Monitor on Psychology - March 2012 - (Page 53)

the latest information in this fast-moving area, Baker adds. Make sure that you: • Periodically check your state legislature’s website for the latest state telehealth laws and regulations. If there is no telehealth law in your state, look to see if there is a board policy statement that provides guidance on telepractice, she recommends. • Check whether your state licensing board has issued any policies related to telepsychology. As of last summer, several states, including Florida, Massachusetts, North Carolina, Texas, Virginia and Wisconsin, had such policies in place. (To contact any state board, visit the ASPPB website.) • Contact your malpractice insurance carrier to confirm that telehealth services — both in-state and across jurisdictional lines — are covered under your malpractice policy. They are likely to be covered for in-state practice but not necessarily for interjurisdictional practice, Baker says. Three states — California, Vermont and Kentucky — have already passed laws specifying psychologists’ legal obligations in online therapy. For instance, Kentucky states that at the outset, a psychologist using telehealth must obtain the patient’s informed consent, which includes documenting whether the patient has the necessary knowledge and skills to benefit from telehealth. Similarly, California requires that providers obtain both written and verbal informed consent before providing telehealth services, including a description of the potential risks, consequences, and benefits of telemedicine. The state does not, however, appear to extend this requirement to consultations between providers where the patient is not directly involved, Baker says. Ethical telepractice The ethics of telepsychology are in a similar state of flux, though there is a lot of good information available, says Jeffrey Barnett, PsyD, professor of psychology at Loyola University Maryland, who regularly teaches and writes about ethical issues in psychology. Included are telepsychology guidelines developed by both the Canadian Psychological Association and the Ohio Psychological Association (visit www.ohpsych. org/resources/1/files/Comm%20Tech%20Committee/ OPATelepsychologyGuidelines41710.pdf and www.cpa.ca/ aboutcpa/committees/ethics/psychserviceselectronically/). In general, all of the standards of the APA ethics code apply, says Barnett. That includes standards on informed consent, competence to practice, confidentiality, doing no harm, and on how terminations, interruption of service and payment arrangements are handled. “In fact, practicing with distance therapies actually raises the bar, because you also need to be competent in the media you’re using,” he says. To this end, get training in using the hardware and software involved in the treatment you plan to provide, Barnett recommends. For example, to preserve confidentiality M a rc h 2 0 1 2 • M o n i to r o n p s yc h o l o g y and therefore meet the requirements of the Health Insurance Portability and Accountability Act, learn how to use encryption software, and for maximum ease of communication between you and your client, how to set up your equipment to provide good sound and visual resolution. You also need training on how to deal with some of the limits of telepsychology. With avatar therapy, for instance, you can’t read a patient’s expressions or body language, though some of that is changing due to advances in technology (see main article on page 49). Fortunately, there are many continuing education workshops on these topics, says Barnett. If you’re unsure how to proceed, contact your state, provincial or territorial psychological association’s ethics committee, the APA Ethics Office, your state licensing board, or knowledgeable colleagues, he recommends. In addition, when using these technologies, it’s important to conduct an initial assessment of each client to determine his or her appropriateness for telepsychology, says Barnett. A client who is suicidal, for example, may require much more active and intensive services than telepsychology can provide. Other factors to consider include making sure you have provided adequate emergency contact information in case your distance client faces a crisis, and ensuring that your patient’s privacy and confidentiality are adequately protected by encrypting electronic transmissions and records, he says. Barnett has an article covering these and more topics in the June 2011 issue Psychotherapy. A new APA Task Force on the Development of Telepsychology Guidelines for Psychologists should further clarify psychologists’ rights and obligations soon. The 10-member group — which includes representatives from APA, ASPPB and the APA Insurance Trust — met in July to review the area and discuss results of a survey sent to all APA governance groups, state associations, state and provincial psychology boards, telepractice-related organizations and interested individuals. The group has developed a working plan and will begin drafting guidelines in the next several months. In addition, the task force is creating a Web page that will provide information about the task force’s work and calls for comments, and will publicize this information in other APA venues as well. Putting the proper safeguards in place should help to ensure that telehealth technologies live up to their promise of improving care, Barnett adds. “There are a lot of good data showing that you can form a good therapeutic alliance using telepsychology, and that these modalities can help people with all sorts of issues,” Barnett says. “Now we just need to develop the formal guidelines, and hopefully the laws and regulations, to make this a successful and safe area of practice.” n Tori DeAngelis is a writer in Syracuse, N.Y. 53 http://www.ohpsych.org/resources/1/files/Comm%20Tech%20Committee/OPATelepsychologyGuidelines41710.pdf http://www.ohpsych.org/resources/1/files/Comm%20Tech%20Committee/OPATelepsychologyGuidelines41710.pdf http://www.ohpsych.org/resources/1/files/Comm%20Tech%20Committee/OPATelepsychologyGuidelines41710.pdf http://www.cpa.ca/aboutcpa/committees/ethics/psychserviceselectronically/ http://www.cpa.ca/aboutcpa/committees/ethics/psychserviceselectronically/

Table of Contents for the Digital Edition of Monitor on Psychology - March 2012

Monitor on Psychology - March 2012
Letters
President’s column
Contents
From the CEO
Supreme Court rejects eyewitness protections
New member benefit: prevention screenings
A psychodynamic treatment for PTSD shows promise for soldiers
Was ‘Little Albert’ ill during the famed conditioning study?
New research identifies ways to improve eyewitness identifications
In Brief
‘Our health at risk’
Perspective on Practice
APA endorses higher education guidelines
TIME CAPSULE
QUESTIONNAIRE
Random Sample
Judicial Notebook
Help for struggling veterans
Driving out cancer disparities
In the Public Interest
SCIENCE WATCH
Practice, virtually
The legal and ethical issues of virtual therapy
Psychologist PROFILE
EARLY CAREER PSYCHOLOGY
Bringing life into focus
Pay attention to me
AMERICAN PSYCHOLOGICAL FOUNDATION
Division Spotlight
Personalities

Monitor on Psychology - March 2012

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