What Are the Rules to Running Online Therapy Ethically?

Therapy options have changed considerably in the last few years. In the past, there was just one way to do therapy: in-person at a therapist’s office. And, that involved extra steps like getting a referral, scheduling an appointment, driving to the office, dealing with insurance, etc. That’s a lot to deal with, especially for patients already struggling with stress, depression, anxiety, or other mental health issues.

Thankfully, all that has changed with the advent of online therapy. Gone are the many barriers that could keep clients from their in-person appointments. Now patients can get the personalized care they need directly from the comfort of their own homes, without all the additional hassles.

But, of course, there are some potential drawbacks to online therapy, especially since the practice is relatively new. Some clients may question whether the sessions are secure, how their privacy is protected, if they’re receiving the highest level of care, etc.

To ensure that you’re running your online therapy sessions ethically and giving patients the best care possible, follow these five guidelines:

1. Choose your platform carefully (and know how to use it)

Before diving into online therapy, you’ll need to consider how sessions will be conducted. There are many avenues to choose from, including therapy apps, websites, and video conferencing software.

Any potential platform should be thoroughly evaluated before selection, paying particular attention to security. While it may seem easy enough to just hop on a video call with a client, you need to be sure that your sessions will be kept completely private and confidential.

You should also test out the technology to make sure you can use it effectively before your first session. Fumbling around trying to unmute your microphone or accidentally pressing the “record” button may cause a client to start questioning your competence. Become familiar with whatever platform you’re using in advance to make sure you can use it correctly with confidence.

2. Keep data secure

With therapy sessions being held online instead of in person, there’s a greater risk that data could be compromised. You need to consider how to keep intake forms, patient assessments, session notes, and insurance information private and secure. Simply storing the data directly on your computer or in the cloud are not viable options. If your laptop is stolen or your account compromised, your patient’s data is at risk.

Conduct a risk assessment to identify potential problems then search for corresponding solutions. For example, you could choose a HIPPA-compliant payment processing company for billing patients directly. To keep client insurance data safe, you could work with a company like Advekit who provides out-of-network insurance billing services.

3. Maintain Proper Informed Consent Practices

Make sure your patients have a clear understanding of what to expect from online therapy sessions. Provide them with detailed information about the following before obtaining consent for treatment:

Session format
Benefits of online therapy
Risks of online therapy
Your privacy policy
Treatment goals and options
Your fee structure
Insurance policies
Availability outside of regular appointments

4. Obey all relevant laws and licensing regulations

To ensure that you’re conducting online therapy sessions in an ethical manner, it’s vital to adhere to all relevant licensing regulations in addition to local, state, and national laws.

It may sound like a no-brainer – of course ethical therapy requires following the law! But it’s not as easy as it sounds. Laws differ from state to state; what’s permissible in Alaska may be prohibited in Arkansas. One good example of this is the limitation on interjurisdictional practice; many states prohibit therapists from practicing if they’re licensed in another state, but not all do. With these variations, it might be difficult to find the exact regulations that govern your practice.

You may be able to find some guidance regarding regulations online. Governing bodies often publish information online to keep therapists informed of the relevant standards and guidelines. A great example of this is the list of guidelines for telepsychology provided on the American Psychological Association website.

Of course, not all the information you find online will apply to your practice; it’s best to consult with your local licensing board to make sure you’re in compliance with all relevant regulations.

5. Recognize the limitations of online therapy

It’s important to recognize that online therapy has its limitations, and it may not be the best option for all of your patients.

One of the biggest limitations is the inability to respond to an immediate crisis. If a patient is experiencing suicidal thoughts or threatening to harm others, it can be difficult to provide the help they need from a distance.

Another disadvantage of online therapy is that technology distances you from the patient; it creates a sort of hurdle that needs to be overcome before you can build trust. When sessions are conducted in person, it’s much easier to read your patient’s body language, find common ground, and build rapport. With online therapy, you may need to put forth extra effort to help your patients feel at ease.