● Revisit the decision with the client to determine if other decisions need to be made. Discussion There will be many decisions the counselor and client will have to make in planning and delivering counseling services. The best practice is a client-centered approach for shared decision making that places the focus on engaging the client in the process based on their needs, preferences, values, and desired outcomes. The counselor takes a supportive role to assist the client in reaching a decision by providing evidence-based information on the options being considered, including risks and benefits of each. Counselors may need to assist the client in determining shortand long-term goals, identifying barriers to those goals, developing a plan of action, and taking steps to move forward.
The client may enter the counseling process believing that the counselor will provide the answers as the authority and that they will assume a passive role. The shared decision- making process may require time to educate the client on the five steps, and additional time for practice, based on the client’s ability to contribute and advance through the process. The counselor will need to continually assess the client’s responses to determine the next course of action as the client learns to apply the decision-making steps. The goal is to build skills for independent decision making that lead to self-reliance or autonomy rather than dependency on others.
TECHNOLOGY ASSISTED COUNSELING
There are many terms to describe distance therapy using electronic methods, which include audio and video communication, including the addition of social media with all the inherent confidentiality and privacy issues. The term “distance” refers to the fact that the counseling is not face- to face with the client and counselor in the same location. A review of many studies shows mixed results in the effectiveness and security of technology-assisted counseling, often called telemental health counseling or E-therapy. Many counselors noted the convenience of the methods, especially during the Covid -19 pandemic, when face-to-face counseling was not possible. Positive outcomes include the ability to reach underserved populations in remote areas that have no access to mental health care or without transportation to travel to a care provider. Clients with health and mobility issues, homebound, residing in care facilities, or incarcerated can access counseling through electronic methods where mental health care would otherwise be unavailable. There are several disadvantages to technology-assisted counseling that (a) Licensees who provide marriage and family therapy to clients or supervision to supervisees outside the State of Texas must comply with the laws and rules of Texas and of the out-of-state authority which govern the practice of marriage and family therapy. (b) Licensees who provide treatment, consultation, and supervision using technology-assisted services must meet the same standards of appropriate practice as licensees who practice in traditional (i.e., in-person) settings. (c) In accordance with Texas Occupations Code, §502.251 (relating to License Required), a person may not practice as a marriage and family therapist unless the person holds a license under this chapter or is exempt under Texas Occupations Code, §502.004 (relating to Application of Chapter). (d) A licensee may provide technology-assisted services. To ensure the competent delivery of services by technology-assisted means, a licensee must maintain an appropriate level of education, training, or experience in using relevant technology. (e) A licensee may not render therapy using technology- assisted services without complying with the following at the onset of each session:
involve confidentiality, security, and privacy issues when the environment cannot be strictly controlled. Communication between client and counselor may be impacted negatively because of the distance between the parties. There is the possibility of missing important signals and cues that the client is in distress or simply not connecting with the counselor or engaging fully in the counseling process. The goal of establishing trust in the client–counselor relationship is based on open communication. Technical difficulties and equipment failure can interfere with or shut down the counseling session. This is not only frustrating to both parties but may severely damage the continuity and effectiveness of the process and may cause clients to withdraw from counseling. Emergency situations may occur where the client or therapist cannot reach each other that could have life- threatening consequences. These issues must be addressed when implementing technology in practice to ensure the benefits outweigh the risks based on the individual needs of each client. (1) fully verifying the location and identity of the client, to the most reasonable extent possible; and (2) disclosing the identity of the licensee. (f) Before providing technology-assisted services, a licensee must determine whether a client is a minor. Upon determining that a client is a minor, and before providing technology-assisted services, a licensee must obtain required consent from a parent or guardian and must verify the identity of the parent, guardian, or other person consenting to the minor’s treatment. (g) The licensee must determine if technology-assisted service is an appropriate delivery of treatment or supervision, considering the professional, intellectual, or emotional needs of the client or supervisee. (h) Informed consent must include, at a minimum, information that defines electronic service delivery as practiced by the licensee and the potential risks and ethical considerations. The licensee must obtain and maintain written or electronic evidence documenting appropriate client informed consent for the use of technology-assisted services including the following: (1) identification of the client, the therapist, and the therapist’s credentials. (2) list of services provided by the licensee using technology-assisted services.
The Texas Administrative Code: Technology Assisted Counseling Texas Administrative Code Rule §801.58 Technology-Assisted Services
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Book Code: PCTX1326
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