___________________________________ Code of Ethics for Counselors and Marriage and Family Therapists
5. Evidence-Based and Ethical Practice 6. Mobile Health Technologies Including Applica- tions 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 populations. b. Therapists must be aware of, recognize, and respect the potential limitations of teletherapy for diverse cultural populations. c. Therapists must remain aware of their own potential projections, assumptions, and biases. 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 environments. 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 geographi- cally diverse clients and of members of vulnerable populations. f. Therapists must be cognizant of the specific issues that may arise with diverse populations when provid- ing teletherapy and make appropriate arrangements to address those concerns (e.g., language or cultural issues; cognitive, physical, or sensory skills or impair- ments; or age may impact assessment). g. Therapists must recognize that sensory deficits, espe- cially visual and auditory, can affect the ability to inter- act 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 accu- rate and transparent information about the website owner/operator, location, and contact information, including a domain name that accurately reflects the identity. f. The therapist and/or client must use connection test tools (e.g., bandwidth test) to test the connection before starting their videoconferencing session to ensure the connection has sufficient quality to sup- port the session. 5. Identity Verification of Client a. Therapists must recognize the obligations, responsi- bilities, and client rights associated with establishing and maintaining a therapeutic relationship. b. The therapist is responsible for assessing and docu- menting the client’s appropriateness for teletherapy treatment. c. It is the therapist’s responsibility to document appro- priate verification of the client’s identity. d. The therapist must take reasonable steps to verify the location and identity of the client(s) at the onset of each session before rendering therapy using tele- therapy. e. Therapists must develop written procedures for verifying the identity of clients, their current loca- tion, and their appropriateness and readiness to proceed at the beginning of each contact. Examples of verification means include the use of code words, phrases, or inquiries. For example, “is this a good time to proceed?” 6. Informed Consent: Availability of Professional to Client a. The therapist must document the provision of informed consent in the record prior to the onset of therapy. b. In addition to the usual and customary protocol of informed consent between therapist and client for in-person therapy the following issues, unique to the use of teletherapy, technology, and/or social media, must be addressed in the informed consent process: 1. Confidentiality and the limits to confidentiality in electronic communication
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