1. Ethical Issues in E-Therapy Gerald P. Koocher, Ph.D., ABPP

2. Problems in Electronic Communication Misunderstanding the medium Inappropriate distribution Inappropriate response Access to personal mail Unauthorized use of super- user privileges Unauthorized access to files or other types of electronically stored material

3. Misunderstanding the Medium E-therapy is not subject to the extended process of of integration with visual cues. The spontaneity factor may result in failure to consider tone, language, or even appropriateness. Home versus office access and corresponding rights differ.

4. Licensing Issues Most states lack legislation. Licensing boards and attorneys general may disagree. Many loopholes exist: –Ten days = 240 hours Jurisdictional issues abound: –Where is the intervention occurring? Will professional liability insurance cover “unlawful practice” across state lines?

5. Public DataPrivate Lives Public Data/Private Lives How much “private” information will actually remain private? How much “private” information will actually remain private? Who really has access? Who really has access?

6. Who Is Responsible? access control: Free access versus regulatory control: –Protecting rights –Preventing harm –Promoting public benefit –Limiting government intrusions

7. E-Therapy What is therapy versus what is therapeutic? –Information sharing –Psycho-educational information –Self-help –Social support –Advice giving

8. E-Psychotherapy The use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, and information across distance Rapidly evolving field that offers great promise and raises significant risks

9. E-Therapy As in any new practice arena, clinicians must… –hold the best interests of the patient paramount. –obey legal requirements. –strive to do no harm.

10. E-Therapists Should Ask Themselves Am I trained to do this? Does it work? What limitations apply? What will I (can I) do in an emergency? Confidentiality? Complaint jurisdictions and licensing regulations? Insurance coverage for services and professional liability?

11. Identity Issues Bogus Identities Lurking Unintended recipients

12. Potential Consequences of Delivering Psychological Services in Cyberspace Murphy’s Law strikes again!