Ethical Practice in Telepsychology

By Nicholas Gamble, Christopher Boyle and Zoe A Morris
Special Issue: Telepsychology: Research and Practice
Volume 50, Issue 4, pages 292–298, August 2015

Objective

Telepsychology has the potential to revolutionise the provision of psychological service not only to those in remote locations, or with mobility issues, but also for those who prefer flexible access to services. Rapid developments in internet communications technology have yielded new and diverse methods of telepsychology. As a result, ethical regulatory and advisory guidelines for practice have often been developed and disseminated reactively. This article investigates how the core ethical principles of confidentially, consent and competence are challenged in telepsychological practice.

Method

Through the application of existing ethical standards, advances in communications technology are considered and their ethical use in psychological contexts explored.

Conclusion

It is expected that psychologists will have basic competencies for the use of everyday technology in their practice. However, the use of internet communications technology for telepsychology has created new opportunities and challenges for ethical practice. For example, telepsychology is geographically flexible, but there can be privacy concerns in cross-border information flow. Psychologists who engage in telepsychology require a particularly thorough understanding of concepts such as data mining, electronic storage, and internet infrastructure. This article highlights how existing technology and communication tools both challenge and support ethical practice in telepsychology in an Australian regulatory context.

The entire article is here.

Telepsychology, Telehealth, & Internet-Based Therapy

From Ken Pope's site

I gathered the following resources to help therapists, counselors, and other clinicians to keep abreast of the rapidly evolving professional guidelines, research, treatments, innovations, and practices in the areas of telepsychology, telehealth, internet-based therapy.

I've divided the resources into 3 sections:

1) Links to 24 sets of professional guidelines that focus on telepsychology, online counseling, internet-based therapy, etc.

2) Citations for 51 recent (i.e., published in 2013-2015) articles

3) State Psychology Board Telepsychology Laws, Regulations, Policies, & Opinions--This third section was generously compiled by psychologist Kenneth R. Drude, and I am indebted to him for his kind offer to post it here.

The resource page is here.

I will link it in the Guides and Guidelines section of this site.

Ethical Framework for the Use of Technology in Mental Health

Online Therapy Institute

Here is an excerpt from their resource page:

A competent practitioner working online will always adhere at least the following minimum standards and practices in order to be considered to be working in an ethical manner.

Practitioners have a sufficient understanding of technology.

Technology basics are required for practitioners who choose to deliver therapeutic services via technology. Practitioners will possess a basic understanding of technology as the technology relates to delivery of services

• Encryption: Practitioners understand how to access encrypted services to store records and deliver communication. Records storage can be hosted on a secure server with a third-party, stored on the practitioner’s hard drive utilizing encrypted folders or stored on an external drive that is safely stored.

• Backup Systems: Records and data that are stored on the practitioner’s hard drive are backed up either to an external drive or remotely via the Internet.

• Password Protection: Practitioners take further steps to ensure confidentiality of therapeutic communication and other materials by password protecting the computer, drives and stored files or communication websites.

• Firewalls: Practitioners utilize firewall protection externally or through web-based programs.

• Virus Protection: Practitioners protect work computers from viruses that can be received from or transmitted to others, including clients.

• Hardware: Practitioners understand the basic running platform of the work computer and know whether or not a client’s hardware/platform is compatible with any communication programs the practitioner uses.

• Software: Practitioners know how to download and operate software and assist clients with the same when necessary to the delivery of services.

• Third-party services: Practitioners utilize third-party services that offer an address and phone number so that contact is possible via means other than email. This offers a modicum of trust in the third-party utilized for such services as backup, storage, virus protection and communication.

The entire resource is here.

College Counseling Centers Turn to Teletherapy to Treat Students for Anxiety

By Jared Misner
Sunoikisis via the Chronicle of Higher Education
Posted September 26, 2014

At the University of Florida, students struggling with anxiety can visit its counseling center and, after an initial, in-person consultation with a counselor, can elect to start a seven-week program called Therapist Assisted Online. The program works like an online course, complete with videos and online activities. Once a week, students meet with their specific counselor, one on one, through a videoconference for 10 to 15 minutes to discuss their anxiety.

That means students visit the counseling center only once and can do the rest from the comfort of their dormitory room. “They like the idea of being at home,” Brian C. Ess, a counselor at Florida’s Counseling and Wellness Center, says.

The entire article is here.

Please visit the Ethics and Psychology podcasts for Episodes 15 and 16, which addresses Ethics and Telepsychology.

The Flight From Conversation

By Sherry Turkle
The New York Times - Opinion
The Sunday Review
Originally published April 21, 2012

WE live in a technological universe in which we are always communicating. And yet we have sacrificed conversation for mere connection.

At home, families sit together, texting and reading e-mail. At work executives text during board meetings. We text (and shop and go on Facebook) during classes and when we’re on dates. My students tell me about an important new skill: it involves maintaining eye contact with someone while you text someone else; it’s hard, but it can be done.

Over the past 15 years, I’ve studied technologies of mobile connection and talked to hundreds of people of all ages and circumstances about their plugged-in lives. I’ve learned that the little devices most of us carry around are so powerful that they change not only what we do, but also who we are.

We’ve become accustomed to a new way of being “alone together.” Technology-enabled, we are able to be with one another, and also elsewhere, connected to wherever we want to be. We want to customize our lives. We want to move in and out of where we are because the thing we value most is control over where we focus our attention. We have gotten used to the idea of being in a tribe of one, loyal to our own party.

The entire is here.

Thanks to Lou Moskowitz for this story.

This story has implications for face-to-face psychotherapy as well as online therapy.

When Your Therapist Is Only a Click Away

By Jan Hoffman
The New York Times

THE event reminder on Melissa Weinblatt’s iPhone buzzed: 15 minutes till her shrink appointment.

She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Weinblatt, a 30-year-old high school teacher in Oregon, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer!”

And, she added, “I even e-mailed him that I was panicked about a first date, and he wrote back and said we could do a 20-minute mini-session.”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype, and encrypted digital software through third-party sites like CaliforniaLiveVisit.com, have made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly.

One third-party online therapy site, Breakthrough.com, said it has signed up 900 psychiatrists, psychologists, counselors and coaches in just two years. Another indication that online treatment is migrating into mainstream sensibility: “Web Therapy,” the Lisa Kudrow comedy that started online and pokes fun at three-minute webcam therapy sessions, moved to cable (Showtime) this summer.

“In three years, this will take off like a rocket,” said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. “Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can’t replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed.”

The pragmatic benefits are obvious. “No parking necessary!” touts one online therapist. Some therapists charge less for sessions since they, too, can do it from home, saving on gas and office rent. Blizzards, broken legs and business trips no longer cancel appointments. The anxiety of shrink-less August could be, dare one say ... curable?

Ms. Weinblatt came to the approach through geographical necessity. When her therapist moved, she was apprehensive about transferring to the other psychologist in her small town, who would certainly know her prominent ex-boyfriend. So her therapist referred her to another doctor, whose practice was a day’s drive away. But he was willing to use Skype with long-distance patients. She was game.

Now she prefers these sessions to the old-fashioned kind.

But does knowing that your therapist is just a phone tap or mouse click away create a 21st-century version of shrink-neediness?

The entire story can be read here.