The Need for Competence and Upholding of Ethical Standards
As a guide for all of the subsequent principles, each reviewed document highlights the need for anyone practicing with technology to take reasonable steps to ensure their competence with both the technologies themselves, and the potential impacts that the technology may hold for both the provider and the patient. To accomplish this, providers should seek research literature (Appendix F), books (Appendix F), formal training (e.g., graduate education, continuing education [CE] programming; Appendix G), consultation, and supervision. Specific foci of educational endeavors include, but are not limited to, the specific benefits of the technology-based approach; the limitations or risks associated with use of the technology; research on outcomes for specific diagnoses, ages, SES, cultures, languages,
Table 3.4 NASW. ASWB, CSWE, & CSWA Standards for Technology in Social Work Practice*
Section |
Standards |
1. Provision of information to the public |
|
2. Designing and delivering services |
|
3. Gathering, managing, and storing information |
|
30 Guidebooks and Recommendations Table 3.4 Cont.
Section |
Standards |
|
|
4. Social work education and supervision |
|
Source: NASW et al. (2017).
Note: * Information is a summary.
Table 3.5 АСА Code of Ethics*
Section |
Standard |
The counseling relationship |
A. 1 Client welfare A.2 Informed consent in the counseling relationship A.3 Clients served by others A.4 Avoiding harm and imposing values A.5 Prohibited noncounseling roles and relationships A.6 Managing and maintaining boundaries and professional relationships A.7 Roles and relationships at individual, group, institutional, and societal levels A.8 Multiple clients A.9 Group work A. 10 Fees and business practices A. 11 Termination and referral A. 12 Abandonment and client neglect |
Table 3.5 Cont.
Section |
Standard |
Confidentiality and privacy |
В. 1 Respecting client rights B.2 Exceptions B.3 Information shared with others B.4 Groups and families B.5 Clients lacking capacity to give informed consent B.6 Records and documentation B.7 Case consultation |
Professional responsibility |
C. 1 Knowledge of and compliance with standards C.2 Professional competence C.3 Advertising and soliciting clients C.4 Professional qualifications C.5 Nondiscrimination C.6 Public responsibility C.7 Treatment modalities |
Relationships with other professionals |
C. 8 Responsibility to other professionals D. 1 Relationships with colleagues, employers, and employees D.2 Provision of consultation services |
Evaluation, assessment, and interpretation |
E.l General E.2 Competence to use and interpret assessment instruments E.3 Informed consent in assessment E.4 Release of data to qualified personnel E.5 Diagnosis of mental disorders E.6 Instrument selection E.7 Conditions of assessment administration E.8 Multicultural issues/diversity in assessment E.9 Scoring and interpretation of assessment E.10 Assessment security E. 11 Obsolete assessment and outdated results E.l2 Assessment construction E. 13 Forensic evaluation: evaluation for legal proceedings |
Supervision, training, and teaching |
F. 1 Counselor supervision and client welfare F.2 Counselor supervision competence F.3 Supervisory relationship F.4 Supervisor responsibilities F.5 Student and supervisee responsibilities F.6 Counseling supervision evaluation, remediation, and endorsement F.7 Responsibilities of counselor educators F.8 Student welfare F.9 Evaluation and remediation F. 10 Roles and relationships between counselor educators and students F. 11 Multicultural/diversity competence in counselor education and training programs |
Research and publication |
G. 1 Research responsibilities G.2 Rights of research participants |
32 Guidebooks and Recommendations
Table 3.5 Cont.
Section |
Standard |
G.3 Managing and maintaining boundaries G.4 Reporting results G.5 Publication and presentations |
|
Distance counseling, technology', and social media |
H.l Knowledge and legal considerations H.2 Informed consent and security H.3 Client verification H.4 Distance counseling relationship H.5 Records and web maintenance H.6 Social media |
Resolving ethical issues |
|
Source: (АСА, 2014).
Note: * Information is a summary
Table 3.6 American Psychiatric Association's Telepsychiatry Toolkit*
Section |
Standard |
History and background |
History of telepsychiatry Advocacy issues Clinical outcomes Evidence base Feasibility and effectiveness Return on investment |
Training |
Adapting your practice, learning to do telemental health Credentialing process Media communication skills Style adaption Working with residents |
Legal and reimbursement issues |
Malpractice issues Medicaid reimbursement Private insurance reimbursement Ryan Haight Act State licensure |
Technical considerations |
Platform and software requirements Security issues Telepsychiatry and integration with other technologies |
Practice and clinical issues |
Child and adolescent telepsychiatry Clinical documentation Clinical and therapeutic modalities Geriatric telepsychiatry Individual models of care Inpatient telepsychiatry Patient safety and emergency management |
Table 3.6 Cont.
Section |
Standard |
Rural and remote practice settings Standard of care and state-based regulations Telepsychiatry practice guidelines Team-based integrated care Team-based models of care Use of telepsychiatry in cross-cultural settings Visual and nonverbal considerations |
Source: American Psychiatric Association (n.d.). Note: * Information is a summary.
Table 3.7 Overlap of primary ethical principles in mental health-focused guides related to telehealth practices*
Primary principle |
A PA |
АСА |
NASW. ASWB. CS WE. & CSWA |
NASP |
American Psychiatric Association |
Ensure competence related to technologies and its impacts on care |
X |
X |
X |
X |
X |
Uphold ethical standards |
X |
X |
X |
X |
X |
Informed consenting practices |
X |
X |
X |
X |
X |
Administrative and documentation practices |
X |
X |
X |
X |
X |
Confidentiality and privacy practices |
X |
X |
X |
X |
X |
Data security |
X |
X |
X |
X |
X |
Data and hardware disposal |
X |
X |
X |
X |
|
Intervention considerations |
X |
X |
X |
X |
X |
Assessment considerations |
X |
X |
X |
X |
X |
Knowledge of relevant laws and standards including licensure standards |
X |
X |
X |
X |
X |
Ensure ongoing professional development |
X |
X |
X |
X |
34 Guidebooks and Recommendations Table 3.7 Cont.
Primary principle |
A PA |
АСА |
NASW, ASWB. CSWE. & CSWA |
NASP |
American Psychiatric Association |
Seek training, consultation, and supervision for new competencies |
X |
X |
X |
X |
|
Representation of provider’s self to public |
X |
X |
|||
Social media use |
X |
X |
X |
X |
|
Conducting research |
X |
Note: * Direct highlighting of topic in documentation.
and disability statuses; means of fostering a strong therapeutic alliance; differences in the application of technology-enhanced techniques as they compare to F2F care; and means of both preventing and addressing challenges, including emergency situations. Beyond these primary foci, part of this gained competency is also a recognition of one’s boundaries of competence. Providers must reflect on their knowledge, realizing that rapid changes may quickly make their knowledge outdated. Further, while some providers may be adept at specific aspects of technology-based care, they may not be as knowledgeable on others.