3Based Upon and Extensions of APA 2002 Code of Ethics and,The 1997 APA Ethics Committee statement on electronic servicesAppendix A
4Ohio Psychological Association Communication & Technology Committee Kenneth Drude, Ph.D., ChairmanAudrey E. Ellenwood, Ph.D.Kathleen (Ky) T. Heinlen, Ph.DCurrent ChairTerry Imar, M.A.Michael Lichstein, Ph.D.Paule Steichen Asch, Ph.D.
5Ohio Psychological Association Staff Michael Ranney, MPABobbie Celeste, PhDDenise Brenner, BAKatie Crabtree Thomas, BA
6Mission Statement“TO PROPOSE A SET OF FLEXIBLE AND WORKABLE GUIDELINES THAT CAN BE APPLIED BY PSYCHOLOGISTS WHEN PROVIDING TELEPSYCHOLOGY SERVICES. . . THEY ARE INTENDED TO BE APPLICABLE TO ANY PSYCHOLOGICAL SERVICES PROVIDED USING COMMUNICATION TECHNOLOGY.”Our intention was to aide psychologists in thinking through the issues of providing services through electronic means. As illustrated by the recent court decision involving a telemedicine case sometimes we think with our hearts in our efforts to help people and forget the importance of using our heads and making sound ethical and legal decisions regarding practice. This area is ripe with opportunities for that.
7What is Telepsychology? Telepsychology is the provision of non-face-to-face psychological services by distance communication technology.
8What does one mean by non face-to-face communications? TAAPP Think AboutWhat does one mean by non face-to-face communications?
9So, What is Non Face-to-Face Communication? Landline telephonesCell phonesVideo conferencingInstant messagingUse of internet services viaInternet meetingsFacsimileChat roomsWebpages
10Why Telepsychology Guidelines? Practiced by many psychologists around the worldPsychologists and clients at risk for potential harm-Lack of clear guidelinesGuidelines provide a frameworkRecommend specific professional behaviors, endeavors, or conduct for psychologistsIt is conceivable that should a case come up in Ohio that the Ohio Board of Psychology will utilize any available guidelines or standards available to protect the rights of the clients.Guideline assumptions: voluntary, represent best practices and evolutionary in nature.
11Categories That Justify Development LEGAL & REGULATORY ACCOUNTABILITYAPA Code of Ethics - no guidelines for electronic communicationsPUBLIC BENEFITPROFESSIONAL GUIDANCE
12What is the difference between TAAPP Think AboutWhat is the difference betweenstandards and guidelines?Code of ethics? Standards? Best Practice?
13Guidelines Vs. Standards Mandatory and may be accompanied by an enforcement mechanismGuidelinesFacilitate the continued systematic development of the professionAssure a high level of practiceNot mandatory or exhaustiveMay not be applicable to all professional and clinical situationsAre not definitiveDo not take precedence over the judgment of psychologistsAPA 2002, p. 1050Code of ethics—REQUIRED standards adopted by a professionStandards are MANDATORY Expectations and closely adhered to comply with professional practice expectationsBest Practices subset of guidelines that address behavior and treatment to be applied in the best interest of the client
14Guideline Assumptions VoluntaryDo not carry the force of the law,Represent best practices and,Evolutionary in nature.Guidelines are only for those practicing in OhioMany states and Canada are modeling after these guideleinesVoluntary recommended practices used to assist psychologists in applying 2002 APA Code of ethicsConsidered best practice and reflect current professional experience and knowledgeEvolutionary –revisited 5 years validity, utility, applicability and relevance
15Process of Development Guidelines and standards created by other health agencies (Table 1)Reviewed the 2002 APA Ethical StandardsDeveloped guidelines DraftOPA reviewedSent out to OPA members and state, regional and national organizations for inputChanges and suggestions were discussed and adoptedFinal version to OPAThree years start to adoption
16Technology Guidelines Approved by theOPA Board of DirectorsApril 12, 2008
17Telepsychology Guideline One TAAPP Think AboutTelepsychology Guideline OneAppropriate Use of TelepsychologyWhat are the key points
18The Appropriate Use of Telepsychology Not appropriate for all problemsSpecific process of providing servicesvaries, situations, setting, timeDecisions made case by case basisPsychologists have specific skills to use technologyCan the clients benefit from technology servicesPsychologist determines, not appropriatecreate alternatives
19Telepsychology Guideline Two TAAPP Think AboutTelepsychology Guideline TwoLegal and Ethical RequirementsWhat are the key points
20Legal and Ethical Requirements Make sure that provision of telepsychology is not legally prohibited by local or state regulationsNeed to be aware of and in compliance with the laws and standards CLIENT RESIDESKnow requirements for reporting individuals at risk to themselves or othersComply section 508 to make telepsycholgy accessible to those with disabilitiesAssure all advertisement is not deceptive
21Telepsychology Guideline Three TAAPP Think AboutTelepsychology Guideline ThreeInformed Consent and DisclosuresWhat are the key points
22Informed Consent and Disclosures Provide information about use of electronic communicationLevel of Experience in Telepsycholgy explainedUse language client will understandObtain appropriate consent for minorsClient’s Informed Consent must be secure (Encryption Services)Limitations of technology and client provides written acknowledgement
23Informed Consent and Disclosures (Cont.) Personal risk to confidentiality of information due to technologyLegally required reporting (Suicidal or homicidal)Written client consentPsychologists make reasonable attempts to verify identity of clientsPsychologists make reasonable attempts to verify clients are capable of providing informed consent
24Informed Consent and Disclosures (Cont.) Alternative means of contacting client or psychologist in emergency situationsInform clients about potential risk of disruption with telepsychologyPsychologist must clearly state :policies on use of telepsychologyWhen they will respond to electronic messagesAlternative communication for emergencies
25CAUTION************** Given the 24 hour, 7 day a w eek availability of online environment, as well as increased disclosure online, clinical clients may be more likely to disclose suicidal intentions and assume the psychologist will respond quickly.
26Telepsychology Guideline Four TAAPP Think AboutTelepsychology Guideline FourSecure Communications/Electronic Transfer of Client InformationWhat are the key points
27Secure Communications/Electronic Transfer of Client Information Use secure communication with clientsEncrypted text messagesSecure websitesObtain consent for use of non-secured communicationsReasonable efforts to ensure the confidentiality of information electronically transmitted to other partiesAvoid using personal info with non-secured meansreason
28Example of Possible Electronic Confidentiality Statement Note: This document contains confidential information. This report is intended for the sole use of the person upon which it is supplied via electronic means. This document or any information contained within may not be released to another person without prior written consent from the client. If you received this document in error please contact …….. Immediately.
29Example of Possible Electronic Confidentiality Statement Note: This fax contains confidential information. This fax is intended for the sole use of the person upon which it is supplied via electronic means. This If you received this fax in error please contact …….. immediately.
30Telepsychology Guideline Five TAAPP Think AboutTelepsychology Guideline FiveAccess To and Storage of CommunicationsWhat are the key points
31Access To and Storage of Communications Inform client who else has access to communicationsHow client’s communication can be directed to a certain psychologistHow client information will be storedUnauthorized persons do not have access to any of the informationComputers and storage devices need to be disposed of when no longer in useTypes of information that will be maintained as part of client’s records
32Telepsychology Guideline Six TAAPP Think AboutTelepsychology Guideline SixFees and Financial ArrangementsWhat are the key points
33Agreement reached specifying: CompensationBillingPayment arrangementsPrior to providing telepsychology services
35Be sure to Review:Ten Interdisciplinary Principles for Professional Practice in Telehealth (Appendix B)Telehealth and Telepsychology (Figure 1)Examples of Relevant Terminology (Appendix C)Standards and Guidelines Relevant to Telepsychology (Appendix D)Handout
36Where next?? Online Supervision using Telepsychology Use of Telepsychology withpsychological assessments