Provision of Mental Health Services via Telehealth: Legal, Ethical and Clinical Considerations
Fulfills California Board of Behavioral Sciences one-time requirement for telemental health.
While telemental health has rapidly become the standard of care, many providers are continuing to work through details regarding how to best use this modality to enhance the clinical interaction. Furthermore, some remain unclear regarding practicing across state laws, as well as fully understanding the legal and ethical requirements necessary when working virtually.
This advanced beginner/intermediate level course contains three sections, the first of which provides an overview of best practices in terms of setting up a virtual practice. HIPAA guidelines and pragmatic guidance regarding practice needs are reviewed as well.
The second section contains two articles highlighting key legal and ethical standards required for every clinician engaging in online treatment. Included is a discussion of informed consent, security, and privacy.
In the final section, the focus shifts to clinical considerations, including how to evaluate who is appropriate for virtual treatment, tips on enhancing the therapeutic alliance, and suggestions on being more creative with the technological capabilities that are available. A section is dedicated to discussing how the online disinhibition effect impacts therapy. The course concludes with recommendations and strategies for working with specific populations.
As a bonus, a sample informed consent is provided in Word format that clinicians can modify to suit their specific practice needs.
Educational Objectives
This course will teach the participant to:
- Discuss best practices for use of technology including lighting, sound, and setting
- Identify HIPAA regulations applying to telemental health platforms, encrypted communication, and record storage
- Implement the telemental health informed consent process in accordance with state laws, ethical principles, and the standard of care
- Discuss how to evaluate appropriateness for therapy via telemental health
Syllabus
- Identifying challenges
- Starting with the basics
- Microphone, camera, and lighting
- Telehealth platforms
- HIPAA compliance
- Security
- Business associate agreement
- Concerns that must be addressed regarding the use of technology in practice
- Statutory requirements for practice
- Provide the client with license number and registration
- Obtain information on relevant local resources
- Document client’s location
- Informed consent
- Verify suitability of appropriateness for tele therapy
- Notes specific to telemental health
- Document location
- CPT and modifier codes
- Telehealth across state lines
- Temporary and reciprocal licensing
- How to determine what is permissible
- Compacts
- Is online therapy effective?
- Who is suitable for online treatment?
- Considerations for online therapy
- Creative use of technology
- Creating a shared experience
- Enhancing the therapeutic alliance
- Contingency planning
- The online disinhibition effect
- Telemental health considerations for specific populations
- Cultural, ethnic, and socioeconomic considerations
- Neurological and medical concerns
- Older adults
- Working with children
- Suicidal patients
- Considerations of specific populations
- Impact on therapists as a result of shift to teletherapy
- New ethical concerns