Code of Ethics for Counselors and Marriage and Family Therapists __________________________________
specific to technology use and distance services. Remember that distance services across state lines mandates compliance with all state statutes for ethical practice and licensure require- ments for all jurisdictions.
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 tradi- tional (in person) settings. 2. Training and Continuing Competency Requirements a. Therapists must adhere to their jurisdiction’s train- ing 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 compe- tence 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 tele- behavioral health competency domains as researched and identified by Maheu et al. and Hertlein et al. [25; 26]: 1. Clinical Evaluation and Care 2. Virtual Environment and Telepresence 3. Technology 4. Legal and Regulatory Issues
TELETHERAPY AND TELESUPERVISION GUIDELINES II
In addition to the guidelines previously covered from the NBCC, ACA, and AAMFT, one of the most current and detailed set of teletherapy guidelines, Teletherapy and Telesupervi- sion Guidelines II , was published by the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) in 2021. These guidelines incorporate reference information from research in the fields of counseling, social work, marriage and family therapy, and the HIPAA Privacy Rule. Due to the length of the guidelines, they will be summarized here and should be viewed in their entirety at https://amftrb. org/wp-content/uploads/2021/09/AMFTRB-Teletherapy- Guildelines-9-21.pdf [22; 23; 24]. Teletherapy and Telesupervision Glossary • Asynchronous: Communication is not synchronized or occurring simultaneously. • Electronic communication: Using Web sites, cell phones, e-mail, texting, online social networking, video, or other digital methods and technology to send and receive messages, or to post information so that it can be retrieved by others or used later. • HIPAA compliant: The Health Insurance Portability and Accountability Act (HIPAA), sets the standard for protecting sensitive patient data. Any company that deals with protected health information (PHI) must ensure that all the required physical, network, and 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. • Synchronous: Communication which occurs simultaneously in real time. • Telesupervision: Refers to the practice of clinical supervision through synchronous or asynchronous
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