- licensing laws limiting practice over state lines
- informed consent
- intake processes
- assessment processes
- mandated reporting
- emergency planning and handling
- continuity of care
Why Are Clinicians Agreeing to Work with Unknown, Unseen, Un-assessed Consumers Online?
The appeal to a financially strapped or uninformed clinician is clear: work from anywhere you please worldwide, slash office overhead, avoid pesky intake and assessment procedures, have a steady flow of clients who are anonymous, avoid uncomfortable mandated reporting and don’t worry about emergency situations. The problem is, it is often not supported by reality. While one may wonder about the judgement of clinicians signing onto web companies who offer anonymous mental health care, across state lines, and void of the many precautions we traditionally provide in our in-person, licensed practices, the truth is that such web companies seem to be able to attract hundreds of clinicians. Whether they realize it or not, these professionals are often agreeing to offer services that are not only illegal, but unethical. Furthermore, text-messaging alone for psychotherapy is an area that has scant empirical support.
Many of you will recall that in February, we at the TeleMental Health Institute posted an article about a series of new websites offering such therapies in Text Messaging for Counseling, Therapy & Crisis Intervention. Just a few years back, we also posted articles discussing Google’s attempt to penetrate behavioral health and other market with Helpouts, a service that has since been abandoned by Google. The position we took in a series of 2013 and 2014 articles titled, How Might Licensed Professionals Think about Google’s “Helpouts?” and Why Online Practice Can Be Harmful about such innovation was this:
How licensed professionals adapt to the challenges offered by the advanced technologies such a Google’s Helpouts is a professional issue and not a technical one.
Whose Working to Change the Situation?
What You Can do
Your review of Mr. Essig’s articles or the Talkspace website are invited below. If you find any websites that you’d like our colleagues to review, please also list them below so we can have a look at them for ourselves. For a list of detailed suggestions for all innovative behavioral health companies, practitioners as well as consumers of such services, you may also want to see the press release on this topic by the Coalition for Technology and Behavioral Science (CTiBS), for which I serve as President.