Guidelines for Mental Health and Healthcare Practice Online.

About the ETHICS Code:

The ETHICS Code was developed in 1999 by leading experts in the fields of healthcare, law and mental health (*) to set the ethical standards for healthcare organizations and individual professionals who practice online in a new field. The EthicsCode aims to guide professional healthcare boards, government and private agencies, as well as individual practitioners. The code is designed for professionals who provide clinical services online. The ETHICS Code is not meant as a guideline for professionals who render general or educational advice to the public.

In general, clinicians who practice online must follow every professional and ethical principle pertaining to in-office care of clients. The following principles for online practitioners are considered a supplement to existing codes and standards which are issued by states and/or professional boards. Guidelines for Professional Practice Online.

1. Understanding and informing:

(a) Online clinicians educate themselves about the uses and limits of online care, they advise potential clients about them in accordance with current research and practice.
(b) Online practitioners inform potential clients of any relevant research and available data about online therapy, including the potential effectiveness or limits for a specific problem.

2. Online and in-office service arrangements:

Online clinicians assess the suitability of potential clients for online care. Online care may be insufficient for clients in crisis or life threatening situations, where in-person assessment and care is the better alternative. If an online practitioner foresees that a potential client may require in-office care at some point, the practitioner informs the client of such an eventuality. The clinician accepts the client into his/her care only if:
(a) both parties agree that the therapist is within a reasonable geographical distance of the client and can thus provide in-office care if such is needed; or
(b) a contingency referral arrangement for such cases is mutually agreed upon by the clinician and client.

3. Emergency contact:

Online clinicians verify the client's identity to the extent possible and establish some means, other than e-mail, of communicating both with clients and emergency contacts.

4. Limits of license and insurance:

Online clinicians provide professional care only to those clients who reside in the state or province in which the practitioner is licensed or certified. Online clinicians explain the limits of out-of-state practice and lack of insurance coverage in such cases to clients who must always sign an Informed Consent form.

5. Understanding confidentiality and security online:

Online clinicians educate themselves about, and advise clients of, the potential risks to confidentiality in regard to Internet transmissions.

6. Privacy measures:

Online clinicians provide care only through "secure" web sites, using current protective procedures.

7. Reimbursement and payment for services:

Online clinicians advise potential clients of the current limitations of online care with regard to third-party involvement, payments or reimbursement for online professional services.

8. Regulating and supervising entities:

Online clinicians provide links to information web sites of those bodies that license, certify or supervise the practitioner, and to whom clients have recourse in case a dispute arises between the therapist and client.

9. Professional standards:

Online clinicians safeguard the privacy of client records using standard office procedures, e.g., of such level and detail as are required and kept in the non-virtual office.

10. Mastery of the modality:

Online clinicians seek technical consultation, or other means of understanding technical issues, prior to providing online professional services.

(*) Auhors: Drs. Ron Kraus, George Stricker, Bruce V. Hillowe & Judy E. Hall.

_____________________________________________________________ was published in 1999 and last updated on November 13, 2021.

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