TeleMental Health: The New Standard – Ethical, Legal, Clinical, Technological, and Practice Considerations

Course materials are available as articles, audio with transcripts, and video with transcripts.

Telehealth, TeleMental Health, E-Counseling or E-Therapy may encompass the practices of not only those providing video or phone therapy, but also the use of emails, chats, or texts with clients. Many therapists came of age and trained before the era of widespread technology – and many more, who trained in the digital era, simply did not receive instruction in the areas of legal, ethical, and clinical aspects of telemental health. Indeed, these areas are continually developing. This course brings the most current information from telemental health experts in the wide and varied areas of telemental health and related ethical, technological, practice, and other considerations.

The research basis for telemental health indicates that it is extremely effective. The US government, and most private payers, aren’t holding back on expanding telemental health services as much as they can!

Telehealth: The New Standard

This introductory level course includes 13 engaging and informative video interviews and 1 audio interview (transcripts available for all videos and audio), as well as several articles. The eight sections of the course will take you through orientation to telemental health practice; basic legal-ethical issues; presenting effectively over video; HIPAA issues specific to online work; client crisis protocols and assessing clients for appropriateness for the medium; technical failure plans; email and texting with clients; the online disinhibition effect and how you can use it to enhance therapy; working with couples, families and groups by video; how to conduct online therapy sessions according to professional standards; and how to start and expand a successful telemental health practice. Additional resources and references are provided for further study, but they are not part of the course.

Disclaimer: This course is purely educational and does not intend to serve as a license (or permission) to mental health professionals to prescribe or practice any of the approaches discussed in this course unless they fall within the scope of practice of your profession. Check with your licensing board about the scope of practice of your profession to make sure you practice within that scope. It also does not serve as a permission to title yourself in any specific way.

Educational Objectives

  • Describe the historical and contemporary context of telemental health standards development.
  • Utilize telemental health in accordance with relevant laws, regulations and ethics codes.
  • Assess one's own competencies for conducting telemental health.
  • Assess if it is legal to work with a client in their location at the time of service.
  • Demonstrate how to present on video in a clinically and technologically effective manner.
  • Demonstrate HIPAA compliance when adding new telemental health technology tools to one's practice.
  • Describe protocols for safely managing telemental health client crises and technology failures.
  • Identify email and texting technology that is appropriate for professional practice.
  • Utilize the unique advantages of telemental health, such as leveraging online disinhibition effect and asynchronous interventions, for clinical effectiveness.
  • Describe basic issues in performing couples, family, and group therapy by telemental health.
  • Identify appropriate tools for telemental health practice.
  • Create and maintain a telemental health practice that is legal, ethical, and effective.


  • Introduction and Telemental Health Practice Master Checklists
    • Practice & Client Needs Checklist
    • Informed Consent & Region/Jurisdiction Needs Checklist
  • Orientation to Practice, Competence, and Legal-Ethical Issues
    • Legal-Ethical Issues Checklist
    • History and context for contemporary telemental health practice
    • Overview of current standards for telemental health practice
    • Overview of legal-ethical issues
      • Cross-state practice
      • Managing multiple licenses, and acquiring more of them to expand practice
      • Competence for telemental health care delivery
      • Security and privacy
      • Practice promotion and marketing
      • Planning for crises and technical failures
      • Multicultural issues in telemental health
    • Reimbursement
  • Practicing Video-Based Telemental Health
    • Basic video presentation skills
    • Preparing computers and Internet connections for a smooth session
  • HIPAA and Security
    • Basic steps to HIPAA compliance
    • Maintaining HIPAA compliance while starting up telemental health practice
  • Emergency Planning Protocols
    • Working with emergency services remotely
    • Assessing clients for clinical appropriateness for telemental health
    • Planning for safety according to client needs
    • Creating backup communication plans for when the primary method fails
  • Email and Texting in Mental Health Practice
    • The role of email and texting in the HIPAA picture
    • Using email and texting in a HIPAA-compliant manner
  • Clinical Interventions in Telemental Health
    • The online disinhibition effect
    • Suler's five-dimensional model of online and computer-mediated psychotherapy
    • Texting with client in a professional, but clinically and relationally effective, manner
    • Using telemental health by video and text as more than just a functional equivalent for in-person therapy
    • Working with couples and families and groups through video
  • Establishing and Continuing Telemental Health Practice
    • Guidelines and checklist for technology selection
    • Legal-ethical guidance on appropriate technology choices
    • Checklist for setting up a telemental health practice & adding new regions
    • Checklist for starting work with new telemental health clients, performing ongoing sessions, and terminating
    • Checklist for items to include in telemental health informed consent
  • The Ethics of Telehealth Practice
    • Ethics in social-media based marketing approaches
    • Establishing or expanding an online practice
    • Evaluating online therapy companies for ethical and legal appropriateness for your practice
    • Sample telehealth disclosure form