Communication

Informed consent regarding communication should be viewed as especially important in order to maintain appropriate boundaries and professionalism (Drum & Littleton, 2014; Huggins, 2016; Luxton et al., 2016, chap. 3). As boundaries are key to effective practice, the patient must understand that merely because the provider is more readily available via telepsychology modalities (e.g., videoconferencing, telephone, email, messaging), does not necessarily mean that the provider is available to them at any moment. For example, while the videoconferencing sessions can be completed outside of the provider’s usual business hours since they can conduct it from their home, does not mean that the provider should or will engage in such activities. Due to this, establishing hours of work, and the average turnaround time for communications can help clarify practices for the patient. In doing so, the provider may indicate that they will return all communications within a set amount of time as long as they are not on vacation, ill, or managing a crisis situation of another patient. Further, the provider can indicate that they may only answer messages within normal business hours for their practice. However, to plan for crises, the provider should outline how the patient can contact them outside of normal business hours, as well as what methods of communication may be appropriate or inappropriate for any correspondences. For example, the provider should include stipulations in the informed consent forms regarding what types of information is appropriate for email or texting, if those services are allowed for between-session communication. The forms can clearly indicate that if a patient is experiencing serious issues that do not warrant higher-level care through an emergency department (e.g., benign suicidal or homicidal ideation), a telephone or video call is necessary, with delayed messaging (e.g., email, texting) being inappropriate due to the need for a more immediate response. While some may merely choose to restrict usage of asynchronous modalities altogether, for those providers that allow use, the patient should be made aware that such messages are often not immediate and may either be delayed or not sent at all. As such, in addition to the provider’s indication of a standard response time for communications, they should include a statement that if a patient does not hear back by a certain time, they are suggested to follow-up with a second message, potentially through a synchronous method.