Telesupervision in Psychotherapy and Counseling: Going Deeper into the Ethical, Legal, Technological, and Clinical Considerations

Note that this course contains content included in the 3-CE Telesupervision in Psychotherapy and Counseling: Ethical, Legal, Technological, and Clinical Considerations course

Fulfills requirement: Supervision

Telesupervision (also known as distance supervision, online supervision, e-supervision, and remote supervision) refers to the use of telecommunications technology to provide supervision and training. In our post-pandemic era, many supervisors and supervisees have recognized the benefits of telesupervision and consider it to be not only a viable alternative to traditional face-to-face supervision but also a complementary approach that can enhance training and professional development. Although there are many similarities in the standards for telesupervision and traditional in-person supervision, there are also several noteworthy additional considerations that mental health professionals must understand before incorporating telesupervision into their clinical practice.

This advanced introductory/intermediate course is designed to equip practitioners with the knowledge and skills necessary for effective telesupervision. It is comprised of three articles (available in written and audio formats) and four interviews (available in written and audio formats). These sources review the relevant issues in ethics, professional standards, state and federal law, technology, and clinical work and emphasize the need to keep abreast of the latest information in this highly evolving field.

The first section of the course provides an overview of the history, modalities, benefits, and challenges of telesupervision and compares telesupervision with traditional in-person supervision. First, the course defines telesupervision and places it within the broader historical context of telemental health services. Next, the common modalities of telesupervision are introduced. After describing the benefits of telesupervision, the course identifies specific challenges of telesupervision and how each one can be addressed. The section concludes with a review of studies that compare telesupervision with traditional in-person supervision.

The second section explores the ethical and legal issues that mental health professionals must consider when conducting telesupervision. First, general topics in ethics include competence, confidentiality and privacy concerns, informed consent, dual relationships, and boundaries. Specific ethics codes and professional guidelines are presented for psychologists, counselors, marriage and family therapists, and social workers. Next, relevant state board regulations and federal laws and guidelines are described, using the State of California as an example. The section concludes with factors to consider when reconciling discrepancies in telesupervision guidelines and laws.

The third section discusses technological considerations and practical clinical skills needed for effective telesupervision. Technological considerations include choosing the right platform, gathering reliable technical infrastructure, maximizing device security, obtaining digital literacy and support, and making appropriate choices related to the environmental setting. Practical clinical skills for effective telesupervision are emphasized in the remainder of the course. These skills include communicating effectively, building rapport and trust, establishing a telesupervision agreement, structuring sessions, managing distractions and disengagement, addressing disinhibition, and fostering supervisee development and competence. Ways in which to improve cultural competence and accessibility are addressed within the context of telesupervision. Future directions in telesupervision, including artificial intelligence, machine learning, and virtual and augmented reality, are reviewed.

The fourth section consists of four interviews conducted by Aviva Lev-David, Ph.D., with two mental health counselors who are experts in the field. The first two interviews are with Roy Huggins, LPCC NCC, mental health technology consultant, and the second two interviews are with Anne Stokes, BACP, counselor in the United Kingdom and France and editor of a handbook on online supervision for mental health practitioners. Mr. Huggins discusses appropriate use of technology as it applies to HIPAA privacy and security concerns and the legal considerations pertaining to licensing board requirements. In addition, he provides practical suggestions for those clinicians relatively new to telesupervision. Ms. Stokes gives an overview of how to create a productive supervisory relationship and addresses ways to mitigate lack of technological expertise on the parts of both supervisor and supervisee. She also discusses ways to promote advanced clinical skills for supervisees who are engaging in both face-to-face and telemental health. These interviews are intended to review and deepen the earlier course content.