Simon Nuttgens

1
The Ethics of Internet-Based Counselling
Services

• Simon Nuttgens
• Associate Professor
• Athabasca University, Alberta

2
Overview of Online Counselling

• A practice of many names
• A practice of many platforms
• Static vs. active
• Synchronous vs. asynchronous
• Newer developments

3
Pros and Cons of Online Counselling

• Pros
• Flexible
• Cost effective
• Suited to some client problems
• Cons
• Loss of visual cues
• Assessment limitations
• Managing crisis situations
• Security of online information
• Regulatory and jurisdictional concerns
• Technology failure

4
Competent Practice

• What percentage of online counsellors learned
  their craft in their graduate training?
• Is special training required for online
  counselling?

5
Competent Practice Cont.

• The ability to develop a working alliance using
  micro skills specific to the online environment
• The ability to manage crisis situations when
  working with clients who live far from the online
  counsellors practice
• Proficiency in online communication technology
• Knowledge of internet and email security systems
• Knowledge of ethical and legal issues germane to
  online counselling
• Knowledge of jurisdictional and regulatory issues
  pertinent to online counselling

6
Record Keeping

• Record retention
• Re-use by client
• Data security
• Unintended uses

7
Confidentiality and Privacy

• Three ways in which client-counsellor
  confidentiality can be compromised
• Computer virus or hacker
• Accidental disclosure
• Client-initiated breach
• What to do?
• Educate clients
• Informed consent
• Encryption
• SSL

8
Informed Consent

• Please click agree
• Who am I communicating with, anyway?
• Photo with declaration
• Trends of dishonesty (Midkiff Wyatt, 2008)
• Arrange for a face-to-face meeting
• Information required for consent to be informed
• What will occur should technology fail and the
  counselor and client are disconnected? Questions
  to consider include who initiates contact via
  what means and after what period of time has
  passed?

9

1. Limitations to the security of online
   communication and what precautionary actions have
   been taken to decrease possible breaches of
   privacy or confidentiality.
2. Whether or not textual, auditory, or video
   content will be recorded, and if so how privacy
   and confidentiality will be maintained.
3. The limitations of online therapy to effectively
   address certain client problems with an emphasis
   on limitations that arise due to the absence of
   visual information. Even when using online video,
   visual cues may be more difficult to discern than
   when the client is present in the room.

10

• How emergency situations will be addressed,
  including danger to self or others, mandatory
  reporting laws, and the management of other
  crisis situations when counselling from a
  distance.
• The cost of services, methods of payment, and how
  missed appointments will be handled.
• An objective statement indicating that less is
  known about the efficacy of online counselling
  compared to well-researched traditional modes of
  delivery.
• A means for the client to verify the counsellors
  credentials

11
Managing Crisis Situations

• Prior assessment
• Informed consent
• Emergency procedures
• Contact information
• Alternative services

12
Regulatory and Jurisdictional Issues

• Where does counselling occur?
• Counselling only your province of residence?
• Gain licensure in multiple jurisdictions?
• Knowing the laws and regulations of other lands

13
Contact me

• simonn_at_athabascau.ca
• Ph. [phone] or [phone]