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E Therapy Keynote Final
- 2. eTherapy Ethical and Clinical Considerations Lin Fraser EdD Distance Credentialed Counselor linfraser.com
- 4. ✦ Definition ✦ Case for eTherapy ✦ Clinical and Ethical Issues/Myths and Realities ✦ Case Study ✦ Links to further information
- 6. Definition Etherapy (e-therapy, cybertherapy, e-counseling, distance counseling, online therapy etc.) normally refers to the provision of mental health services through electronic media. The main differentiating factor from traditional face- to-face (f2f) is the medium by which the therapy occurs
- 8. Case for eTherapy ✦ Timing and Access ✦ Readiness and Appropriateness of Transpeople for online therapy ✦ Convenience /Flexibility/ Cost ✦ Increased Containment / Ongoing Connection/ Mobility
- 10. Clinical and Ethical Issues Myths and Realities
- 12. Clinical Myth ✦ Inability to see person/Problems with therapeutic alliance ✦ Not secure/Issues of confidentiality Reality ✦ Video/Ongoing connection/Power of words ✦ Encryption
- 14. Ethical/Legal ✦ Who Can Practice? ✦ Where can one practice? ✦ Where is cyberspace? ✦ Three premises: ✦ Maintain licensure ✦ Follow ethical principles ✦ Stay current with laws and regulations
- 16. APA Ethics The APA supports the use of tele-medicine as a legitimate component of a mental health delivery system to the extent that its use is in the best interest of the patient and is in compliance with the APA policies on medical ethics and confidentiality (APA Ethics Committee 1995)
- 18. Case Study
- 20. ✦ What is in best interest of patient?Is eTherapy in best interest for this person at this time? ✦ Check with licensing and ethics boards ✦ Frame Screening/Informed Consent/Confidentiality/Backup/Fees ✦ Good records/continued monitoring and evaluation/ ongoing consultation ✦ Links/Emergency plan
- 21. Reflections ✦ Power of text/word ✦ from confusion to single identity ✦ similar to f2f ✦ slowing down ✦ ongoing connection ✦ from guilt and fear to ✦ transference/therapeutic acceptance alliance ✦ disclosure/transition ✦ global access ✦ complete record ✦ therapy outcomes
- 23. Case offers clinical evidence consistent with research of benefits of eTherapy to trans client
- 25. Further Information ✦ linfraser.com ✦ ISMHO.com ✦ eTherapylaw.com
Notas del editor
- Asked by Dr Eli Coleman, Chr of SOC Cmmte- provide exploratory and background material for possible inclusion of etherapy in next Rev of SOC. This I was happy to do as I was recently certified as a Distance Credentialed Counselor (counseling from a Distance) and have a 30 yr subspecialty with TG people & their families
- Asked by Dr Eli Coleman, Chr of SOC Cmmte- provide exploratory and background material for possible inclusion of etherapy in next Rev of SOC. This I was happy to do as I was recently certified as a Distance Credentialed Counselor (counseling from a Distance) and have a 30 yr subspecialty with TG people & their families
- Training & exam covrd 5 topics I’ll be describing today 1. Def.and comparison to f2f. 2. ability apply-extrpolate evdnce bsd knldge abt ethrpy to online practice-the Case 4 eT. 3.knowledge Clin.&Ethcl etc. 4. how to conceptualize an actual online case. In ths talk, I’ll describe Am Transprsn n Saudi w/SF therapst 5. knldg how & where to access info abt chngng lgl,ethkl&clnc considerations in this changing enviro. This talk wl NOT include a discussion -online eval&refrl for h&s- this remains area that can’t be extrapolated from knwn data- We need to compile data ourselves. Other speakers may address this. My talk about PSYCHOTHERAPY.
- read above.. the therapist is the same- application of skills are different the therapist needs new technical skills/knowledge of delivery of services/not clinical ones needs to learn how to extrapolate known ethical & clinical considerations to new modality
- read above.. the therapist is the same- application of skills are different the therapist needs new technical skills/knowledge of delivery of services/not clinical ones needs to learn how to extrapolate known ethical & clinical considerations to new modality
- Case for eTherapy in our population is quite strong. 1.1 problem of our pop. has to do w/access. Many are geographically isolated and live in plces where they may be stgmtzd or evn crimlzd. 1 of R goals & missions is 2 advkt &prvd care regardls of demogrfcs. The Infrastructure allowing fast easy access is growing worldwide. The Proliferation of Internet alng w/the burgeoning worldwide trans community online has set in place a ideal avenue 4 outreach & care online. 2. eT shown to appeal 2 certain types of people. One criterion is technical comfort. Others have to do with psychological characteristics such as motivation, verbal skills, ability to tie words to feelings and meanings. Also- research shows that stigmatized populations may be more comfortable initially working at a distance. . 3. Another advantage of eTherapy is tha multiple modalities and delivery methods are available depending on preference of the client and creativity of the therapist, offering convenience, flexibility and cost containment. Each delivery method has its advantages. 4. Other advantages have to do with the increased containment of the therapy provided by the ongoing connection and the fact that eTherapy offers mobility for both therapist and client.
- Case for eTherapy in our population is quite strong. 1.1 problem of our pop. has to do w/access. Many are geographically isolated and live in plces where they may be stgmtzd or evn crimlzd. 1 of R goals & missions is 2 advkt &prvd care regardls of demogrfcs. The Infrastructure allowing fast easy access is growing worldwide. The Proliferation of Internet alng w/the burgeoning worldwide trans community online has set in place a ideal avenue 4 outreach & care online. 2. eT shown to appeal 2 certain types of people. One criterion is technical comfort. Others have to do with psychological characteristics such as motivation, verbal skills, ability to tie words to feelings and meanings. Also- research shows that stigmatized populations may be more comfortable initially working at a distance. . 3. Another advantage of eTherapy is tha multiple modalities and delivery methods are available depending on preference of the client and creativity of the therapist, offering convenience, flexibility and cost containment. Each delivery method has its advantages. 4. Other advantages have to do with the increased containment of the therapy provided by the ongoing connection and the fact that eTherapy offers mobility for both therapist and client.
- Many clinicians have clinical and ethical concerns about eTherapy. Research shows that most of the concerns are more myth than reality
- 1 myth is that due to inability to see the person-one can’t form therapeutic alliance.Reality is that w/video-pple cn see each other. More important (shown n case study-also in resrch) is importance of text. Words can B as pwrfl as visual. Also-ongoing connection via screen, in cyberspace and imagination can create strng holding envirnmnt. Strong evidence about clinical benefits are in lit and I’ll refer U to links at end. Another myth is that therapy interactions are not secure which raise issues of confidentiality. This concern solved by encryption software.
- 1 myth is that due to inability to see the person-one can’t form therapeutic alliance.Reality is that w/video-pple cn see each other. More important (shown n case study-also in resrch) is importance of text. Words can B as pwrfl as visual. Also-ongoing connection via screen, in cyberspace and imagination can create strng holding envirnmnt. Strong evidence about clinical benefits are in lit and I’ll refer U to links at end. Another myth is that therapy interactions are not secure which raise issues of confidentiality. This concern solved by encryption software.
- Main issue is Who can practice? Where does one practice etherapy? Where is location of therapy? Where is cyberspace? This hasn’t actually been sorted out nor has case law defined it. In the meantime, many are practicing using the following premises: All who practice are licensed in their jurisdictions and follow ethical principles applied to online work. Where possible,add eTherapy to liability insurance. In my case, it was an additional 10%. Stay current with your own laws and regulations. For example, as an MFT, I can practice eTherapy in CA and as an NCC/DCC, I can practice anywhere else, and they’re working on Int’l credential. Regulations are slowly catching up to practice. Sometimes there’s a contrast between common sense & law. It may be ethical according to your ethics board and not with local law. A good link is eTherapylaw/ it covers ethics of various organizations/state, national & international law. Link at end.
- Main issue is Who can practice? Where does one practice etherapy? Where is location of therapy? Where is cyberspace? This hasn’t actually been sorted out nor has case law defined it. In the meantime, many are practicing using the following premises: All who practice are licensed in their jurisdictions and follow ethical principles applied to online work. Where possible,add eTherapy to liability insurance. In my case, it was an additional 10%. Stay current with your own laws and regulations. For example, as an MFT, I can practice eTherapy in CA and as an NCC/DCC, I can practice anywhere else, and they’re working on Int’l credential. Regulations are slowly catching up to practice. Sometimes there’s a contrast between common sense & law. It may be ethical according to your ethics board and not with local law. A good link is eTherapylaw/ it covers ethics of various organizations/state, national & international law. Link at end.
- Good example of common sense approach is APA ethics statement which focusses on ethics and confidentiality. Bottom line is- What is in the best interest of the patient? In our situation, there’s an easy case to be made.
- Good example of common sense approach is APA ethics statement which focusses on ethics and confidentiality. Bottom line is- What is in the best interest of the patient? In our situation, there’s an easy case to be made.
- illuminating the clinical and ethical principles described earlier