How Professionals Can Promote Online Therapy
Yesterday I completed facilitation of a two-day Distance Credentialed Counselor training in Springfield, IL. Every time I do a training I meet great people and I learn. In this training there was much concern expressed about therapists being able to cross state lines; how to know what each state’s law says, and whether there is a “clearinghouse’ for such information.
Well, OTI has an Ethics and Law wiki and we do our best to keep it updated as we receive information about the legal and ethical aspects of practicing online counselling across the globe. But still, this method relies on all of us to make sure the updates are received in a timely manner and that Kate and I can upload the information that is sent to us if a person does not enter the information to the wiki him/herself.
So in this training I heard of two more states that may have implemented restrictive language into their law regarding online counseling- not allowing a licensed practitioner in that state to offer online therapy services to anyone outside the state (MA and NE). I am hoping I can get more clarification and actually see a copy of their language.
And so on my drive back the hotel it occurred to me that one way we can effect change as professionals in our various states and countries is to become active in our professional organizations. If you are in the states and you are member of APA, ACA, NASW, get involved. Join taskforce committees. To have influence in your state, join a state chapter. Volunteer to be on the board. Be part of a government relations or ethics committee. Become the ethics chair of your state chapter. That is how we can begin to educate our colleagues about the value of online counseling. I do not think we should be legislating WHERE online counseling can occur. I think we should be legislating competency.
It is obvious to me that state licensing boards are way behind the curve when it comes to understanding the global community – and global e-commerce. Placing practice restrictions on licensed professionals does not allow consumers choice in treatment, and seems to be a rather paternalistic stance. And clearly, state licensing boards have no clue about the online culture. Most states require practitioners to have taken a class on multiculturalism to obtain a license to practice, yes? Yet the boards do not understand that we have an entirely new culture of people who live within a mixed reality, choosing to receive professional services online through their global community. So if we look at the online community as a culture, then we could make the claim that in this instance, our state boards are not being very culturally sensitive, could we not?
While this issue of “crossing state lines” is rather U.S.-centric, my point in this post is to encourage professionals to become involved in their local professional organizations no matter what country, so that we can all make a difference. We want online therapy to be a viable option within the global community!!
Have a great summer day!
DeeAnna
Glad you posted this DeeAnna. It amazes me that these states are taking such steps to thwart their residents’ attempts to embrace wellness from the comfort and privacy of their own homes. Actually, I fear the hypocracy, because there are great practitioners in our country who are encouraged to practice their craft outside of state lines, volunteering for Doctors Without Borders, traveling to assist FEMA and the Red Cross in areas devastated by fires and floods. Will the next “Hurricane Katrina” clean up require a federal law be passed before our counselors are again asked to leave the comforts of their homes and practices to help others who have experienced trauma?
I agree, it is time for the citizens of the USA to lobby for change. And, perhaps time for the citizens of the globe to influence our government as well?
It would be odd if these licensing boards are restricting professionals from practicing (online or otherwise)outside of the state, since the purpose of such a board is to ensure that the residents WITHIN their state are being protected and receiving competent professional services. If they believe they provide that through their licensing procedure, then what do they care if that professional also serves someone in Kansas? In fact, it would seem to exceed their jurisdiction to prevent a licensee (whom they have certified as competent)to practice in another state. That would fall to the authority of the other state.
My review of NE and MA guidelines and Board minutes yielded nothing on NE. However, the MA board has adpoted a policy [Policy No. 07-03] to address this issue. However, it does not address prohibiting MA licensees from practicing online or with others out of state. Rather, it prohibits anyone NOT licensed by MA to practice online with citizens within MA. OF course, good luck with enforcing that with a guy in Alaska who helps someone in Boston.
Eventually, we’ll end up with a national criteria, probably driven by the lobbying of our professional organizations. So I agree with DeeAnn that we need to be involved and keep this a “front burner issue” with them. Of course, I expect we’ll see a national license about the same time as we adopt an effective national health care policy. And it will probably continue to be a messy road ’til then.
This talk about licensing boards restrictions seems to me to be something of a red herring. My concern is that the process of counseling is severely hampered if the therapist cannot have some control over the venue in which she/he does therapy. Much like a surgeon has minimal conditions that must be met to be able to do professional and ethical surgery, I think we mental health workers have professional and ethical obligations to provide therapy in an environment that we know to be therapeutic and we can keep it that way for the duration of the session. I think this we owe to any one we work with, especially “the global community”.
Thanks for this wonderful posting. Done correctly, online therapy can be a terrific alternative for many people. I have worked with some clients in this manner, and it has been a very positive experience.
Thank you, DeeAnna, for this informative and thought-provoking post. I agree with your perspective on the online community representing a culture (or subculture). I also am inclined to agree with Geoffrey Bullock regarding board responsibility. Lets hope, as the information about MA & NE comes in, that we discover a misunderstanding rather than exclusionary measures. Excellent article…thanks.
I think E-therapy is going to require a distinct boundary from traditional psychotherapy to work out the legal/ethical/competence issues.
It is not the same as face to face therapy nor should it be treated as such.
It is a viable and economical alternative that can benefit people, but it is not without obvious limitations.
Current licensing boards/regulations are simply not suitable for e-therapy especially when it comes to working with international clientele.
There is also a large contingent of clinicians/educators who do not support the idea of online therapy. I’ve even debated an older clinician on his point that the internet is primarily a schizoid phenomenon and not conducive to a therapeutic environment, a point not entirely without merit
I believe eventually there will be some sort of central online credentialing body where online clinicians can receive training and certification that is generally recognized world-wide and is separate from the current structure.
May you live in interesting times!