Code of Ethics for Counselors and Marriage and Family Therapists __________________________________
g. Therapists must be aware of the limitations of “blind” test interpretation, that is, interpretation of tests in isolation without supporting assessment data and the benefit of observing the test taker. These limitations include not having the opportunity to make clinical observations of the test taker, such as test anxiety, distractibility, or potentially limiting factors such as language, disability, or to conduct other assessments or interviews that may be required to support the test results. 19. Telesupervision a. Therapists must hold supervision to the same standards as all other technology-assisted services. Telesupervision must be held to the same standards of appropriate practice as those in in-person settings. b. Before using technology in telesupervison, supervisors must be competent in the use of those technologies. c. Supervisors must take the necessary precautions to protect the confidentiality of all information trans- mitted through any electronic means and maintain competence. d. The type of communications used for telesupervision must be appropriate for the types of services being supervised, the clients and the supervisee needs. e. Telesupervision is provided in compliance with the supervision requirements of the relevant jurisdiction(s). Supervisors must review state board requirements specifically regarding face-to-face contact with supervisee as well as the need for hav- ing direct knowledge of all clients served by their supervisee. f. Supervisors must: 1. determine that telesupervision is appropriate for supervisees, considering professional, cognitive, cultural, intellectual, emotional, and physical needs 2. inform supervisees in writing of the potential risks and benefits associated with telesupervision and of both the supervisor’s and supervisees’ responsibilities for minimizing such risks. 3. ensure the security of their communication medium 4. only commence telesupervision after appropriate education, training, or supervised experience using the relevant technology. g. Supervisors must be aware of statutes and regulations of relevant jurisdictions regarding sexual interactions with current or former supervisees.
h. Communications may be synchronous or asyn- chronous. Technologies may augment traditional in-person supervision, or be used as stand-alone supervision. Supervisors must be aware of the potential benefits and limitations in their choices of technologies for particular supervisees in particular situations.
EMERGENCY PLANS TO SAFEGUARD TELEMENTAL HEALTH SERVICES
Contingency plans must be developed, written, and signed that give consent to service as well as outline procedures to handle technical difficulties and/or crisis situations. If the counselor or therapist is not in the same location as the client or family, then there must be a plan to handle emergency situations in the client’s home or employment area. This requires that the practitioner identifies and collaborates with professional contacts in facilities that are immediately available to assist the client, if needed. These resources should include profes- sional colleagues’ contact information, crisis hotlines, mental health outreach programs, clinics, hospitals, mental health facilities, and law enforcement agencies. These contacts must also be shared with clients and included in their treatment or counseling plans. Procedures that effectively outline when and how to contact these resources, as well as when to call 911, must be written out and discussed with the client. Crisis con- tingency plans must also be included in the informed consent documents signed by the client. Any informed consent would include the client’s understanding of all of the risks involved in technology, long-distance service, and the implementation of the crisis plan. HIPAA STANDARDS FOR MOBILE DEVICES HIPAA outlines the national standards developed by the Department of Health and Human Services to secure elec- tronic protected health information (ePHI) that is “created, received, used, or maintained by a covered entity” [24]. The security of a client’s health information may be at risk when using mobile devices because the data is stored within the device in its onboard memory through the use of a security information module (SIM) card. This card identifies the owner and stores data and can be removed from the cellular device. The device may also have a memory chip, which is a microchip that can be plugged into a computer to provide more memory. An eSIM card is hardwired into the phone so it cannot be removed or stolen, making it more secure. Mobile devices may not have the capability to restrict access to data by encryption and authentication, so practitioners must be cautious when sharing ePHI using mobile devices. Sending or receiving information through publicly available Wi-Fi, or unsecured cellular networks, risks exposing ePHI to anyone. To ensure that ePHI is not compromised or stolen when using a mobile device, the practitioner must use a secure website or a virtual private network (VPN) that encrypts information as it is received and sent from the device.
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