1. Therapy Inside the Box: From My Computer to Yours
Dr. Susan Meyerle, LIMHP
Life Resources, LLC

2. Our Objectives
Explore regulations related to effective electronic practice to ensure ethical behavior.
Identify best practices for providing quality client care.

3. Terminology Telemental Health Telemedicine Distance Counseling
Cybercounseling
E-therapy
Others?
Important to note when you’re inquiring about coverage by insurance companies.

4. Trends in Regulation
19 states regulate electronic communications for counselors (but only within the state lines)
19 states + DC have no regulations
6 states specifically state they do not support electronic communications under their scope of practice for PCs. (MD, NM, SD, TN, VA, IN)
Source: Licensure Requirements for Professional Counselors, ACA, 2016.

5. Licensure needed!
BOTTOM LINE: You must be licensed in the state in which you are providing services.

6. So…??? Get trained in electronic practice because you may be a…
trailblazer!
So….You need to know what you’re doing. BE SURE to check with your malpractice insurance carrier!!

7. Modalities in Regulation
Note: There is no video playing here.

8. “Proving” Competence No state requires a specific credential
(as of 3/17/17)
Training options:
DCC through NBCC replaced by BC-TMHP
9 core areas of training required
Exam
Telemental Health Institute
Life Resources, LLC

9. Telemental Health Practice
Nitty, gritty details

10. Client Verification Confirming the client is who you believe they are
Confirming current location of the client
Recommended to begin EACH session

11. Establishing the Relationship
Best practice: Provide a quick consultation with client to ensure all is set up smoothly (This is not covered by insurance)
Test internet speeds with at
Signed Informed Consent (specifying additional risks of electronic practice)
Note: Does jurisdiction allow for electronic signatures?

12. Information for Client
Your training in teletherapy
Risks/benefits
How to contact you if an emergency arises
License # and how to contact the Board
Insurance coverage for the client
Information collected and any passive tracking mechanisms utilized.

13. Client Screening Consider technological aptitude of client
Appropriateness of video therapy for client and,
their presenting as well as assessed issues

14. Documentation Traditional record-keeping applies
IF the session is recorded, consent is required as is information about storage/destruction of video record.

15. Emergency Management Know what your options are for EPC
(and what its called in each jurisdiction)
What are options for hospitalization?
What about other supports in the community? (e.g., Lincoln has Keya House)

16. Arizona – PhD = permissive, all other = required.
Delaware – SW = permissive, MHC = required.
Illinois – therapist = permissive, PhD or MD = required.
Georgia – discretionary, duty to protect when a patient makes threats and is released negligently from hospital.

17. Technology Disruption
Emergency:
Need to be determined at onset of therapy what the protocol will be.
Non-Emergency:
What other options are available?
Protocol for rescheduling or reconnecting

18. Technology Standards Point-to-point encryption
Virus protection up-to-date (therapist & client)
Robust passwords
HIPAA compliant, follow HITECH requirements

19. Best Practice Tip!
“Therapists shall retain copies of all written communications with clients.”
AMFTRB Teletherapy Guidelines, September 2016
State regulations revisions are now including all correspondence. Are you prepared?

20. Just for you!
Use code WVCA2019 for a 20% discount on trainings listed on

21. Commandment #3
Thou shall not engage in a “personal virtual relationship” with a client.

22. Commandment #10
Thou shall conduct compliance reviews.

24. Dr. Susan Meyerle
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