Archive for the ‘Guidelines for online work’ Category

Thursday, September 9th!

Join Kate Anthony, DeeAnna Merz Nagel and John Wilson as they host a VIRTUAL TOWN HALL MEETING ABOUT THE IMPACT OF TECHNOLOGY AND MENTAL HEALTH AND ALL THAT IS ONLINE THERAPY!

We will discuss efforts of three of the leading organizations representing online mental health and we will offer information about upcoming conferences, continuing education opportunities and publications. This is a great opportunity for a brief introduction followed by a Q&A session.

You can join us in Second Life at the Online Therapy Institute Conference Centre, alternatively you can view this event from the OnlinEvents website and you will be able to communicate with us using the chat room on our Live Video page.

There is no charge for this event!

Check out the time of the event in your time zone:

San Francisco: 12:00 PM – 1:00 PM
New York: 3:00 PM – 4:00 PM
London: 8:00 PM – 9:00 PM
Sydney: 5:00 AM – 6:00 AM

For more information visit www.onlinevents.co.uk

Recently Anthony S. Ragusea, Psy.D. offered this informative email to several of us inquiring about this topic. I asked Dr. Ragusea if I could blog his response to all of us and he graciously gave permission. You can read this information at the Breakthrough.com Blog as well.  You can visit his profile at the Online Therapy Social Network.  Enjoy his wise words on a timely topic! Thanks Dr. Ragusea!

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…the Myers-Briggs is indeed online and has been for years, but it is not considered a serious test of personality by experts on test design.  It is not admissible in court and the research clearly shows that it’s not much better than a horoscope.  So let me draw a distinction between serious, rigorously designed tests, and those that are not rigorously designed and thus the designers/publishers are less concerned about the issues I’m about to summarize.  That said, there ARE tests available via computer that are good, solid tests (e.g., the Strong Interest Inventory (career-aptitude test), behavioral rating tests like the CBCL and BASC-2, etc.) but these tests don’t NEED to be administered in person, and also in my experience tests are more EXPENSIVE by computer than paper.  The MMPI-2 is also available for computer administration, but not on the Internet, the client needs to be in the office with the computer.  And it’s more expensive than paper administration, again.  Companies tend to charge high fees for software, plus fees for each test “form,”  and sometimes subscription fees to maintain the service.

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In articles I’ve written, I’ve argued that as of now it is not ethical for psychologists to try to conduct certain kinds of psychological evaluations (like forensic evals) solely via telehealth.

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Here are some of the issues.  One is that some tests MUST be administered in person as they are currently designed because they involve interaction between the examiner and client.  IQ and memory tests, for example, have puzzle pieces, test booklets that require pencil writing and drawing by the client, etc.  In addition, the examiner needs to have control over the testing environment and how the test is administered–the examiner may pick and choose which subtests are administered, for example, or alter the test protocol for a specific purpose.  The examiner also needs to be able to observe HOW the client is behaving and dealing with test items, the test items are only part of the evaluation.  Behavioral observation during test administration is crucial to evaluating people.  For example, the Rorschach Inkblot test could be adapted to computer administration, but then I can’t SEE a potentially schizophrenic client becoming afraid and anxious in response to an inkblot that looks like Satan to the client.  That’s important information.   It might be possible to adapt IQ and memory tests to a computer-based format, but the therapist would still need control over the administration in real-time, and would need to be able to observe the client.

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Another issue relates to STANDARDIZED ADMINISTRATION.  Rigorous tests like IQ, memory, neuropsychological, and others are often designed to be administered under highly specific conditions.  Manuals specify the kind of environment the test should be taken in, where the client should be sitting, exactly what the examiner should say, etc.  Now, some aspects of standardization are better enforced via computer than by a live person, but what can’t happen is that the client be permitted to, for example, take these tests on their laptop in their bedroom with music blasting.  The reason is that it is crucial that all clients take the tests under the same conditions, so that the test validly assesses what’s designed to assess and to permit legitimate comparisons between different subjects who take it.  Changing the protocol potentially ruins the test’s validity.

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The next issue relates to what Mark mentioned, is a computer equivalent to a piece of paper?  I don’t think we have a good body of research on this topic yet.  Intuitively I would agree with Mark, a test that is administered just on paper without any interaction with the examiner should likely be equivalent on a computer (assuming the test-taking conditions are otherwise the same).  But we don’t KNOW that.  For example, does eye fatigue affect performance when taking a test on a computer monitor?  It may depend on the test.  Some tests may need to be entirely re-normed on a population that takes it on the computer, and that’s expensive.

The next issue is very important, and relates to TEST INTEGRITY.  There are hundreds of tests out there, many of them not very well designed, and many that don’t worry about test integrity.  By that I mean are the test items and information about how they are scored and interpreted available to the public.  The Myers-Briggs items, for example, are easily accessible by anyone, as is the scoring and interpretive method.  Many serious, rigorously designed tests require complete test integrity.  It is potentially illegal, and certainly a violation of ethical standards, for a psychologist to make MMPI-2 items, for example, available for anyone to see.  The MMPI-2 must NEVER leave the control of the examiner.  The MMPI-2 is the world’s most well-respected and researched personality test, and part of its validity comes from the fact that whoever takes the test has no prior familiarity with it.  There are examples of people who illegally post MMPI-2 items online so that, for example, people in child custody cases can see them and be coached on how to answer them in a custody evaluation.  Obviously, that can’t be permitted.  Results of personality, IQ, and achievement tests can have extremely serious consequences in real life, so it is CRITICAL that the public does not have access to them and is naive to how the tests are scored and interpreted.  This is why these tests can’t be administered on the Internet, because somebody could copy the items down, take screenshots of items, etc.

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I once consulted with a psychologist who was doing online work and wanted to administer the MMPI-2 to clients located at distant locations.  The only way I could tell her to do it ethically was to have the client take the test at a health clinic in their hometown and arrange with staff there about how to handle the test materials to maintain test integrity.  But that’s difficult and time consuming, and I don’t know if she ever followed through.

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The last issue is one that I touched on earlier–the importance of live observation.  If I’m evaluating a person and the outcome of my eval will have serious consequences, it is absolutely necessary that I see the client in person, at least for part of the eval.  Otherwise, I can’t smell alcohol, I may miss subtle behaviors that are clinically important, I may not be able to see subtle signs of neurological damage like difficulty walking, writing, grasping things, I may miss family interactions that are clinically important, etc.  Even video can’t replace it.  It’s similar to the reasons why the AMA doesn’t want physicians prescribing online to people they’ve never evaluated in person.

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So, to summarize, there are certainly tests that can be administered online appropriately, but others that, as of right now cannot, either because the design of the test makes it impossible to adapt to a computer or because of concerns about security and test integrity.  Sometimes there are concerns that a computer-based test is NOT equivalent to taking it on paper.  Bottom line is that as of right now I can’t administer the core battery of tests that I administer in a psychological evaluation, which really limits what I can do with telehealth.  Other mental health professions aren’t qualified to administer the tests that psychologists are, so they don’t feel the constraint.  But I do think this limitation puts a damper on psychologists’ enthusiasm about moving their practice into the Internet age.

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Anthony S. Ragusea, Psy.D.
Clinical Psychologist

P.S. Be sure to read more about online testing and assessment in our upcoming book —The Use of Technology in Mental Health: Applications, Ethics and Practice due out this fall from Charles C. Thomas Publisher, Ltd.

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We are working hard on putting together our new OTI magazine, TILT (Therapeutic Innovations in Light of Technology).

The magazine will be online and free, and launched in September 2010. It will be a blend of news, innovations, member profiles, articles, features, marketing toolboxes, news on textbooks, and advertisements of interest. We will have more news on this very soon as the first issue comes together.

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Each issue will include the following:

· Editors introduction and contents (Kate Anthony & DeeAnna Merz Nagel)
· News from the cyberstreet (tweets members, what is at OTI blog, new research news)
· New Breakthroughs column
· Online Therapist column (A Day In The Life)
· Online Supervisor column
· Ethical Dilemmas column
· Feature article 4000-6000 words
· Other article(s) – about 1500 words
· Marketing toolbox column
· Featured Verified website
· Letters/reader comments
· Book descriptions of 3 books per issue
· Advertising and conferences

If you have an article of up to 1500 words that you are burning to get out of your system on any topic related to innovative delivery of therapeutic services via technology (including coaching), please do submit it no earlier than August 1st and no later than August 20th to editor@onlinetherapymagazine.com

We’re very excited at this new development at the Online Therapy Institute and will let you know even more about the content soon!

We look forward to reading your article!

If you have other inquiries about the magazine including advertising options please email info@onlinetherapyinstitute.com

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Kate will be presenting at a conference in Brussels that begins on June 17th and DeeAnna will present at a conference in Pennsylvania that begins June 28th.  Details of both conferences and sessions about online therapy follow:

Employee Assistance European Forum Brussels Conference 2010  See the link for the full agenda.

Best Practices for Providing EA Services via Email Exchange

Ms. Kate Anthony, Founder “The Online Therapy Institute”, President of the International Society for Mental Health Online, U.K.

 2010 EAP-MAP Conference Villanova Conference Center, PA See the link for the full agenda.

Panel Discussion – “Let your Fingers do the Talking: Adding Online Counseling to your Therapeutic Repertoire”
Jane Weiler, LCSW – Program Coordinator, NY Presbyterian Hospital Workplace Services
Mary Ellen Gornick, MA – Senior Vice President – Global Products, Workplace Options
DeeAnna Nagel, MEd, LPC, DCC – Co-Founder, The Online Therapy Institute
Cedric Speyer, MA, MAEd – Clinical Supervisor of E-Counseling, Shepell

We hope to see you there!

A new article was just published in the Student Assistance Journal! The article is entitled Using Technology to Deliver Career and School Guidance Services: Establishing a Global and Inclusive Ethical Framework  and is co-authored by Harvey Schmelter-Davis, Kate Anthony and DeeAnna Merz Nagel. The article features a full reprint of the Online Therapy Institute’s Ethical Framework for the Use of Technology in Career and School Guidance.  As the abstract states, the article features a framework that strives “to offer a best standard of practice that all career and school guidance practitioners can easily adhere to regardless of particular professional identity, region and/or organization affiliation.”

PDF download:

Using Technology to Deliver Career and School Guidance Services

Schmelter-Davis, H., Anthony, K. & Nagel, D. (2009). Using technology to deliver career and school guidance services: establishing a global and inclusive ethical framework. Student Assistance Journal. 21(3), 26-34. 

The Student Assistance Journal Magazine is published by PRP Media, Inc.

Get Verified!

Do you have a website that offers information, services or products related to mental health?

Online Therapy Institute verifies websites so that individuals and businesses can demonstrate to their audience that their website is in compliance with what OTI considers to be “best practice” and in accordance with OTI’s Ethical Frameworks.

Getting OTI Verified means whether you offer website development and marketing services, you are an individual practitioner in private practice or you own an e-clinic or you represent a charity or educational organization you can indicate to the public that you understand the ethical implications of delivering mental health information and services online.

Website Categories

• Client Services (therapy, counselling. counseling, coaching)
• Therapist/Coach Directory
• Social Network
• Blog
• Peer Support
• Self Help
• Practice Building/Marketing
• Supervision/Consultation
• Education/Professional Development
• Crisis Intervention

You may have a website that fits into more than one category. Or you may have two websites under the same business name. For instance, some people have a private practice website and a separate blog site. We will offer an OTI Verified Seal that you can use on all of your sites. By implementing the items on our checklist that apply to your website categories, you can Get Verified .

• Your seal will be a choice of two styles.
• Each seal carries your company name and the current date.
• The seal cannot be replicated onto another site.
• The cost is $99.99 for the first year and $49.99 renewal each year following.

Instructions

You must have Adobe Reader to Download the following files

OTI Get Verified Checklist ….. OTI Get Verified Notes

• Compare your website to our checklist to be sure your website is ready for verification.
• Read through the notes that offer clarification for items on the checklist.
• Once you are sure you meet the criteria, click Google Buy Now button below.
• Following the completion of the payment process, you will be directed to the application.
• You will be contacted within 10 business days with your OTI Verified Seal.
• Should your website not meet the OTI Verified criteria, we will make recommendations.

Get Verified!

The Online Counselling and Therapy in Action (OCTIA – see www.octia.org.uk) conference (now in its second year), took place in Manchester, England  and online this March 2010  through chat rooms, live video and my own presentation taking place in Second Life with its own chat.

The photograph below shows me presenting to the room of delegates at the OCTIA conference venue, with my own laptop in front of me.  Behind me on the screen is the view from my laptop perspective into Second Life, where I was joined by colleagues from all over the world represented as avatars, who had their own chat facility with me via my laptop and the delegates in the room who were also in Second Life as avatars (hence the laptops in the audience).  The screen on the wall to my right is where I was shown live from the perspective of one of the other delegates in the room in Second Life, with the official OCTIA chatroom being scrolled to the right of the video, where I was also taking part via audio and my laptop via text.

If that description sounds confusing, the point is that I was present in five different realities simultaneously, presenting worldwide.  This groundbreaking event reached four continents – Europe, the USA/Canada, South America and Australia – bringing them together to discuss the use of virtual and mixed realities in counselling and psychotherapy experientially.  To ensure the delegates watching in the physical room and online were truly able to understand what working in mixed realities is like, I wore the same clothes that my avatar is based upon, clearer in the photograph below (with my virtual self centre-front of the screen (from my perspective, hence the back view)).

You can also view a video by John Wilson of OnlinEvents and pics of the event. Jokay, founder of Jokaydia where our OTI office and conference center is located,  took some great pics while inworld. We are ever so grateful for her design expertise and professional support.

The Islands of jokaydia is a virtual worlds community of practice facilitated by Jo Kay aka jokay Wollongong. We are exploring the use of virtual worlds and games for education, arts and social change. You can find us in Second Life, Reaction Grid and our new virtual worlds presence – the jokaydia Grid!

We hope you will visit us inworld! If you’d like to check out Online Therapy Square, and the OTI Headquarters visit: http://slurl.com/secondlife/jokaydia%20II/110/68/24.

Hi Everyone!

I invite you to join me and over 10 other expert speakers for a complementary Therapist Resource Telesummit. Over three days, you will have access to some incredible information on how to create an authentic and profitable therapy business, helping many more clients. I will be discussing online therapy and I am thrilled to be joining such a dynamic group of speakers!

See details here:
Therapists Resource FREE Telesummit March 12 – 14

You’ll discover:

* How to stop giving your money away to insurance companies and the biggest mistakes therapists make in building a successful fee-for-service therapy business

* How to help your potential clients TALK THEMSELVES into working with you and what you’ll need to know to attract way more clients without compromising your values

* The mindset shift and business model change you need to learn so you can easily double your current income

* How to use coaching to build a fee-for-service practice making six to seven figures a year

* The reason why you may be procrastinating in your business and the biggest gift you can offer your clients

* The marketing approach that helps your community, while growing your practice at the same time

* How to expand your practice using text-based therapy: what you need to know about using email and chat with your clients- everything from encryption, client screening, and cyber-cultural awareness

* How to create a signature presentation that leaves your potential clients asking for more

* Practical tools you can use to earn expert status and how to utilize technology and marketing strategies to engage clients, build credibility, and earn loyalty

* Specific ways social media improves your visibility online and how to use directories and google local business center to gain exposure and attract new clients

* How online networking sites and technology can bring therapists, students, and interested professional together in a global web community, maximizing your practice exposure

And so much more!

Join me!

March 12th, 13th and 14th, 2010
Register and see details here:
Therapists Resource FREE Telesummit March 12 – 14

Wishing everyone the best!

DeeAnna

The BACP Guidelines for Online Counselling and Psychotherapy are now in their 3rd Edition (Anthony & Goss, 2009 – see also Goss et al., 2001; Anthony & Jamieson, 2005) and now the British Association for Counselling and Psychotherapy have revised and amended the main Ethical Framework to reflect this (the full link is below, with references).

This embraces the importance of recognising online therapy – and indeed the function of technology in general –  as a vital component of the profession.

The new Ethical Framework states:

Variations in client needs and the diversity of settings within which counselling and psychotherapyservices are delivered have also been carefully considered. Clients vary in their requirements in order tocommunicate effectively and to gain access to services. Ethically aware services strive to meet theseneeds and to avoid excluding someone from receiving a service or lowering the quality of that servicesolely on the grounds of a client’s learning difficulty or physical disability. Services may be provided bythe independent practitioner working alone, one or more practitioners working to provide a service withinan agency or large organisation, specialists working in multidisciplinary teams, and by specialist teamsof counsellors and psychotherapists. Most work is undertaken face to face but there are also a growingnumber of telephone and online services. Some practitioners are moving between these different settingsand modes of delivery during the course of their work and are therefore required to consider whatconstitutes good practice in different settings. All practitioners encounter the challenge of responding tothe diversity of their clients and finding ways of working effectively with them. This statement thereforeresponds to the complexity of delivering counselling and psychotherapy services in contemporary societyby directing attention to significant issues that practitioners ought to consider and resolve in the specificcircumstances of their work.

The Online Therapy Institute embraces this amendment, as the work of BACP remains the basis of part of our own Ethical Framework for the Use of Technology in Mental Health (http://www.onlinetherapyinstitute.com/ethical-training/).

Kate

http://www.bacp.co.uk/ethical_framework/

Goss, S., Anthony, K., Jamieson, A. and Palmer, S. (2001) Guidelines for Online Counselling and Psychotherapy. Rugby: BACP.

Anthony, K. &  Jamieson, A. (2005) Guidelines for Online Counselling and Psychotherapy 2^nd Edition, including Guidelines for Online Supervision. Rugby: BACP.

Anthony, K. &  Goss, S. (2009) Guidelines for Online Counselling and Psychotherapy ^3rd Edition, including Guidelines for Online Supervision. Rugby: BACP.

The Online Therapy Institute is pleased to launch a series of online courses about online therapy.  We will be adding courses so do check back. Our 5 clock hour courses are reasonably priced at $69.99/£45.00. For an additional $25.00 we offer continuing education credits for most mental health disciplines in the United States. Currently our courses also qualify for Registered Social Worker professional development in Canada. We have also applied for PDH course approval for Certified Employee Assistance Professionals (CEAP) as well.

We will be adding new continuing education/professional development opportunities so if you would like our courses to count toward requirements in your country, please let us know and will will gladly look into it!

Our current list of courses:

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Introduction to Cyberspace: A Primer for Helping Professionals

Relationships in Cyberspace: An Introduction for Helping Professionals

The Online Therapeutic Relationship: Theoretical Considerations

Ethical Considerations of Online Therapy

Working Therapeutically Using Asynchronous Email

Working Therapeutically Using Synchronous Chat

Continuing Education is available for U.S. psychologists, social workers, counselors, addiction specialists, marriage and family therapists, nurses and educators.

Our courses are co-sponsored by R. Cassidy Seminars.  You will take a test and receive a certificate of completion within the course module but if you are a practitioner in the U.S. and you wish to obtain accredited continuing education hours, the cost is an additional $25.00 per workshop.

Online Therapy Institute Accreditation

Co- sponsored by R. Cassidy Seminars

Satisfactory Completion

Participants must have paid course fee, submitted signed verification statement, completed evaluation, and completed post-test with passing grade of 75% in order to receive a certificate. Failure to complete and submit these materials will result in forfeiture of credit for the entire course. No exceptions will be made. Partial credit is not available.

Psychologists

R. Cassidy Seminars is approved by the American Psychological Association (APA) to offer continuing education for psychologists.  R. Cassidy Seminars maintains responsibility for this program.

Also covers LPCs, MFTs, and SWs in the District of Columbia

Social Workers

R. Cassidy Seminars, ACE provider #1082 is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) Program. Approval Period: April 15, 2009-April 15, 2012. R. Cassidy Seminars maintains responsibility for the program. Social workers should contact their regulatory board to determine course approval. Social workers will receive __#__ continuing education (clinical, social work ethics) clock hours in participating in this course.

Covers Social Workers in these states: AL, AK, AR, AZ, CT, DE, FL, GA, ID, IA, IL, IN, KS, KY, MA, MD, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NM, OK, OR, PA, RI, SC, SD, TN, TX, VA, VT, WA, WI, WY. Also covers Licensed Professional Counselors in PA

DC: See approval for Psychologists

CA: Course meets the qualifications for (#) hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences, Provider #PCE418.

OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for ( ) clock hours, #RCST110701

Counselors

R. Cassidy Seminars is recognized by the National Board for Certified Counselors to offer continuing education for certified counselors.  We adhere to NBCC continuing education guidelines.  Provider #6375.  (#) hours.

AK, AL, AR, AZ, CT, DE, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MN, MS, MT, NC, ND, NH, NJ, NM, OK, OR, RI, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY.

OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for ( ) clock hours, #RCST110701

Marriage and Family Therapists

AK, AL, AR, AZ, CT, FL, IA, ID, IN, KS, MD, ME, MT, NE, NJ, NM, OK, OR, RI, SD TN, UT, VA, WA, WY. See approval for Counselors.

DC & MS: See approval for Psychologists

CA: Course meets the qualifications for (#) hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences, Provider #PCE418

IL: Illinois Dept of Professional Regulation, Approved Continuing Education Sponsor, #168-000141.  (#) hours.

OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for ( ) clock hours, #RCST110701

TX: Approved CE Sponsor through the Texas State Board of Examiners of Marriage & Family Therapists. Provider #151

Chemical Dependency Counselors

Provider approved by NAADAC Approved Education Provider Program for (#) contact hours.  Approval #000654.

CA: Provider approved by CAADAC, Provider #4N-00-434-0210 for (#) CEHs. CAADAC is an ICRC member which has reciprocity with most ICRC member states

TX: Provider approved by the TCBAP Standards Committee, Provider No. 1749-06, (#) hours general and/or (#) hours (specific specialization), Expires 3/2009.  Complaints about provider or workshop content may be directed to the TCBAP Standards Committee, 1005 Congress Avenue, Ste. 460, Austin, Texas 78701, Fax Number (512) 476-7297.

Nurses

CA: Provider approved by the CA Board of Registered Nursing, Provider #CeP12224, for (#) contact hours.

Teachers/Educators

IL: Provider approved by the Illinois State Board of Certification #080304164719171

TX: R. Cassidy Seminars is an approved provider with the Texas Education Agency CPE# 501456. This course is (#) CE Hours.

Please Note: Licensing Boards change regulations often and while we attempt to stay abreast of their most recent changes, if you have questions or concerns about this course meeting your specific board’s approval, we recommend you contact your board directly to obtain a ruling.