Copied from an email from Sally Gelardin on 2/3/08.
1. Here's a post in which I talk about web nettiquette:
http://lifeworkps.com/ppo/weblog/2995.html .
2. Following are two links to California consumer info regarding
psychotherapy:
2.a. http://www.bbs.ca.gov/consumer/consumer_psych_online.shtml,
Department of Consumer Affairs, Board of Behavioral Sciences 2.b. http://www.psychboard.ca.gov/internet_therapy.htm, Board of Psychology
3. Following is some material found by the ACA cybercouseling committee on legal and ethical state guidelines. We shall be coming out with a full report soon. This is just for state-licensed counselors, but it can be helpful to understand some of the issues that could affect other online practitioners and clients.
COLORADO – The committee could not find mention of a policy on cyber- counseling across state lines, but Colorado does requires that the first contact between a counselor and a client, as well as any initial evaluations, be made face-to-face if cyber-counseling will be the modality of treatment.
FLORIDA - The Florida Board of Clinical Social Work, Marriage & Family Therapy & Mental Health Counseling (Section 491, Florida
Statutes) has clarified the Florida Administrative Code, Rule
64B4-2.002 defining supervision as face-to-face contact, by posting a notice on their web page advising registered mental health interns (i.e., pre-licensure practitioners) that "neither supervision nor clinical hours obtained via the Internet may be counted towards meeting the supervised experience requirements for licensure.
KANSAS - The Kansas Behavioral Sciences Regulatory Board defines counseling as having occurred in the State of Kansas if the client was in that state, regardless of the counselor's location, and requires either Kansas licensure or reciprocal licensure: "Except as authorized... each person, regardless of the person’s location, who engages in either of the following activities[,] shall be deemed to be engaged in the practice of professional counseling in this state" (Rule 102-3-16; emphasis added).
At the time of this writing, the web page of the Kansas Board states it is considering allowing an exemption for out-of-state practitioners, who would apply for a permit to practice cyber- counseling with Kansas residents.
MARYLAND - The Maryland Department of Health & Mental Hygiene, Board of Professional Counselors and Therapists acknowledges that currently no restrictions limit mental health intern' access to telephone or cyber-supervision. The implication is that few other states name these practices specifically.
MASSACHUSETTS - On November 16, 2007 the Massachussetts Board of Registration of Allied Mental Health and Human Services Professionals voted to approve Policy No. 07-03 regarding the status of cyber- counseling across state lines. While Board "policy" does not have the legally binding effect of Board "rule" or statute, policy still is used internally by the Board to guide its decisions.
Regarding Massachusetts-licensed counselors who provide services to a resident of another state, the board cautions:
"Distance delivery of counseling and therapy is considered to occur in two locations: where the client is located and where the clinician is located . . . . Board licensees who wish to provide services via electronic means to clients located outside of Massachusetts are urged to ensure that they meet the requirements for practice within the jurisdiction where the client is located." (emphasis retained from original document) Regarding licensees of another state who provide counseling to a Massachusetts resident, the board warns:
"Mental health professionals licensed by any jurisdiction other than Massachusetts, and not licensed by any Massachusetts Board or not eligible for an exception to Massachusetts licensure, are considered unlicensed by this Board for practice in Massachusetts . . . . The provision of counseling and/or therapy to individuals located within Massachusetts at the time services are occurring, are considered to fall under the jurisdiction of the Board, regardless of the location of the provider . . . . Unlicensed providers of electronic-assisted counseling will be treated by the Board in the same manner as providers of unlicensed counseling in traditional settings."
(For unity, the order of the above definitions has been modified; sentences have been moved from their original presentation as list items, and re-combined into paragraph form. )
MINNESOTA - Permits cyber-supervision for licensure purposes, provided that at least 75 percent of overall supervision hours are be received in person.
Without mentioning cyber-counseling specifically, the 2007 Minnesota Statutes, 148B.592 allow "nonresidents" authorized to provide counseling elsewhere to practice counseling inside Minnesota for up to 30 days, subject to review of qualifications and Board approval.
MISSOURI - The Committee for Professional Counselors (Department of Insurance, Financial Institutions and Professional Registrations) allows cyber-supervision for licensure purposes, but only if the the electronic format is "contemporaneously or simultaneously visually and verbally interactive" meaning that asynchronous protocols are not acceptable (20 CSR 2095-2.020). Non-interactive courses are not acceptable for continuing education.
MONTANA - The Department of Labor and Industry, Chaper 219 Board of Social Work Examiners and Professional Counselors makes a definition of "Direct client contact" as "physical presence, telephonic presence, or interactive video link presence of the client, client family member, or client representative" (24.219.301). While this definition seems to include some forms of cyber-counseling while excluding others, the practical ramifications for for licensure, billing and duty-to-warn issues are speculative and beyond the scope of present analysis. However, the definition seems to ring consonant with Missouri's distinction between different modalities of electronic contact with clients or other professionals.
NEBRASKA - Mental health practitioners are considered under the broader category of "health care providers" under the 1999 Nebraska Telehealth Act. Mental Health counseling is recognized as one of the most widely practices forms of telehealth occurring within the state.
Information publicly available from the Nebraska Statewide Telehealth Network, a partnership of 70 hospitals and 19 public health departments, seem to suggest that all categories of health care providers must be licensed in Nebraska if the client or patient resides in Nebraska. Additionally, Nebraska health care providers intending to practice in Kansas, Iota, South Dakota, or Colorado are generally cautioned that they should be licensed in those states.
Keywords: 1Q08, 2/3, 20%, 2008, hph, Information on cyber advising, lwpspr
