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 involve confidentiality, security, and privacy issues when the environment cannot be strictly controlled. Communication between client and counselor may be impacted negatively (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: (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
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. 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. (3) client agreement that the therapist determines on an on-going basis whether the condition being assessed or treated is appropriate for technology-assisted services. (4) details on security measures taken with the use of technology-assisted services, as well as potential risks to privacy notwithstanding such measures. (5) information regarding secure protocols and back-up plans in case of technical failure. (6) the licensee’s credentials or training to engage in technology-assisted services, and contact information. (7) risks and benefits of engaging in the use of technology. (8) emergency procedures to follow when the therapist is not available. (9) information collected and any passive tracking mechanisms used. (10) third-party websites or services used by the licensee to facilitate technology-assisted services; and (11) an explanation of how records are maintained electronically, including encryption type and record security, and the archival storage period for transaction records. (i) Therapists who use technology-assisted services must meet or exceed applicable federal and state legal requirements of health information privacy, including compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191; The Health Information Technology for Economic and Clinical Health (HITECH) Act, 42 U.S.C. Chapter 156, Subchapter III; Texas Health and Safety Code, Chapter 181 (relating to Medical Records Privacy); and state privacy, confidentiality, and security rules. Introduction Counselors understand that the profession of counseling may no longer be limited to in-person, face-to-face interactions. Counselors understand the additional concerns related to the use of distance counseling, technology,
The Texas Administrative Code: Technology Assisted Counseling Texas Administrative Code Rule §801.58 Technology-Assisted Services (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.
The ACA Code of Ethics: Technology Assisted Counseling Here is a summary of guidance offered by the ACA on the use of technology in counseling (ACA, 2014): Section H Distance Counseling, Technology, and Social Media
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Book Code: PCTX1325
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