Members of the American Telemedicine Association’s (ATA) telemental health special interest group (SIG) have laudably published a number of “Best Practices” or “Guideline” documents. These guidelines however, expressly exclude Internet-based practice in Telehealth. Telemedicine has a long history of connecting hospitals to hospitals, or hospitals to clinics using highly secure T-1 or T-3 communication channels. Solo and independent practitioners face a different set of challenges than our institutional colleagues.
As small business owners (in essence), independent practitioners operate with fewer layers of protection from liability and with less oversight by supervisors. We typically work in small offices, free from the same adherence to either treatment or practice protocols as might exist when working in academic, government or other large institutional settings.
We therefore have somewhat different experiences — and risks. It is my opinion then, that those differences with respect to telemental health warrant attention by those associations who accept our yearly dues and set standards for us as a group.
Aside from documents issued by the National Board for Certified Counselors (NBCC) and the International Society for Mental Health Online (ISMHO), two relatively small groups that paralleled each other in strongly advocating the use of e-mail and chat rooms to work with unseen, previously unknown and undiagnosed mental health clients or patients, I have awareness of one formally produced document that addresses the myriad complexities of remote ethical practice for solo practitioners in the United States. That document is the “Telepsychology Guidelines” produced by the Ohio Psychological Association, originally published in 2008.
Since then, most of us have witnessed the rapid proliferation of services such as Skype-type videoconferencing services on the Internet, cell phone use and texting, and have heard of colleagues who use these services. Unfortunately, many of those practitioners seem to be jumping on the new technologies without training in ethical or legal vulnerabilities with respect to consumer protection or their own risk management.
Therefore, I have these question for you, my resourceful colleagues:
- Are you aware of any other statements, ethical decisions, announcements or other documents for independent practitioners seeking guidance for practice through the Internet as produced by any of the large US professional associations?
- Do you live in a country other than the U.S., and have a professional association that has published such a document?
If you are aware of any such resources, please leave links or details in the comments section below.