Terry Casey – Ethics and Distance Therapy: Navigating the Most Challenging Issues with Teletherapy

Outline

Navigating Ethical Issues
The Multiple Perspective Model©: An effective and easy-to-use method
Step #1 – Evaluate the problem from the five key perspectives

• Ethical issues – applicable code(s) of ethics
• Legal issues – federal laws, state laws & licensing rules
• Clinical-therapeutic issues
• Institutional policies
• Therapist’s variables & issues

Step #2 – Identify, search & review the appropriate code(s) of ethics

• Foundational principles
• Standards
• Glossary or list of definitions

Step #3 – Consultation

• Consult with colleagues who you know well
• Consult with professionals who can be fully objective

Step #4 – Decision and documentation – Show your work!

• Who, what, where & when
• Narrative descriptions
• A guide for how to make your decision

Navigating Distance Therapy: The Six Keys to Distance Therapy
Key #1 – Technology must meet HIPAA requirements

• What HIPAA compliance means
• Business associates & BAAs
• When FERPA applies rather than HIPAA

Key #2 – Interjurisdictional practice

• Authority limits of state licensing boards
• Therapy for a client/patient who is in another state
• When the provider is in a state other than the one in which she/he is licensed

Key #3 – Competence

• State-mandated training requirements
• Actual competence to practice

Key #4 – Informed Consent

• Setting up a distance therapy-specific process
• Topics & issues to include in the process

Key #5 – Institutional / private practice policies

• The purpose of policies
• Considerations for writing policies

Key #6 – Insurance related issues

• Clients’ health insurance policies
• Coverage for distance therapy
• Limitations of benefits
• Provider’s liability insurance: Possible limitations

Distance therapy-related vignettes

Strategies & Methods for Avoiding Ethical and Legal Problems

• Secure Internet access
• Importance of business associate agreement (BAA)
• Telehealth laws app
• Certification in distance therapy
• Establish a separate informed consent process
• A communication and social media policy
• And lots more…