Telepsychology: Ethical Guidelines of Practice for Psychologists

Psychology services provided through video or phone has become quite common among therapists and clients.

Telepsychology is seeing a psychologist who is not physically present in the room with you. Also known as online and virtual therapy, the psychologists provide their service by two means:

1. Synchronous - Communications delivered in real-time via video call (skype and other platforms) or phone call.
2. Asynchronous - Communications via email and text messages.

However, for psychologists, telepsychology guidelines and teletherapy rules can be a bit challenging. Telepsychology being significantly different and unique from an in-person session, there are two main elements to consider:

1. Are you, as a psychologist, capable enough to deliver telepsychology and have ample knowledge in the use of this service?
2. Are the clients aware of and understand the risk of losing confidentiality associated with using such telecommunication means?

Psychologists have to be familiar with a set of guidelines when delivering telepsychology.

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Interjurisdictional policy

As a psychologist, you should have the legal authorization to practice or deliver telepsychology services outside your jurisdiction.

For example, if you are residing in the state of California and your client is in Texas, then you must have the license to practice in Texas.

Every state has a distinct set of guidelines. You have to abide by the laws and rules of a particular jurisdiction for practicing telepsychology in that state.

The process involved in procuring a permit to work in a jurisdiction outside yours entails a fee. However, it may be cumbersome, and requires you to be familiar with the regulations of providing telepsychology services to your clients across state lines or even international borders.

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Proficiency of the psychologist

Psychologists may require to obtain relevant training - professional and technical - to ensure their capability of using the technologies for telepsychology.

Several courses train you in the use of skype and other telecommunication technologies for telepsychology.

You may be required to determine if telepsychology is suitable for a client. You have to understand the client's ability to engage and grasp the risks and benefits of telepsychology.

Since there is a lack of research available in the use of specific telecommunication technologies, there is no evidence of the effectiveness of the service. However, this does not mean you deny telepsychology to the client.

As a psychologist, when you handle in-person sessions, you are familiar with the resources available for any crisis, emergency response information, a support person in the client's life, or hospital contact.

However, things are significantly different when delivering telepsychology outside your jurisdiction. You have to address the absence of required resources and provide your clients with relevant information which they can use in case of an emergency in their jurisdiction.

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Confidentiality of data

Do you think Skype obeys HIPAA?

The practice of providing counseling services over the internet raises questions regarding the confidentiality of personal data and information.

Psychologists must ensure the protection of their clients' data and information. You have to inform your clients about the possible risks of loss of confidentiality that comes with the use of technologies.

There have to be security methods in place to prevent breaches. Clients must be informed about the risk of others gaining access to communications between them and the psychologist via telephone or email.

As a "telepsychologist", you will have to consider possible threats that may lead to the disclosure of client data.

• a computer virus
• hackers
• damage to devices
• theft
• failure of software and security systems
• unsecured files
• outdated technology

You will have to control access to such sensitive information. You must be aware of jurisdictional rules and regulations concerning the storage of client data and information.

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Informed consent

You will have to make efforts to provide a clear and complete description of the telepsychology service to your clients. You will have to obtain and document informed consent.

Inform your client about the policies and procedures involved in telepsychology and specific telecommunication tools used in your sessions. Make them aware of the ethical issues in telecommunications and a set of online communication practices and rules.

There may be differences regarding informed consent between the rules in the jurisdiction where you reside and your client's jurisdiction.

In the case of minors, informed consent must be secured remotely from parents or guardians.

Psychologists are encouraged to address the following:

• type of client data stored
• where will it be stored
• how secure is it
• who will be able to access it
• any technology-related vulnerabilities
• security measures to ensure the protection of client data and information.

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Safe disposal of data

Psychologists are urged to dispose of client's information including the technologies used to create, store, and communicate the same. It must be done securely without compromising any information by following the relevant organizational rules and guidelines.

The routine removal of malware and cookies is recommended when using telecommunication technologies.

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Psychological tests and assessment

Most psychological tests and assessments were developed for in-person sessions. Psychologists must be aware of the impact of such tests and the virtue of these assessments, their limitations, and data interpretations when conducted through telepsychology.

Any modifications or upgrades needed for such tests according to the conditions must be taken care of by the psychologist to ensure a successful telepsychology session.

Psychologists can ensure the presence of a trained assistant at the location of the client who can verify the client's identity and provide on-site support for any assessment or test.

You must be aware of any issues - language, cultural, cognitive, physical, or other impairments - that is common when dealing with clients of varied populations. Addressing these issues is crucial since it can have an impact on psychological tests.

These guidelines offer the best way to incorporate telecommunication technologies and psychological services. As the industry involves, this recommendation will steer psychologists towards the efficient practice of telepsychology.

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