Course excerpt from E-Therapy: Ethics & Best Practices
E-therapy (a.k.a. distance therapy, telepsychology, telemental health, remote therapy, etc.) refers to the delivery of mental health services in which electronic equipment and therapeutic communication converge online. Typically the online services include emails, discussion lists, chats, or audiovisual conferencing. This kind of therapy is proliferating rapidly, and its applications have the potential to advance the field of mental health in a multitude of ways.
Research suggests that e-therapy may have similar or, in some cases, even better therapeutic benefits than face-to-face (F2F) therapy. Studies have also suggested that e-therapy for certain purposes can be very cost-effective because it can require minimal or no therapist involvement. However, (good news for all of us?) therapist involvement is still generally preferred.
In their article on home-based telemental health (HBTMH), Pruitt and Luxton (2014) state that “one of the principle benefits of HBTMH is its potential to improve treatment attendance and satisfaction, which can lead to more positive treatment outcomes. The benefits of reduced travel, less time off work, shorter appointment wait-times, and greater personal control are frequently cited as advantages of telehealth-based care over in-person care.”
Patients with Limited Mobility
The main advantage of e-therapy is that it can reach people who might not otherwise seek therapy, such as disabled people or those who live in remote areas; it also reduces the contact time between therapist and patient.
A Sense of Anonymity
It has been observed that online interactions can differ from in-person encounters in that the former imparts a sense of disconnect or anonymity. This phenomenon has been referred to as the “online disinhibition effect.” This is essentially the observation that while online, some people self-disclose or act out more frequently or intensely than they would in person. A positive aspect of this effect – in the context of remote online therapy – is that some individuals may be inclined to disclose information they might not be disposed to share in a traditional therapy session.
Bypassing the Stigma
According to Luxton et al. (2012), “Home-based TMH is a viable solution to provide improved access to quality mental healthcare for those unable or unwilling to seek traditional care because of mobility, geography, or concerns about stigma.”
Even in current times, when it is fairly commonplace for individuals to seek psychotherapy for life’s issues, there is still some residual stigma associated with psychotherapy – at least in the minds of some individuals. Particularly in small communities or certain occupational spheres like the armed services and police departments, it is not unusual for everyone to know everyone else’s business. This concern may play a role in the decision of some not to avail themselves of therapeutic resources, even when they are in need and even when such resources are otherwise available and affordable.
Where therapy offices and waiting rooms are visible to others, concerns about privacy can be a significant issue. In rural areas or small towns, or even in some areas of larger cities, it is not uncommon for patients to encounter people they know in clinical waiting rooms. Patients who forgo seeking treatment due to such privacy concerns may be willing to participate in care if it is provided in a private place such as their own home.
E-Therapy: Ethics & Best Practices is a 3-hour online continuing education (CE) course that examines the advantages, risks, technical issues, legalities and ethics of providing therapy online. E-therapy can be used to address age-old problems, such as how to reach out to those who might not otherwise avail themselves of psychotherapy services even though they are in acute need. At the same time, it is clear that many providers have embraced the new technologies without a firm grasp on the new and serious vulnerabilities that are introduced when their patients’ personal health information goes online. Included in this course are sections on video therapy, email, text messaging, smart phone use, social media, cloud storage, Skype, and other telecommunications services. This course is focused upon the ethical principles that are called into play with the use of e-therapy. Among them the most obvious concern is for privacy and confidentiality. Yet these are not the only ethical principles that will be challenged by the increasing use of e-therapy. The others include interjurisdictional issues (crossing state lines), informed consent, competence and scope of practice, boundaries and multiple relationships, and record keeping. In addition to outlining potential ethical problems and HIPAA challenges, this course includes recommended resources and sets of specific guidelines and best practices that have been established and published by various professional organizations. Course #30-87 | 2016 | 52 pages | 20 posttest questions
This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.
About the Author:
Leo Christie, PhD, LMFT, is a Florida-licensed Marriage and Family Therapist with a doctorate in Marriage and Family Therapy from Florida State University. Past President of the Florida Council on Family Relations, Dr. Christie is currently CEO of Professional Development Resources, a nonprofit corporation whose mission is to deliver continuing education credit courses to healthcare professionals throughout the United States. He has more than 20 years’ experience in private practice with a specialty in child behavior disorders and as an instructor for over 500 live continuing education seminars for healthcare professionals.
Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).