Table of ContentsView AllTable of ContentsSecurityTechnologyEthicsInformed ConsentDuty to ProtectChanging GuidelinesNext in Working With a Therapist GuideOnline Therapy for Depression
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Table of Contents
Security
Technology
Ethics
Informed Consent
Duty to Protect
Changing Guidelines
Next in Working With a Therapist Guide
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Online therapy, also known as teletherapy, virtual therapy, or internet/online counseling, rapidly expanded during the COVID-19 pandemic, and it continues to grow. Because online therapy involves communication via computers or mobile devices, it has security issues that are different from face-to-face therapy.
Additionally, someethicaland legal concerns become more complicated with teletherapy. If you are getting started with online therapy, it’s important to understand how a therapist or digital platform will keep your private information safe and follow all of the appropriate protocols.
This article discusses the ethical, legal, and security issues related toonline therapy. It also discusses some special concerns including recent changes due to world events.
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Is Online Therapy Secure?
Therapists and patients engaging in online therapy need to be aware of potential security threats to data and private information, including:
As with any other common practice that has moved online in the digital age, such as banking or shopping, security and privacy must be top priorities for any telehealth services.
If you are seeking therapy, you don’t want to have to worry about exposing information about your physical or mental health, your credit card number, or any of the private details you may share during a session.
Because of these potential violations of privacy and confidentiality, both therapists and individuals seeking therapy need to be very aware of the technology they are using and any potential limitations it may have. Both parties should do what they can to ensure that online therapy does not introduce any security-related stressors to the relationship.
Use safe, updated software and applications that reduce the risk of a privacy breach, and be aware of any new technology or online programs that may better assist you. As with any online activity, be extremely protective of your personal information. Do not share anything private unless you feel comfortable that you and your therapist are using a safe, secure program.
Guidelines
The American Psychological Association providesspecific guidancefor therapists who use telecommunication to treat patients. This advice—which can also apply to clients using teletherapy services—includes the following precautions:
If you are a patient, discuss these issues with your therapist to make sure that they are following safe technology practices, just as you would want a therapist to keep your in-person sessions safe and confidential.
Online Platforms
You may be accessing online therapy through a former in-person provider who has gone digital. Or, you may use a subscription-based platform likeTalkspaceorBetterHelpthat can quickly and easily connect you to a therapist if you are in need.
Many of these platforms boast high-grade encryption services to ensure that your data will be protected, but some companies have also gotten into hot water about privacy and the sharing of personal information. While doing your research, it’s worth checking FAQ sections on these sites to see for yourself how your privacy will be protected and doing a quick Google search to see if the company has ever gotten in trouble for violating privacy standards.
It is still important, of course, to continue taking your own security measures, such as using a strong password and changing it often, even if you fully trust the platform you’re using. As more and more aspects of daily life move online, these strategies will be increasingly useful, whether or not you continue using online therapy.
RecapEthical guidelines suggest that online therapy should rely on services that are secure and that conform to HIPAA guidelines. Both therapists and clients should be aware of the potential risks to privacy that online therapy poses.
Recap
Ethical guidelines suggest that online therapy should rely on services that are secure and that conform to HIPAA guidelines. Both therapists and clients should be aware of the potential risks to privacy that online therapy poses.
Technology Challenges
Teletherapy is more accessible and convenient for many. Still, it also presents challenges for people who lack technology skills or do not have access to the resources needed to attend virtual therapy sessions. Access to private spaces and internet services can also be more challenging for vulnerable or underserved clients.
This can be a particular concern among older adults. Lack of digital proficiency is frequently abarrier to telehealth servicesfor people in this age group.
A Verywell Report: Americans Find Strength in Online Therapy
Ethical Codes
Several professional associations have posted ethical guidelines for telehealth. For example, theNational Board for Certified Counselors(NBCC) is one licensing organization that adheres to a strict policy for counselors providing distance services. This policy and its list of standards can be found on its website.
Therapists must obtaininformed consentfrom all teletherapy clients. They must also take care to respect professional boundaries.
What Is Informed Consent?Informed consent is a legal procedure to ensure that a patient or client knows the potential risks and benefits of a healthcare intervention before giving permission for treatment or disclosing information.
What Is Informed Consent?
Informed consent is a legal procedure to ensure that a patient or client knows the potential risks and benefits of a healthcare intervention before giving permission for treatment or disclosing information.
The elements of informed consent include informing the client of the nature of the treatment, possible alternative treatments, and the potential risks and benefits of the treatment. These will be the same online as they would be in person.
Some questions you should ask before giving informed consent include:
How Informed Consent Is Used in Psychological Treatment
Although the therapist has an obligation to protect the patient’s confidentiality, there are exceptions to this rule. This is called “duty to protect.”
The therapist may have an obligation to disclose or warn third parties if they feel the client presents dangers to another person (called “duty to warn”), there are concerns for child or elder abuse, or the person poses a risk to themselves.
It may be challenging for the online therapist to meet this ethical obligation if the therapist does not know the patient’s real name or geographic location. If you or a loved one are seeking online therapy, it is important to balance the need for privacy with safety concerns.
Duty to Warn in Therapy
While therapists can treat clients from all over the globe, they should adhere to the laws and ethical guidelines of the state or country where they are licensed to practice. Unfortunately, the global nature of the Internet can make codes of conduct challenging to enforce, soif you are thinking about using an online counselor, be sure to look into their certification and credentials.
While states have differing laws, many specify that therapists must see clients within the state where they are licensed. Many states temporarily suspended these requirements due to the COVID-19 pandemic.But with many of these changes now expiring, some clients may have to change therapists in order to conform with state guidelines.
A practice agreement known as the Psychology Interjurisdictional Compact, orPSYPACT,may change this. It is an interstate licensing agreement that allows therapists to practice remotely across state lines in those states participating in the agreement.
PSYPACT reports that 42 states have now enacted legislation to allow the interstate agreement, and more are in the process of enacting or introducing it.
A Word From Verywell
Online therapy is here to stay. During the pandemic, 98% of therapists practiced teletherapy. However, many online therapists have knowledge gaps, indicating a need for specialized training and education for more effective online therapy.
If you are interested in online therapy, spend some time researching your options. Learn more about the platforms and technology that online therapists use as part of their practice.
The U.S. Department of Health & Human Services created a list ofHIPAA-compliant video communication productsthat online therapists and potential clients can consult. Using such tools can help safeguard privacy and safety, but it is also up to therapists and individuals to protect their personal information.
Get Help NowWe’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.
Get Help Now
We’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.
How to Pick the Right Therapist for You
3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Calkins H.Online therapy is here to stay.Monitor on Psychology. American Psychological Association.PSYPACTMap - psychology interjurisdictional compact (PSYPACT). (n.d.-c). https://psypact.gov/mpage/psypactmapSampaio M, Navarro Haro MV, De Sousa B, Vieira Melo W, Hoffman HG.Therapists make the switch to telepsychology to safely continue treating their patients during the Covid-19 pandemic. Virtual reality telepsychology may be next.Front Virtual Real. 2021;1:576421. doi:10.3389/frvir.2020.576421
3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Calkins H.Online therapy is here to stay.Monitor on Psychology. American Psychological Association.PSYPACTMap - psychology interjurisdictional compact (PSYPACT). (n.d.-c). https://psypact.gov/mpage/psypactmapSampaio M, Navarro Haro MV, De Sousa B, Vieira Melo W, Hoffman HG.Therapists make the switch to telepsychology to safely continue treating their patients during the Covid-19 pandemic. Virtual reality telepsychology may be next.Front Virtual Real. 2021;1:576421. doi:10.3389/frvir.2020.576421
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Calkins H.Online therapy is here to stay.Monitor on Psychology. American Psychological Association.PSYPACTMap - psychology interjurisdictional compact (PSYPACT). (n.d.-c). https://psypact.gov/mpage/psypactmapSampaio M, Navarro Haro MV, De Sousa B, Vieira Melo W, Hoffman HG.Therapists make the switch to telepsychology to safely continue treating their patients during the Covid-19 pandemic. Virtual reality telepsychology may be next.Front Virtual Real. 2021;1:576421. doi:10.3389/frvir.2020.576421
Calkins H.Online therapy is here to stay.Monitor on Psychology. American Psychological Association.
PSYPACTMap - psychology interjurisdictional compact (PSYPACT). (n.d.-c). https://psypact.gov/mpage/psypactmap
Sampaio M, Navarro Haro MV, De Sousa B, Vieira Melo W, Hoffman HG.Therapists make the switch to telepsychology to safely continue treating their patients during the Covid-19 pandemic. Virtual reality telepsychology may be next.Front Virtual Real. 2021;1:576421. doi:10.3389/frvir.2020.576421
Hannah Owens, LMSW
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