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The Ethics of Internet-Based Counselling Services

The Ethics of Internet-Based Counselling Services. Simon Nuttgens Associate Professor Athabasca University, Alberta. Overview of Online Counselling. A practice of many names A practice of many platforms Static vs. active Synchronous vs. asynchronous Newer developments.

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The Ethics of Internet-Based Counselling Services

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  1. The Ethics of Internet-Based Counselling Services Simon Nuttgens Associate Professor Athabasca University, Alberta

  2. Overview of Online Counselling • A practice of many names • A practice of many platforms • Static vs. active • Synchronous vs. asynchronous • Newer developments

  3. Pros and Cons of Online Counselling • Pros: • Flexible • Cost effective • Suited to some client problems • Cons • Loss of visual cues • Assessment limitations • Managing crisis situations • Security of online information • Regulatory and jurisdictional concerns • Technology failure

  4. Competent Practice • What percentage of online counsellors learned their craft in their graduate training? • Is special training required for online counselling?

  5. Competent Practice Cont. • The ability to develop a working alliance using micro skills specific to the online environment • The ability to manage crisis situations when working with clients who live far from the online counsellor’s practice • Proficiency in online communication technology • Knowledge of internet and email security systems • Knowledge of ethical and legal issues germane to online counselling • Knowledge of jurisdictional and regulatory issues pertinent to online counselling

  6. Record Keeping • Record retention • Re-use by client • Data security • Unintended uses

  7. Confidentiality and Privacy • Three ways in which client-counsellor confidentiality can be compromised: • Computer virus or hacker • Accidental disclosure • Client-initiated breach • What to do? • Educate clients • Informed consent • Encryption • SSL

  8. Informed Consent • Please click “agree” • Who am I communicating with, anyway? • Photo with declaration • “Trends of dishonesty” (Midkiff & Wyatt, 2008) • Arrange for a face-to-face meeting • Information required for consent to be informed: • What will occur should technology fail and the counselor and client are disconnected? Questions to consider include who initiates contact via what means and after what period of time has passed?

  9. Limitations to the security of online communication and what precautionary actions have been taken to decrease possible breaches of privacy or confidentiality. • Whether or not textual, auditory, or video content will be recorded, and if so how privacy and confidentiality will be maintained. • The limitations of online therapy to effectively address certain client problems with an emphasis on limitations that arise due to the absence of visual information. Even when using online video, visual cues may be more difficult to discern than when the client is present in the room.

  10. How emergency situations will be addressed, including danger to self or others, mandatory reporting laws, and the management of other crisis situations when counselling from a distance. • The cost of services, methods of payment, and how missed appointments will be handled. • An objective statement indicating that less is known about the efficacy of online counselling compared to well-researched traditional modes of delivery. • A means for the client to verify the counsellor’s credentials

  11. Managing Crisis Situations • Prior assessment • Informed consent • Emergency procedures • Contact information • Alternative services

  12. Regulatory and Jurisdictional Issues • Where does counselling occur? • Counselling only your province of residence? • Gain licensure in multiple jurisdictions? • Knowing the laws and regulations of other lands…

  13. Contact me… simonn@athabascau.ca Ph. (250) 496-5143 or (866) 916-9653

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