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An Examination of the APA’s “Guidelines for the Practice of Telepsychology” Part II

APA Telepsychology Guideline As we detailed last week, the American Psychological Association released its draft Guidelines for the Practice of Telepsychology in July, 2012. Currently, the draft is available for review by consumers and APA members and the deadline for submission of comments regarding this document is October 26, 2012.

The authors of the present article applaud the APA Telepsychology Guideline Task Force for their success. We recognize the vision, resources and effort expended by the APA to make this guideline both useful and inspirational for its members to expand their scope of practice; give psychologists new possibilities for earning their living in today’s challenging market place; reach new populations of clients and patients who need psychological services; influence U.S. health care policy; serve as a model for other groups seeking to deliver behavioral services and improve human welfare.

Based on our review of the Guidelines for the Practice of Telepsychology, we agree with most of the guidelines as written. Because one of this article’s authors has been asked by numerous colleagues for her perspective on the guidelines, we offer our comments as practicing telepsychologists for your consideration in formulating your own comments by the October 26th deadline:

Our Comments

  1. Language. Phrases containing absolute terms could be mis-used against psychologists in court. Consider striking the following phrases from the document: “complete and clear,” “any risks and benefits,” “assume some role,” “ensure full and complete,” “continuously evaluating,” “make every effort,” “address any lack of appropriate resources,” “document all,” and “utilize all.” We further suggest the deletion of guideline suggestions that cannot be operationalized when taken literally.
  2. Relevance to In-Person Care & Empirical Basis. Make recommendations no more stringent than those in existence for in-person care, except where there is the evidence-based or legal-based need for greater stringency (e.g., if a specific course of action or type of documentation is suggested, what empirical basis serves to justify the recommendation? Is there a legal precedent for the recommendation?) Provide all such bases and their references in the reference section of the document.
  3. Clarity. Given the novelty and complexity of many concepts discussed in the guidelines, the guidelines might be enhanced with more examples. Consider giving at least one example for each recommendation to demonstrate applicability of the recommendation to the service being delivered (e.g., pediatric psychotherapy) or the specific technology being addressed (e.g., email, text messaging, telephone, video, other), or both.
  4. Structure. If the guideline is to be considered an extension of the current APA Ethical Principles of Psychologists and Code of Conduct, clarify the relevance, practicality and applicability of suggestions made in the guideline and their relationship to that current ethical code. Each recommendation could be titled and numbered as per the Ethical Principles of Psychologists and Code of Conduct so as to facilitate comparison.
  5. Revisions & Unaddressed Arenas. Given the rapidly evolving depth and breadth of technical innovation, this document could be improved by including a clear and concise statement regarding how and when it will be revised. A statement about the APA’s intent regarding other technologies that are not named in this document would also be helpful. We are concerned about practice of using the wide range of non-named, non-telecommunication technologies. It reasonable to expect guidance regarding arenas such as virtual reality, gaming, electronic health records, behavioral informatics, health homes, smartphone and smart device “apps”, computer simulation, robotics, biosensing, haptics, etc., where mental health professionals already are visible, working and seeking guidance. It would be useful to have a short statement giving direction to psychologists interested in these areas, outlining what to expect as well as whom to contact for direction.

To our readers, we strongly encourage you to disseminate this newsletter to all other interested parties and discuss the APA guidelines with your colleagues.The APA has created an online form for you to leave your comments here. Remember, the deadline for comments is October 26, 2012. Once these have been promulgated, all APA members will be held to them if brought up on charges for actions related to telepsychology.

We also want to mention that members of the current APA staff and leadership pride themselves on their willingness to listen to them membership. Make your voice heard.

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