● Abide by all regulations in all jurisdictions in which they practice. ● Represent themselves accurately and make attempts to confirm the identity of the client and the client’s contact information. ● Protect client information in the electronic record. ● Provide services consistent with accepted standards of care, regardless of the medium used. ● Use available technology to both inform clients and mobilize individuals and communities so that they may advocate for their interests. ● Advocate for technologies that are culturally sensitive, community specific, and available for all who can benefit from them. ● For those in administrative practice, keep themselves informed about technology that can advance quality practice Virtual or e-therapy Depending on their mental health focus and where they practice, many mental health practitioners offer online therapy services through real-time chats, email, videoconferencing, telephone conferencing, and instant messaging. The benefits touted by supporters of online therapy, as described by Kanani & Regehr (2003), include the ability to: ● Serve millions of people who would otherwise not participate (e.g., people with certain conditions such as agoraphobia, persons living in remote locations, or those concerned about the stigma of counseling). ● Decrease inhibitions clients may have about fully disclosing relevant information. ● Increase the thoughtfulness and clarity of communication as an unintended by-product of written communication. ● Produce a permanent record that can be easily referred to, forwarded to clients or colleagues for review and consultation purposes. ● Substantially reduce overhead costs, thus reducing costs for the consumer. ● As discussed earlier in this training, one of the major areas still under debate as a result of this new technology is that of jurisdiction. For example: ○ When the client lives in a different state, how can violations of licensing laws be avoided? And which state’s laws would be applicable? Limiting risk in the practice of E-therapy Matthew Robb (2004) recommends the following for those practicing e-therapy: 1. Full disclosure : This relates to informed consent and the need to fully disclose the possible benefits and risks of distance counseling, including informing the client that this is a new area of practice, which has not had the benefit of long-term study. 2. Comprehensive assessment : Provide clients with detailed and complete assessment tools and encourage full disclosure by client. 3. Confidentiality and disclosure of safeguards : Take all precautions to safeguard the confidentiality of information and avoid misdirected emails, eavesdropping, hacking, etc. Alert the client to these potential risks as well. 4. Emergency contact : Obtain information for an emergency contact and together develop a clear emergency plan. 5. Consult your association’s code of ethics : Review standards regarding informed consent, confidentiality, conflict of interest, misrepresentation, etc. 6. Consult state licensing provisions : Research both the statutory regulations of your board and those in the client’s home state. 7. Consult a malpractice/risk management attorney : Consider asking a legal specialist to review website materials to determine compliance with standards of care and potential malpractice issues.
and operations, invest in systems, and establish policies that ensure security and privacy. ● Conduct a thorough assessment, including evaluation of the appropriateness of potential clients for e-therapy. This includes the need for the social worker to fully understand the dynamics involved and the risks and benefits for the client. ● Evaluate the validity and reliability of research collected through electronic means and ensure that the client is likewise informed. Continue to follow applicable standards and laws regarding supervision and consultation. ● Adhere to NASW Standards for Continuing Professional Education and applicable licensing laws regarding continuing education. ○ Is the origin or location of counseling in the client’s community or the therapist’s? Or is it somewhere in cyberspace? ○ And what defines location if a busy executive is involved in an online session while flying from Tucson to Bangkok? This is clearly an ambiguous area that will undoubtedly continue to be discussed. Kanani & Regehr (2003) have summarized some of the other concerns regarding the use of e-therapy: ● E-therapy does not allow practitioners to observe and interpret facial expressions and body language. ● The Internet poses serious risk to security and thus to confidentiality. ● Inappropriate counseling may occur due to therapist ignorance about location-specific factors related to the client (e.g., living conditions, culture). ● Clients cannot be sure as to the credentials, experience, or even identity of the person they are trusting to provide services. ● Clients may not have any legal recourse for malpractice, given unresolved questions about jurisdiction and standards of care. 8. Provide communication tips : If communicating solely by text-based messaging, provide client with clear tips regarding communication. Texting has become more common in clinical practice. In spite of the imminent risk to client privacy and breach of confidentiality, some clients, especially adolescents, prefer this mode of communication. Practitioners using texting as a form of communication should have a clear policy outlining when texting will be used or is acceptable (NASW, 2017). Informed consent should also address and cover this risk. Should texts be included in the health record? The short answer is “Yes.” Whether to include the exact text or a summary of text discussion is at the discretion of the provider, but there should be some record of text communication. Texts, much like email, need to reflect the values, ethics, and mission of the practitioner’s profession (NASW, ASWB, CSWE, & CSWA, 2017; Reamer, 2018b; Sidell, 2015). Current guidelines for the use of technology are discipline-specific, and clinicians wishing to use technology in their practices should ensure that they are following their profession’s ethical and legal standards. When practitioners decide to engage in texting with clients, their policies should be provided to clients during the first session, and they should obtain informed consent. Therapeutic contact via texting is now being advertised. Although texting may be a comfortable means of communication for some clients, this means of engagement with clients can
Page 51
Book Code: SWTX1524
EliteLearning.com/Social-Work
Powered by FlippingBook