Psychologists are increasingly incorporating the use of technology to provide a wide range of services. Older technologies such as telephones and facsimile machines have been used for decades but more often use of newer technologies such as teleconferencing, email or texting are becoming common practice.
Psychological services provided via telecommunications or telepsychology can include not only psychological interventions or assessments with clients but also supervision to supervisees, receiving or providing consultation or doing training or education online.
No matter what form telepsychology services take or technologies used, psychologists have ethical and legal obligations to consider.
A review of the ethical and legal requirements that apply to psychological practices, whether they be in-person or at a distance, is recommended prior to initiating telepsychology services. The American Psychological Association ethics code and Guidelines for the Practice of Telepsychology are good starting points. These documents offer a general set of expectations that are helpful in developing a telepsychology practice.
Some major issues relevant to telepractice that they reference include competency, confidentiality, documentation, interjurisdictional practice and mandated reporting. How those ethical requirements and guideline recommendations apply when providing telepsychology services needs to be carefully considered and reflected in your policies and procedures. The same ethical requirements for in-person psychological services in general apply to services provided at a distance.
Another recommended set of relevant ethical telepractice guidelines are several interdisciplinary telemental health guidelines adopted by the American Telemedicine Association that are available at the ATA website (http://hub.americantelemed.
Each state has its own psychology licensing law and rules that apply to telepsychology. Check to see if your state psychology law and rules reference telepsychology. Most state laws and rules include little or nothing specific to telepsychology practice. Consult your licensing board if you have questions, especially about providing services across state lines. This includes both state boards where you are licensed as well as where your clients are located.
In addition to laws and regulations, licensing boards sometimes issue specific case rulings or opinions about telepsychology practice that may not be in the law and rules but are accessible on the licensing boards’ websites. These may have explicit restrictions or expectations that are important to know.
Generally state licensing boards expect anyone providing psychological services (including telepsychology services) to be licensed in the state where the client is located at the time of service. An exception to this may be available from a licensing board where the client is located if the board offers a temporary psychology practice permit that includes interjurisdictional telepsychology.
In addition to being knowledgeable about licensing laws, familiarity with other relevant state and federal laws and regulations that apply to telepractice (e.g. insurance, HIPAA, etc.) are important as well.
A critical requirement before initiating any new psychological practice is to obtain competency in the new area of practice. Psychology graduate programs generally have included little about telepsychology in their curriculums. This necessitates psychologists finding and receiving the necessary training and experience after graduate school before offering telepsychology services.
Telemental health educational programs are available online that include standalone webinars or organized series of online classes. (e.g. Telebehavioral Health Institute, Zur Institute, Person-Centered Tech). Some training programs offer a telemental health certificate that formally recognizes that recipients have obtained such training.
Attending a few workshops, seminars, reading articles or listening to webinars, however, is not sufficient to prepare one for telepsychology practice. Such training may be important in providing necessary knowledge about competent telepsychology practice but is not likely to offer opportunities for developing the skills to apply that knowledge.
That is where obtaining appropriate experience, supervision and/or consultation is also important to include in developing any new practice area. As telepsychology and telehealth in general is a rapidly evolving area of practice, it is incumbent upon psychologists to remain informed about what are considered best practices.
Kenneth P. Drude, Ph.D., is a psychologist in private practice in Dayton, Ohio. He currently serves on the Ohio Board of Psychology and has participated in the development of telemental health standards and guidelines in Ohio and nationally. His email address is: firstname.lastname@example.org.