1. DECEMBER 9, 2011

2. FOR YOUR INFORMATION According to a 2009 study, an estimated 210 BILLION emails are sent each day Bradley et al. 2011

3. FOR YOUR INFORMATION Trepal,Haberstroh,Duffey, and Evans (2007) study regarding the effectiveness of Internet counseling drew mostly favorable conclusions. However, they noted issues to be addressed such as lapse of time between communications, issues of ethics and confidentiality, and a lack of verbal communication.

4. FOR YOUR INFORMATION In research by Hrick and Scott (2007) concluded that an electronic communication of unsolicited confidential information to an attorney implied a attorney/client relationship when none exists. Might this also be true of communications to counselors/therapists?

5. FOR YOUR INFORMATION Know the rules of your license. Know what the policy for your agency/organization regarding electronic technology Refer to respective Code of Ethics for guidance. Check with your malpractice carrier about coverage.

6. FOR YOUR INFORMATION According to Professional Counselor Licensing of OSDH, there are no current rules in LPC or LMFT regarding the use of email, telephone, video media, facebook, twitter, etc. in the counseling environment. LMFT rules allow for some supervision to occur by way of technology assistance.

7. FOR YOUR INFORMATION ACA CODE OF ETHICS A12.a Inform client of Benefits and limitations A12.b Technology Services. Counselor determines intellectual and emotional capacity of client to use electronic applications. A.12.c Inappropriate Services. When technology is inappropriate, consider face-to-face services. A.12.d Provide reasonable access A.12.e Does not violate laws; local, state, federal, international.

8. FOR YOUR INFORMATION ACA Code of Ethics, cont’d A.12.g Technology and Informed Consent. 1. difficulty in maintaining confidentiality. 2. Inform who might have access. 3. Aware of authorized and unauthorized users. 4. Inform of legal rights of practice across state lines. 5. Use encryption when possible. 7. How long will archives be maintained. 8. Possibility of technology failure.

9. FOR YOUR INFORMATION ACA Code of Ethics, cont’d A.12.g.9 Inform client of emergency procedures such as “911”, call crisis hotline when counselor not available. g.10. Discuss time zone differences, local customs/language g.11. Inform client when technology-assisted counseling is not covered by insurance.

10. FOR YOUR INFORMATION ACA Code of Ethics, cont’d A.12.h Sites on World Wide Web. h.4 Establish method for verifying client identity. h.5 Obtain the written consent of the legal guardian.

11. FOR YOUR INFORMATION What about transparency?  Clients googling therapists/counselor  Counselor googling clients

12. FOR YOUR INFORMATION  Online evaluations  www.yelp.com www.yelp.com  www.rateMDs.com www.rateMDs.com  www.coomplaintsboard.com www.coomplaintsboard.com  www.pissedconsumer.com www.pissedconsumer.com  Social networking: Facebook LinkedIn Twitter others

13. FOR YOUR INFORMATION Compounding issues with use of technology  Online self-disclosure  Texting during sessions  Social networking with clients  Communications between sessions via cell phone, email, chatrooms, Skype, etc.  Telehealth, Telemental Health, E-therapy

14. FOR YOUR INFORMATION DIGITAL HARASSMENT  Clients put multiple Internet negative postings about their therapist.  Clients post their online comments under many pseudo- names on many different sites.  Clients post on special websites detailing their negative evaluation of a therapist.

15. FOR YOUR INFORMATION What about emails and therapy/counseling? o ?Are emails considered therapy or counseling? o How often do I need to check it? o Is it HIPAA compliant? o Encryption, email signature o Are emails part of the clinical record?

16. FOR YOUR INFORMATION WHAT CAN COUNSELORS AND THERAPISTS EXPECT? That. modern, informed “consumers” will google their counselor. That they will do so before, during, and after therapy. Expect clients to post evaluation on any of the various sites. ALL of your web postings to stay in cyberspace forever! Facebook privacy settings to be perfectly imperfect.

17. FOR YOUR INFORMATION WHAT ABOUT A CLIENT AS A FACEBOOK FRIEND?  Facebook Page vs. Profile  Confidentiality  If you have Facebook, what is your profile?  Privacy settings  Public access  Do you have Social Media Policies?  Does it constitute “dual/multiple relationships?

18. FOR YOUR INFORMATION Positives of texting between sessions. Can be very effective Convenient Immediate Anytime-Any place Clients can view the message repeatedly Can be used as an appointment reminder Rescheduling

19. FOR YOUR INFORMATION SKYPE  Skype-to-Skype is free  Additional services may be added by various subscription plans.  Is Skype secure? What about encryption?  Is Skype HIPAA compliant?

21. REFERENCES 1. American Counseling Association (ACA). Code of Ethics (2005). 2. American Mental Health Counselors Association (AMHCA). Code of Ethics (2000). 3. Bennett, B. et al. Assessing and Managing Risk in Psychological Practice: An Individualized Approach (2006). The Trust. Rockville, MD. 4. Bradley, L., Hendricks, B., Lock, R., Whiting, P., Parr, G. (2011). E-Mail communication: Issues for mental health counselors. Journal of Mental Health Counseling. Vol.33. Number 1. pages 67-79. 5. Corey, G., Haynes, R., Moulton, R., Muratori, M. (2010). Clinical Supervision in the Helping Professions 2 nd Edition. American Counseling Association. 6. Jacobs, D., David, P., Meyer, D. (1995). The Supervisory Encounter. Yale University Press. 7. Oklahoma State Department of Health, Professional Counselor Licensing. Rules and Regulations (2011). 8. Wheeler, A., Bertram, B. (2008). The Counselor and the Law: A Guide to Legal and Ethical Practice. Fifth Edition (2008) 9. Zur, Ofer. 2011.

22. FOR YOUR INFORMATION Michael D. Swafford, Psy.D.,LPC 105 S. Bryant, Suite 302 Edmond, OK 73034 405.844.7793 DrMikeSwafford.com DrMikeSwafford@aol.com