For Clinical
What are some ways that teletherapy can be administered?
Text, chat, phone call, video chat
What things have we talked about previously that zoom or video therapy inhibit more than meeting in person with a mask?
Body language, fidgeting, tone of voice, relationship building with counselor
What aspect of E-Therapy makes a student more willing to sign in to a virtual session opposed to walking into a counselor's office at school?
Less intimidating, lack of peer judgement
What is one of the biggest issues that students may face when having to use virtual counseling?
Lack of technology and/or wifi
Korina is a licensed counselor in a rural part of the state. Her neighbor, Janine, who lives about a half-mile down the road, calls her office for an appointment. Janine appears to be depressed, having great difficulty coping after the death of her husband in a farm accident eight months ago. Her response seems well beyond a normal grief reaction. Korina is not close friends with Janine, but they occasionally attend the same social functions, and Korina did go to Janine’s husband’s funeral. Over the ten years Korina has lived in this town she has been in Janine’s house twice. If Janine is driving down the road while Korina is outside in the yard, she usually stops the car to chat for a few minutes. Many years ago Korina’s children sometimes played with Janine’s. Because Korina is the only licensed female mental health professional in town she accepts Janine as her client despite the social connections.
Not Unethical;
They live in the same town and there is not a lot of people; think of it as a dual relationship, be humble; if seen out in public within the same town, do not introduce each other or acknowledge one another
What pro e-therapy factor would be beneficial to clients living in a rural area?
Geographic accessibility
True or False: Mental Health Counselors only need to be licensed in the state they live in, not the states their clients live in?
False, they should be licensed in both the state they reside and any state they are providing service
What factor about school aged children make them able to work well with the virtual design of E-Therapy?
The experience in technology that the younger generations have.
What kind of assessment are counselors missing out on with virtual counseling with students?
Physical assessments; counselors may not be able to see any bruises or cuts since kids are able to hide them better through a camera, which means physical abuse is not being picked up on like it normally would in a face to face setting. Along with body language and noticing incongruencies
Petra is a recent immigrant from Bosnia. She lost three brothers during the war there. She lives in the United States with her parents and she works as a meter-reader for a utility company. Over the last 6 months Petra has become increasingly depressed. Her work performance has suffered and the employee assistance program at work has referred her to Jonathan for therapy. Jonathan is an experienced mental health professional who also conducts research on the effectiveness of psychotherapy for depression. He has never worked with a recent immigrant from Eastern Europe, and he has little knowledge of the war in Bosnia. Jonathan decides to refer Petra to another clinician who is from Eastern Europe, but whose knowledge and experience in treating depression is not as extensive as his. Consider Jonathan's decision to refer Petra to another counselor and reflect on if you agree or disagree with that decision. Further, consider the consequences of Jonathan's decisions on Petra, both good and bad.
Unethical
True or False: E-therapy tends to be more cost effective than traditional therapy
True! E-therapy typically charges one price for unlimited communication, whereas traditional therapy charges per session.
What issue can both clients and therapists experience in their mental health or social life by solely using telehealth or e-therapy interfaces?
With the Pandemic, the lack of in person contact can cause both clinicians and clients, participating in only e-therapy to feel isolated
True or False: Students often struggle being able to afford school counseling due to lack of insurance support.
False, most schools are able to provide free counseling. The only limiting factor is the counselor to student ratio.
True or False: There are no outside distractions for students at home while with their school counselor
False! Students may have any given number of outside distractions going on at the exact same time that they are with their school counselor ie: parents, siblings, pets, games, tv's
MaryAnn is an intern who routinely explains her training status to all clients, obtains permission for tape recording, and informs clients that she is required to discuss her counseling cases with her supervisor and that her supervisor will sometimes listen to the tapes. Clients who do not wish to accept this arrangement are referred to other professionals in the agency. With difficult clients, MaryAnn’s supervisor sometimes listens in while the session is in progress, in an adjacent office wired for that purpose. MaryAnn does not inform clients about this simultaneous supervision when it occurs, because she and supervisor believe the prior consent procedures are sufficient to cover this arrangement.
Consider MaryAnn and her supervisor's actions and the ethics of the situation.
Not unthical, but important to remember to remind the client at the beginning of every session that they are being recorded and that their information may be reviewed by our supervisor
What is the name of the laws that ensure privacy and confidentiality, even for e-therapy?
HIPPA
What privacy issues have been repeatedly acknowledged in virtual therapy settings over in person meetings?
Unknown locations, distractions, presence of others or thin walls
This generation of students sometimes needs immediate attention. What Pro E-Therapy factor would be beneficial in this situation?
Timely and immediate care
Why would it be not so easy to address an emergency situation virtually with students?
You are not their to either first address the situation at hand, you can not easily intervene, ie: suicide attempts, parents fighting, friends fighting etc
Jenna, a licensed professional counselor, accidentally sees a colleague, Jeb, at a restaurant. Jeb is having dinner with a client. Jeb and his client are deep in conversation, laughing and having a grand time. From her table, Jenna watches behaviors she usually associates with couples who are dating. Jeb and his client finish and leave the restaurant without ever seeing Jenna there. The following Monday Jenna learns from the secretary that the person with whom Jeb was having dinner Saturday evening is still a current client. In fact, that client is scheduled to see Jeb later this week. Jenna makes an appointment to see the clinical director of the agency later that day and leaves Jeb a voice-mail message that he would be well advised to attend that meeting. Ultimately, Jeb is reprimanded by the agency for violating its rules and the director files an ethics complaint to the licensing board. Jeb tells Jenna he believes she also acted unethically when she did not talk with him before telling the director. He says that as a colleague he deserved better treatment.
Unethical; DO NOT DATE YOUR CLIENT
Name a specific population named in the other presentations that can truly benefit from e-therapy.
Homebound clients, agoraphobic clients, etc.
What are the biggest presented issues with using technology as a sole mode of therapy?
Glitches/Technological issues, access to technology, internet access
True or False: Students will benefit from E-Therapy if they are sick or immobile but also if they lack transportation.
True, E-Therapy is absolutely necessary and should be utilized past the global pandemic.
What would be a critical factor when dealing with a younger student by having school counsel virtually?
Attention Span, a 5 year old will not be willing sit in front of a computer to just talk to someone, they need to have more hands on counseling instead
Philip is a school counseling intern at an elementary school. One of his clients has a number of bruises on her arms and legs. When asked, the child cannot account for the bruises -- she just shrugs her shoulders and says, I don’t know.” Philip reports this child’s injuries to Vivian, his supervisor, and tells her he plans to call the child abuse hot line. Vivian suggests that no report is necessary because her case is already under investigation for an injury that was reported to them by the child’s teacher two weeks ago. At first, Philip is surprised by his supervisor’s advice, but then decides that she must be correct and does not report this new incident.
Consider Philip's predicament and Vivian's decision to tell him not to contact the hot line.
Unethical; you should report any time of abuse, having more then one report helps put cases into motion faster