AEDP Institute

Participant Agreement: AEDP Advanced Skills (ES2) Retreat Online LA, Week 2, Presented by Benjamin Lipton, LCSW, April 16 – 20, 2021

Including Your Agreement Not to Record and to Maintain Confidentiality

To attend this program, you must agree to the following important terms. If you do not agree to these terms, or you have any questions about them, please do not complete this form and instead contact The AEDP Institute (“AEDPI”) immediately at admin@aepdinstitute.org.

By completing and submitting this form you agree to all the terms. 

  • Your Participant Agreement for AEDP Advanced Skills (ES2) Retreat Online LA, Presented by Benjamin Lipton, LCSW, April, 2021

  • The Content in this program – in other words, all of the information, in any form, that is within or accompanies this program – includes training in the theory and practice of AEDP, Accelerated Experiential Dynamic Psychotherapy, as promoted and supported by AEDPI. The Content includes the intellectual property of AEDPI and/or the presenter(s). The Content may also include excerpts from or descriptions of actual clinical therapy sessions with patients or descriptions of their treatment. These patients and their therapists have graciously and generously consented to share their experiences with you for educational purposes as part of this program.
  • In return for access to this Content, as a professional, you have three important duties: Confidentiality, Respect and Personal Responsibility.
  • CONFIDENTIALITY: BY COMPLETING THIS FORM YOU ARE AGREEING TO KEEP THE CONTENT CONFIDENTIAL. You may engage with the Content only for training purposes. Do not disclose the Content to others. You may take notes for your own educational use while you attend this program, but otherwise, DO NOT RECORD ANY PART OF THE CONTENT IN ANY FORM. DO NOT SHARE ANY PART OF THE CONTENT.
  • I Acknowledge My Agreement (please type your name below):
  • RESPECT: As professionals, we share an ethic of respect for our patients and for each other. Please respect the patients who have allowed their therapists to share this Content and respect their decision to reveal themselves to professionals in training, like you -- people they do not know -- so those professionals can learn how to help other patients more effectively.
  • THEREFORE, IF YOU KNOW THE PATIENT WHOSE THERAPY SESSION IS BEING PRESENTED, REMOVE YOURSELF FROM THE TRAINING WHILE THEIR THERAPY IS SHOWN AND DISCUSSED. (The presenter will tell you if any exception can be made to this rule; but in every other event, exit the program and contact AEDPI to discuss whether a partial refund may be appropriate.)
  • Even beyond any other legal obligation of confidentiality, you agree to treat this Content the same way you would treat the experiences and records of your own patients. For example, DO NOT VIEW THIS CONTENT IN A PUBLIC PLACE, OR IN A WAY THAT WOULD ALLOW OTHERS TO SEE OR OVERHEAR IT. Do not share any information about the patients depicted in the Content in any way that might lead to someone identifying these patients.
  • Professionals also respect the work of their colleagues. Therefore, you are agreeing not to infringe the intellectual property contained in and constituted by this Content (including but not limited to copies of any presentations or handouts). Again, DO NOT COPY THE CONTENT OR SHARE OR DISTRIBUTE IT IN ANY WAY.
  • I Acknowledge My Agreement (please type your name below):
  • PERSONAL RESPONSIBILITY. You are also agreeing to respect the spirit in which your fellow professionals are offering the Content. Psychotherapy is not an exact science, and patient responses and outcomes will always vary based on the individual and many other factors. Indeed, AEDP training and AEDPI programs by nature frequently involve trial-and-error, experimentation and learning from mistakes. Therefore, you are agreeing that you understand that the practices and techniques discussed in the Content do not guarantee any particular patient outcome, and that AEDPI and its advisors, faculty, experiential assistants, trainers and staff as well as your fellow participants in this program (collectively, “the Institute”) are accepting no responsibility or liability whatsoever for any actions, omissions, injuries or damages by, to or of you or any third party. In addition, you agree that the Content is provided for general education and exemplary reasons only, and that neither AEDPI nor any other individual or entity within the Institute is: providing you with therapy or professional advice of any kind; owes you or your patients any expert, professional, heightened, special or fiduciary duty of any kind; or is responsible for the statements or misstatements of others, intentional or otherwise.
  • You understand that you will be held fully responsible for your own professional activities and patient care and for any violations of this agreement, as well for as any and all consequences, damages, losses, costs or claims (including reasonable legal fees) resulting (in whole or in part) from such activities or violations (“Costs”). You agree to indemnify, defend and hold harmless AEDPI and the rest of the Institute from and against all Costs. Other consequences for your violation of this agreement are wholly within the discretion of AEDPI and may include: dismissal from the program for which you are registering or some other program/workshop/training group or individual and small group consultation/ supervision session; notification to your licensing board or professional organization(s); loss of your certification or continuing education credits; suspension or withdrawal of any AEDPI certification; and legal action. You also hereby consent to be subject to laws of the State of New York and to the exclusive jurisdiction of the state and federal courts venued therein.
  • IN NO EVENT WILL AEDPI, THE INSTITUTE, OR ANY PERSON OR ENTITY WITHIN THE INSTITUTE OR DEPICTED IN THE CONTENT BE LIABLE IN CONTRACT, IN TORT (INCLUDING FOR ITS OWN NEGLIGENCE) OR UNDER ANY OTHER LEGAL THEORY (INCLUDING STRICT LIABILITY) FOR ANY DAMAGES, INCLUDING, WITHOUT LIMITATION, DIRECT, INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE, CONSEQUENTIAL, OR SIMILAR DAMAGES, LOST PROFITS OR REVENUES, LOSS OF USE, OR SIMILAR ECONOMIC LOSS, ARISING OUT OF THE USE OF, CONTENT IN, OR INABILITY TO USE, THE CONTENT YOU ARE ACCESSING.
  • I Acknowledge My Agreement (please type your name below):
  • If you’re having issues completing or submitting this form, if you have a question, or if you need to report a problem, please email us at admin@aepdinstitute.org
  • Please type your name below:
  • Other: If you selected "Other" above, please describe below:
  • Please tell us the country where you work for an institution or have a private practice so we can, if needed, a) learn about your country's licensing requirements AND b) call you in an emergency (we may need to find the country code!)
  • Please Provide a Phone Number where we can reach you, ideally by text, during the course should there be a technical problem we need to help you. We will not share this number or call you for marketing or other purposes.
  • TO INDICATE YOUR AGREEMENT TO ALL THESE TERMS, PLEASE ENTER YOUR FULL NAME BELOW TO INDICATE THAT YOU AGREE.