This Informed Consent for Telemental Health Services contains important information focusing on doing psychotherapy using the phone or the Internet. Please read this carefully and let me know if you have any questions. When you sign this document, it will represent an agreement between us.
Benefits and Risks of Telemental Health: Telemental Health refers to providing psychotherapy services remotely using telecommunications technologies, such as video conferencing or telephone. One of the benefits of Telemental Health is that the client and clinician can engage in services without being in the same physical location. This can be helpful in ensuring continuity of care if the client or clinician moves to a different location, takes an extended vacation, or is otherwise unable to continue to meet in person. It is also more convenient and takes less time. Telemental Health, however, requires technical competence on both our parts to be helpful. Although there are benefits of Telemental Health, there are some differences between in-person psychotherapy and Telemental Health, as well as some risks. For example:
- Risks to confidentiality. Because Telemental Health sessions take place outside of the therapist’s private office, there is potential for other people to overhear sessions if you are not in a private place during the session. On my end I will take reasonable steps to ensure your privacy. But it is important for you to make sure you find a private place for our session where you will not be interrupted. It is also important for you to protect the privacy of our session on your cell phone or other device. You should participate in therapy only while in a room or area where other people are not present and cannot overhear the conversation. Also, if other people may walk through the area where you are, you may want ensure they are appropriately attired to avoid embarrassment!
- Issues related to technology. There are many ways that technology issues might impact Telemental Health. For example, technology may stop working during a session, other people might be able to get access to our private conversation, or stored data could be accessed by unauthorized people or companies.
- Crisis management and intervention. Usually, I will not engage in Telemental Health with clients who are currently in a crisis situation requiring high levels of support and intervention. In any event, we will have an emergency response plan to address potential crisis situations that may arise during the course of our Telemental Health work.
- Efficacy. Most research shows that Telemental Health is about as effective as in-person psychotherapy. However, some therapists believe that something is lost by not being in the same room. For example, there is debate about a therapist’s ability to fully understand non-verbal information when working remotely.
Electronic Communications: I use the Doxy.me platform for video conferencing (as well as other platforms from time to time). There is no additional cost to you for using any of these services. You will need to have a computer that has audio and video capabilities for us to use video conferencing. You will also need fairly reliable internet service. For communication between sessions, I only use email communication and text messaging with your permission and only for administrative purposes unless we have made another agreement. This means that email exchanges and text messages with my office should be limited to administrative matters. This includes things like setting and changing appointments, billing matters, and other related issues. You should be aware that I cannot guarantee the confidentiality of any information communicated by email or text. Therefore, I will not discuss any clinical information by email or text and prefer that you do not either. Also, I do not regularly check my email or texts, nor do I respond immediately, so these methods should not be used if there is an emergency.
Treatment is most effective when clinical discussions occur at your regularly scheduled sessions. But if an urgent issue arises, you should feel free to attempt to reach me by phone. I will try to return your call within 24 hours except on weekends and holidays. If you are unable to reach me and feel that you cannot wait for me to return your call, contact your family physician or the nearest emergency room.
Confidentiality: I have a legal and ethical responsibility to make my best efforts to protect all communications that are a part of our Telemental Health. However, the nature of electronic communications technologies is such that I cannot guarantee that our communications will be kept confidential or that other people may not gain access to our communications. I will try to use updated encryption methods, firewalls, and back-up systems to help keep your information private, but there is a risk that our electronic communications may be compromised, unsecured, or accessed by others. You should also take reasonable steps to ensure the security of our communications (for example, only using secure networks for Telemental Health sessions and having passwords to protect the device you use for Telemental Health).
The extent of confidentiality and the exceptions to confidentiality that I outlined in my Professional Disclosure Statement and Confidentiality in Psychotherapy forms contained in the Client Handbook. These still apply in Telemental Health. Please let me know if you have any questions about exceptions to confidentiality.
Appropriateness of Telemental Health: From time to time when it is feasible to do so, we may schedule in-person sessions to “check-in” with one another. I will let you know if I decide that Telemental Health is not a good option for us to engage in. If this is the case, we would discuss options of engaging in in-person counseling or referrals to another professional in your location who can provide appropriate services.
Emergencies and Technology: Assessing and evaluating threats and other emergencies can be more difficult when conducting Telemental Health than in traditional in-person therapy. To address some of these difficulties, we are creating an emergency plan before engaging in Telemental Health services. You must identify an emergency contact person who is near your location who I will contact in the event of a crisis or emergency to assist in addressing an emergent situation. By executing this document, you are authorizing/allowing me to contact your emergency contact person as needed during such a crisis or emergency.