to submit the form. This release is required for participation in all sessions and events.

I understand that issues addressed using the Intention Method (which is derived from Family Constellation work and based specifically on the Identity-oriented Psychotrauma theory, or IoPT, developed by Professor Franz Ruppert) may be of a highly personal and emotional nature.  I understand that by participating in this process, I may experience or observe emotional or physical manifestations related to the presenting issues or the result of previous accident, injury, or trauma. I consider myself to have adequate mental, physical, and emotional health to be able to accept all such risks and I hereby agree to assume this risk.  I understand that my participation is voluntary and that I am responsible for assessing my own level of participation.  I also agree to inform Katrina Mikiah of any preexisting or current conditions, which may adversely impact my ability to participate in this process. I understand that I am free to leave at any time.

I understand that the Intention Method is not intended as a substitute for psychotherapy, medical treatment, or for any other professional consultation. I understand that Katrina Mikiah is not a licensed therapist and does not claim to be one. I understand that it is my sole discretionary decision to initiate or cease any other form of therapy.  I understand that no guarantee of results has been implied nor stated.  I understand that this work, though practiced for more than three decades in Germany and other countries around the world, is still considered to be innovative and that research into its long- and short-term effects is ongoing.

I understand that confidentiality concerning all attendees and their situations as presented in any group process is expected and required. I hereby agree to refrain from discussing the work outside of the circle, except in such a way that each participant’s identity remains confidential.  Additionally, I understand that discussing or interpreting the details of my own or another person’s process following the work is counterproductive and can interrupt the beneficial effects of the work and I shall refrain from such discussions.

If I am participating in a group workshop or support group, I understand that not all who attend may have the chance to do a personal process. However, as the nature of this work draws on the shared energy and experience of the group, the movements that take place and resolutions that are found have meaning for all who participate or observe.

I acknowledge that I have read, understood, and agree to the terms of this Informed Consent and Release of Liability.  I willingly agree to hold harmless and release from all liability the facilitator, Katrina Mikiah, as well as any supporting IoPT facilitators and fellow participants.

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