Hello and thank you for taking the time to show your interest in participating in this free art therapy workshop centered around recycled sculptures as part of my research for my graduate thesis. 

You are being invited to participate in a research study. This form is not a consent form, and it is not an automatic enrollment in the study. Completing this form will let me know that you're interested in participating in the group. I will send an email letting you know whether or not you're accepted as a study candidate, and send a digital consent form for you to sign. I will also have printed copies at the first session and we will go over the details and answer any questions you might have. 

If you have any questions, you can contact me directly at: ggimpe@artic.edu

You must submit this form no later than April 3rd, 2024 to be considered for the study.

WHY IS THIS STUDY BEING DONE?

You are being asked to take part in this study because:

You are a person aged 18-26 who self identifies as experiencing stress, anxiety, despair, or grief that is caused or made worse by the climate crisis (natural disaster, pollution related health issues, environmental threats to food security, etc.). 

The purpose of this research study is to contribute to a graduate thesis investigating the effectiveness of creating climate-centered protest art in addressing and treating climate grief and anxiety. 

WHAT IS INVOLVED IN THIS STUDY?

If you agree to participate in this study, you will be asked to do the following: …

• We will meet as a group at the Creative Chicago Reuse Exchange (CCRX). The address is: 2124 W. 82nd Place, Chicago, IL 60620. The workshops will take place on April 6th, 13th, 20th, 27th. 

• The group meetings will be from 12-3 pm. In total, the study would involve 12 hours of your time (3 hours per session).

• Participants will have to be available for all four sessions.

• If someone misses one session, they will still be allowed to participate in the study.

• If more than one session is missed, the participant’s data will not be included in the study. 

• Participants will take a survey before the study that asks questions about your mental well being and level of anxiety or hopelessness as it relates to climate change. Your responses will be confidential to other members of the study, the general public, and the researcher. 

• The group art therapy sessions will involve making sculptures using recycled materials (cardboard, discarded billboard vinyl, recycled plastic containers, etc.) and open conversations about how protest art can be used as a coping skill for despair about climate change, and other interconnected humanitarian emergencies.

• The art will reflect themes of climate justice activism. 

• Photos of the artwork will be taken as data for the research. The images may, or may not be included in the final publication of the study. If they are included, no identifying information will accompany them and they will be credited to your pseudonym. 

• The art pieces will belong to the participants, and they will be able to take their work when the research ends. 

• You will be asked to complete another survey at the end of the study to measure how the workshop may or may not have affected your feelings and well being. 

• The sessions will be audio recorded with a handheld voice recorder. The recordings of the discussions will also be used to inform the results of the study. The recordings will be deleted after notes are taken on the sessions weekly.

• The content of the study is confidential, and your identifying information will not be included in the study. A pseudonym will be assigned to any of your responses or artwork that is specifically cited in the study. 

• You will not be paid for the study, but access to materials at CCRX and enrollment in the workshop will be free. 

• You will have access to the results of the study.