process security measures are in place and followed. This includes covered entities (CE), anyone who provides treatment, payment and operations in healthcare, and business associates (BA), anyone with access to patient information and provides support in treatment, payment, or operations. Subcontractors, or business associates of business associates, must also comply. ● HITECH—Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 addresses the privacy and security concerns associated with the electronic transmission of health information through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules in the revised HITECH Act Enforcement of Interim Final Rule, 2016(HHS, 2016). ● Synchronous—Communication which occurs simultaneously in real time. ● Telesupervision—Refers to the practice of clinical supervision through synchronous or asynchronous two- way electronic communication including but not limited to telephone, videoconferencing, email, text, and instant messaging, for the purposes of developing trainee marital and family therapists, evaluating supervisee performance, ensuring rigorous legal and ethical standards within the bounds of licensure, and as a means for improving the profession of marital and family therapy. ● Teletherapy/Technology-assisted services—Refers to the practice of marriage and family therapy of diagnosis, evaluation, consultation, intervention, and treatment of behavioral, social, interpersonal disorders through synchronous or asynchronous two-way electronic communication including but not limited to telephone, videoconferencing, email, text, and instant messaging. AMFTRB Guidelines for the Regulation of Teletherapy Practice 1. Adhering to Laws and Rules in Each Jurisdiction a. Therapists of one state who are providing marriage and family therapy to clients in another state must comply with the laws and rules of both jurisdictions. b. Treatment, consultation, and supervision utilizing technology-assisted services will be held to the same standards of appropriate practice as those in traditional (in person) settings. 2. Training and Continuing Competency Requirements a. Therapists must adhere to their jurisdiction’s training requirements for teletherapy prior to initiating teletherapy. b. Therapists must review their discipline’s definitions of “competence” prior to initiating teletherapy to ensure that they maintain recommended technical and clinical competence for the delivery of care in this manner. c. Therapists must have completed basic education and training in suicide prevention. d. Therapists must assume responsibility to continually assess both their professional and technical competence when providing teletherapy services. e. Therapists must demonstrate competence in a variety of ways (e.g., encryption data, HIPAA compliant connections). Areas to be covered in training must include, but not be limited to, the following seven telebehavioral health competency domains as researched and identified by Maheu et al
6. Mobile Health Technologies Including Applications 7. Telepractice Development
f. Therapists conducting teletherapy must demonstrate continuing competency in each license renewal cycle in their jurisdiction. 3. Diversity, Bias, and Cultural Competency a. Therapists must be aware of and respect clients from diverse backgrounds and cultures and have basic clinical competency skills providing treatment with these population b. Therapists must be aware of, recognize, and respect the potential limitations of teletherapy for diverse cultural population c. Therapists must remain aware of their own potential projections, assumptions, and biase d. Therapists must select and develop appropriate online methods, skills, and techniques that are attuned to their clients’ cultural, bicultural, or marginalized experiences in their environment e. Therapists must know the strengths and limitations of current electronic modalities, process, and practice models, to provide services that are applicable and relevant to the needs of culturally and geographically diverse clients and of members of vulnerable population f. Therapists must be cognizant of the specific issues that may arise with diverse populations when providing teletherapy and make appropriate arrangements to address those concerns (e.g., language or cultural issues; cognitive, physical, or sensory skills or impairments; or age may impact assessment). g. Therapists must recognize that sensory deficits, especially visual and auditory, can affect the ability to interact over a videoconference connection. Therapists must consider the use of technologies that can help with visual or auditory deficit. Techniques should be appropriate for a client who may be cognitively impaired or find it difficult to adapt to the technology. 4. Establishing Consent for Teletherapy Treatment a. A therapist who engages in teletherapy services must provide the client with their license number and information on how to contact the board by telephone, electronic communication, or mail, and must adhere to all other rules and regulations in the relevant jurisdiction(s). The consent must include all information contained in the consent process for in-person care including discussion of the structure and timing of services, record keeping, scheduling, privacy, potential risks, confidentiality, mandatory reporting, and billing. b. A clinical treatment relationship is clearly established when informed consent documentation is signed. c. Therapists must communicate any risks and benefits of the teletherapy services to be offered to the client(s) and document such communication. d. Screening for client technological capabilities is part of the initial intake processes. (e.g., This type of screening could be accomplished by asking clients to complete a brief questionnaire about their technical and cognitive capacities). e. As appropriate teletherapy services must have accurate and transparent information about the website owner/operator, location, and contact information, including a domain name that accurately reflects the identity.
(2018) and Hertlein et al. (2021): 1. Clinical Evaluation and Care 2. Virtual Environment and Telepresence 3. Technology 4. Legal and Regulatory Issues 5. Evidence-Based and Ethical Practice
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Book Code: PCUS1525
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