WRCAC Telemental Health Resource Center

Ethical Issues 

Professional Association Codes of Ethics and Guidelines on TeleMental Health, E-Therapy, Digital Ethics, & Social Media This webpage gives a complete comparative list of Codes of Ethics from different professional associations that have their distinct guides on telehealth practices. 

Digital Ethics, HIPAA, & TeleMental Health This webpage developed by the Zur Institute has resources, guides and practical applications for professionals in the field of mental health who are using digital technology in their services. There are digital ethics codes, as well as telemental health resources regarding ethics for online platforms available. 

Therapy Online: A Practical Guide (Anthony & Nagel, 2010) This book provides readers with ethical and legal advice of joining or developing a telemental health service as well as practical skills for online therapy. Within this guide, an Ethical Framework is described for professionals to apply to their practice in TMH. 

A Practitioner’s Guide to Telemental Health: How to Conduct Legal, Ethical, and Evidence-Based Telepractice (Luxton, Nelson & Maheu, 2016)  This book outlines best practices when using videoconferencing for psychological services like assessment, treatment delivery, psychoeducation, supervision and consultation. A chapter is dedicated to ethical, legal and risk management considerations that are useful when developing/applying policies and practices in a new or existing TMH program. 

Telemental Health Best Practices: Do’s and Don’ts to Developing a Thriving Service  This webinar presented by Marlene M. Maheu PhD discusses practical methods for developing a telemental health service that follows compliance with all legal and ethical requirements.

Telebehavioral Health: What Every Provider Needs to Know This webinar provided by SAMHSA discusses the legal, ethical, clinical and technical issues that go along with providing telebehavioral health services. 

TherapyTech with Rob and Roy: Episode 105 Telemental Health This podcast discusses what telemental health is and the ethical considerations behind providing online counseling services. 

The Ethics of Telemental Health: The New Era of Technology-Assisted Media (Presented on Friday January 31, 2020) This workshop clarifies concerns and addresses the ethical requirements and considerations of providing telemental health services to clients. Some topics will include distinguishing between telemental health and technology-assisted media, the HIPAA Business Associate Agreement, benefits and limitations and specific details pertaining to telemental health services. 

Ethical Challenges, Risk Management, and the Emerging Technology of Telehealth for Mental Health  This course is aimed at assisting users to examine telehealth in mental health services as well as the ethical and risk management challenges of using technology in clinical settings. 

Screening for Fit for Telemental Health Services, Online Self-Study This course provides clinicians with details on how to screen prospective and current clients for telemental health services. 

Psychiatric/Mental Health Consultation by Telemedicine PDF This template, developed by the Northwest Regional Telehealth Resource Center, is a checklist for mental health providers to assess if a client is appropriate for telemental health services and walks through a potential referring process. 

Suicide Risk Management During Clinical Telepractice (Luxton et al., 2014) This article reviews procedures used in the authors work to provide on-going assessment and management of suicide risk via telemental health services. There is a table on page 23 that lays out the authors safety plan steps and processes that can assist those developing safety plans for their TMH practices. 

Managing Risk and Protecting Privacy in Telemental Health: An Overview of Legal, Regulatory, and Risk-Management Issues (Kramer et al., 2013)This chapter from the book Telemental Health: Clinical, Technical, and Administrative Foundations for Evidence-Based Practice lays out guidelines to alleviate the concerns of patient safety and privacy while delivering telemental health services. 

Behavioral Emergency Management Guidelines for Telemental Health (Shore, 2012) These powerpoint slides sponsored by the Office of Telehealth Service provides an overview of telemental health and the VA’s work with it, as well as the basics of emergency management in TMH. Topics include pre-session procedures, technology breakdowns, contingency plans, patient evaluations, and established guidelines.

Home-Based Telemental Healthcare Safety Planning: What You Need to Know (Luxton et al., 2012)  Telemental health (TMH) care provided directly to the home is an emerging area of care delivery. TMH care involves awareness of safety issues and adequate safety planning, although detailed practical recommendations for home-based TMH safety planning are absent in the literature. With this article we aim to increase awareness of safety issues associated with home-based synchronous TMH treatment and to discuss recommendations for consistent safety planning that can inform the development of standard operating procedures, emergency protocols, and overall good TMH practice. Specific areas discussed include consideration of state and local requirements, appropriateness of TMH care, technology and infrastructure, and emergency management and monitoring procedures. The topic of safety, as it relates to TMH policy, as well as the need for additional TMH research are also discussed.

Safety of Telemental Healthcare Delivered to Clinically Unsupervised Settings: A Systematic Review (Luxton, Sirotin & Mishkind, 2010) This article provides an overview of safety issues associated with telemental healthcare. A systematic review of the literature was conducted on 76 articles to evaluate the safety of telemental healthcare delivered to unsupervised settings. The review resulted in a total of nine studies that specifically evaluated the delivery of telemental healthcare to unsupervised settings. Six of the nine studies reviewed explicitly described safety plans or specific precautions that could be used if necessary. Two of the nine studies reported events that required the researchers to use safety procedures to effectively respond to concerns they had regarding participant safety.

Practice Guidelines for Video-Based Mental Health Services (ATA, 2013) PDF On pages 12-13 Section F 1-7 of these guidelines are instructions and suggestions on emergency management and planning while providing mental health services through videoconferencing. 

Emergency Management Guidelines for Telepsychiatry (Shore, Hilty & Yellowlees, 2007) This article outlines the administrative, legal/ethical and clinical issues that are present when working in emergency telepsychiatry services. These guidelines can be used in general telepsychiatry or emergency telepsychiatry services. 

Patient Safety and Emergency Management in Telepsychiatry with Children and Adolescents  This short video sponsored by the American Academy of Child and Adolescent Psychiatry walks through emergency management procedures in both traditional and non-traditional health care settings.