Medium-Risk IPDV Women’s Group Contract

Welcome to SAIF: Stop Abuse for Individuals and Families

Medium Risk Women’s Group


Please review the contract below and submit your signature to confirm that you have read and understand the policies within the IPDV Women’s treatment group. Contact the Restorative Services Center at 715-425-1100 with questions or concerns.

PLEASE NOTE: this contract must be signed and submitted to Restorative Services prior to receiving the Zoom link and other information pertaining to the group.

SAIF: Stop Abuse for Individuals and Families
Working Agreement for Women’s-Group Participants

SAIF Mission Statement:
To aid in the elimination of intimate partner abuse by providing services to defendants of intimate partner domestic violence, referred to the SAIF Program. Through cognitive behavior group work, psycho-education and licensed therapeutic counseling, SAIF will provide the tenants of responsibility and accountability to program participants to promote safety and justice for victims and children, and to bring about social change necessary to end intimate partner abuse in all its forms; verbal, emotional, financial, psychological, physical and sexual.

SAIF maintains that:
• Individuals are solely responsible for their actions and addresses the incorrect assumption that abuse occurs due to provocation, loss of control/without conscious thought, anger, mental health, or substance use.
• Recognizes that violence is a choice. Violence and coercive and controlling tactics can be eliminated from intimate relationships.
• Treatment and education can provide options to stop abusive behavior and embrace belief systems respectful of intimate partners.
• SAIF has the ultimate responsibility to commit to the safety of all individuals in our community. The SAIF program will abide by commonly accepted standards in order to not jeopardize the partner or family of program participants.

SAIF program treatment is individualized (based upon a risk, needs, response) but generally consists of weekly, 2-hour group sessions, individual Secondary Treatment Contacts, and Treatment Reviews. Participants are determined by the referral source, SAIF Counselor, IPDV Assessment and by the SAIF Director. Groups are in a closed format – new participants will not be added to a group. Individual participation is determined by Participant need/risk. Each participant is responsible for the work within their treatment plan. If a Participant is court-ordered or on probation, they understand that completion of all components of this program are a part of his requirements.

Medium Risk Participants: Participants who have been evaluated as a Medium-Risk Participant are required to attend women’s group treatment once per week for two hours per week for a minimum of 6 weeks. All individual requirements and discharge eligibility are determined by the Counselors.

• All fees must be paid at time of treatment by Credit/Debit unless alternative payment form is approved.
• SAIF may refuse admittance without payment, which could result in Participant being removed from the group.
• Fees will not be refunded when service is delivered or if participant drops out/is removed.

Participant agrees to attend and complete required group and individual sessions per Risk Level to receive a Verification of Completion back to the referring entity.
• SAIF expects Participants to arrive on time – check-in starts at 5:45p.m. and sessions start promptly at 6p.m. and end at 8p.m. Doors will lock at exactly 6p.m. and no admittance will be allowed.
• Tardiness may mean the participant is not admitted and is counted absent.
• Only one (1) absence is allowed and must be made up at the end of program.
• Two (2) absences from group, participant will be dismissed from the program.
• At dismissal, SAIF notifies the referring entity, victim and others involved.
• Restarting the program means no credit for sessions attended/paid for.

• Participants are responsible for their involvement. SAIF expects participants to discuss their attitudes, feelings, beliefs and behavior in their relationships. SAIF expects participants to take part in discussions and exercises.
• SAIF expects Participants to refer to all persons, present or not, in respectful terms.
• SAIF expects written assignments to show thought and effort. The Counselor will assign homework. It is due at the start of the next session.
• Counseling staff determines completion from the program. Successful completion criterion includes, but is not limited to, cooperation with the counselor, compliance with the Working Agreement and all SAIF policies, active involvement in discussions, and personal progress toward accountability and nonviolence.
• Noncompliance may result in dismissal from the program or additional requirements to graduate, as determined by SAIF Counseling staff.

• In order to provide the best conditions for therapeutic work, Participants are entitled to confidentiality about their identity and other information shared in group. Any information SAIF releases to a third party will be limited to that which is required by referral sources. Each Participant is also required to keep the identity and personal information shared by other group members confidential.
Limitations to Confidentiality, include:
o When a Participant is believed to be in imminent danger to themself or others;
o When a Participant reveals information that suggests child or elder abuse or abuse of a person with a handicap, staff are obligated by law to inform the Wisconsin Department of Family and Protective Services;
o When a judge through a court-ordered subpoena requires records and/or testimony;
o When a Participant provides written consent.
Communication disclosing any dangerous or potentially dangerous behavior toward self or others as mentioned above will be disclosed to the agency administration and to the proper authorities. Participant signature below indicates that participant has read and understands the limits to confidentiality and agrees to not hold Restorative Services (SAIF) liable for the above reporting requirements, for injury or any incident while receiving services with Restorative Services (SAIF).

• Participants are responsible for providing SAIF any changes in address or phone number(s).
• Call SAIF at 715-425-1100 if you have any questions or concerns regarding programming.
• In emergency situations, call 911
• For a family violence crisis, call 911.

I agree to the program goals of safety, ending all violence, and healthy relationships based on equality and accountability.
• I agree to be non-violent and non-abusive while participating in the SAIF Counseling program.
• I will comply with all conditions of my court order, probation, personal bond or other referral source; including abstinence from alcohol and controlled substances.
• I will not bring weapons of any kind on the premises.
• If I demonstrate threatening, disruptive, or inappropriate behavior, I understand I will be asked to leave and counted absent.
• If I come to group under the influence of alcohol or drugs, I understand I will be asked to leave and counted absent.
• If I do not leave the premises when asked by any SAIF staff, I will be subject to termination from the program or law enforcement intervention if required.
• I agree to inform SAIF of any violent incident or police call to my home resulting from a family disturbance and to discuss this in group or individually.
• SAIF reserves the right to change program policies and procedures at any time, for those changes to become effective immediately upon adoption, and for them to apply to all current and future participants.
I understand that SAIF makes no guarantee as to the results of their efforts regarding counseling and my future success; this responsibility is solely my own.

By my signature I understand and agree to the conditions of the SAIF program as outlined above and acknowledge that I have received a copy of this agreement. Failure to comply with these agreements and rules may result in my suspension or dismissal from the program and, if court ordered, legal consequences.

IPDV Women's Group Contract