Ethical Standards Compliance of Internet Counseling Sites - Research Paper Example

? Ethical Standards Compliance of Internet Counseling Sites For many people, the internet is a source of information and self-help ideas concerning issues of physical and mental health, they look up problem and obtain solutions to most simple problems although it is advisable to consult a doctor before attempting some of the cures suggested online. However, there is an emerging trend where individuals use the internet to access psychiatric help commonly referred to as E-therapy or online counseling in which one gets treatment from a therapist through the internet through a variety of means such as video chat, text or voice chat (Ainsworth, 2004). One of the dominant arguments in favor of E-Therapy is that treatment for mental problems can be supplied without geopolitical constraints. This new trend however raises several issues especially legal and ethical ones, for example, when a therapist is treating a patient who is in different country, should they not be registered in that country first? Furthermore, if there violations or disagreements between patient and therapist, what body has the jurisdiction to mediate especially if the patient and therapist are in different countries or states (Corey, Corey, & Callahan, 2010). Cyberspace presents a whole new set of ethical issues that need to be addressed especially confidentiality since one cannot be sure that software or media used to contract the therapist will be safe from third party access, in addition the therapist could end up treating the patient without and effective diagnosis in the absence of a face to face interview. Furthermore, this sort of therapy does not guarantee continuity since network or hardware issues may temporarily cause termination of therapy for long periods, which may put the patient at risk. NBCC standards for online counseling NBCC takes cognizance of the practice of the Web Counseling, which it defines as professional counseling, and delivery of information through electronic means to bridge geographical separation between the patient and therapist. NBCC expects therapist to adhere to its code but also provides another code customized to cover the unique circumstances that arise in online counseling (NBCC 2012). Some of the major requirements of these codes of ethics include that the clients should be informed specifically of the modes of encryption used to secure their personal data as well as how long this information will be stored. The site should register with a licensing body and NBCC so that they can verify the identity of the therapist as well as ascertain their professional qualifications moreover; the procedure for contacting the therapist while they are offline should be clearly stated (Heinlen et al., 2003). Additionally, in case of failure of technology such a video calls in the middle of therapy the online therapist should have a contingency to mitigate any potential negative effects that may result. Clients should also be made aware of what should be done to cope with issues resulting from misunderstandings owing to lack or visual cues and between them and the therapist. Five online therapy sites One of the sites examined for the compilation of this paper is serenity online therapy (http://serenityonlinetherapy.com/onlinetherapy.htm), the site primarily uses three methods of therapy. These include real time therapy through Skype in a private chat room, then there is email counseling, which involves the delayed feedback, and interaction by sending email, and finally a patient can choose to combine both. The site provides objective advice for patients before they engage in therapy and informs them of the situation when it is appropriate or inappropriate for them to use online therapy. For example, it categorically states that patients who are experiencing violent and suicidal tendencies should not use online therapy, this way the site provides information beforehand. This is in line with NBCC’s ethical requirements that clients should be informed about the potential consequences and risks that can result from the therapy to shall inform clients of the purposes, goals, procedures, limitations, potential risks and benefits of services. In addition, the NCC counselors are expected to ensure they uphold the patient’s confidentiality (NBCC 2012). From the information of the sites confidentiality tab, it is evident that they conform to the requirements for privacy as they only use encrypted channels to conduct therapy, the encryptions may vary and patients get information about the once they are have agreed commit to therapy. The fact that the therapists use can use email exclusively as a means of therapy raises the ethical issue of effectiveness since email, without face-to-face conversation may lead to misinterpretation. Moreover, the therapist can make recommendations based on misunderstanding resulting to possibly harming the patient, which is direct contravention of the ethical requirement that the therapist shall aspire to do no harm. The second online counseling site is sunrise services operated by Reverend Sutton who engages in Christian oriented counseling (http://sunrisecounselling.com/Confidentiality.html). She is evidently qualified to practice as she has testimonial of her academic qualification and she has provided the potential client with contact of her alma mater to verify her qualifications. She is also in compliance with confidentially requirements since her emails and all files regarding to patient information are encrypted. She however makes it clear that there are exemptions to privacy especially when the abuse of minor or potentially harmful behavior to the patient or self is involved; these exemptions are however in line with the NBCC code of ethics. She has provided information concerning client’s rights and freedom in matters such as billing termination and the involving of third parties in therapy. Notwithstanding, the fact that one can access her services from anywhere in the world brings up a legal and ethical issues, although she is registered with the “International Society for Mental Health Online” the body is not universally recognized. Therefore, if a patient from a country that is not a member was to use her services, he/she would be basically getting the services of an unlicensed therapist, at least in their particular country. The panic anxiety and stress therapy society is the third online counseling site, (http://www.passn.com/), a team of highly trained psychologist operates it, all of them are licensed and the site is registered under the international society for mental health online. Their services are offered through video chat and like the other sites they promise confidentiality through encryption or all correspondence as well as not sharing the information with third parties. From an overview of their policies and their details on the site there are no outward ethical issues save for the fact that they do not restrict patients based on nationality meaning they can also potentially attend to patients in areas where they are not licensed to practice. Robert Morse E-therapy is the fourth site, which offers counseling for a wide range of mental problems inclusive of by not limited to m schizophrenia, depression and anger management (https://rmetherapy.com/). The site uses either video email service, in which the therapist send the client a video responding to their problems or live chat and/or therapy by phone, the confidentiality agreement promises to uphold clients privacy and the therapist is qualified so patients re in no danger of receiving sub-standard care. An ethical issue, which however emerges, is the provision for abruptly termination of therapy except if it is voice video, which is more expensive 24 hours after it has commenced. This could be harmful to clients since the use of the word abrupt does not imply that the therapist needs to inform the patient in advance or even explain their reasons for termination. From an ethical perspective, this is wrong since the patient has the right to be kept abreast or all developments in their therapy and they should have a say in as to whether they deserve a refund or not after termination. Furthermore, terminating therapy abruptly is likely to cause the patient psychological harm since it would make them feel rejected. The final site examined is the AASHYEN which uses email and secure chat to counsel people from all over the world and assist them in dealing with stressful issues such as divorce, breakups, to gain assertiveness and others, policy on patient confidentiality is enhanced by the fact that they are willing to operate in anonymity (http://www.onlinecounselling4u.com/). This could however result in sacrificing efficacy at the expense of security since the patient may not open up very well to a therapist if they see them as a stranger and cannot even use their real name. The site is explicit in that they do not handle matters of suicide or other elements of immediate danger to the patient or their society such as violent tendencies and they advise such patients to get a physical therapist. This is line with medial ethics since such situations cannot be remedied by remote therapy and taking on such patients may result in escalation of the problem and the patient may end up harming him/self or others. However, it appears that all the sites including this one that provide professional services are potentially in breach of legal and ethical codes since by availing their services on an international scale, they risk giving therapy in areas where they are not licensed to practice and therefore they cannot be legally take responsibly for their therapy. Coaching vs. counseling Another emerging trend in therapy is coaching which is however sometimes confused with counseling; the primary difference between the two is that in coaching the therapist tries to improve on non-medical issues such as career wealth attainment social interaction and so on. Conversely, in counseling, the underlying motive has to do with diagnosis and treatment of mental disorders, coaches strive to motivate clients (not patients) make their life goals and strive to achieve them by preparing a strategic plan. Like therapy, coaching can also be offered online to those wishing to improve their physical intellectual or social abilities, while it can be offered by trained therapists, one does not require any specific qualifications in as far as academics are concerned to qualify as a coach. References Ainsworth, M. (2004). E-therapy: History and survey. Retrieved from http://www.metanoia.org/imhs/history.htm Corey, G., Corey, M.S., & Callahan, P. (2010). Issues and ethics in the helping professions. Belmont, CA: Brooks Cole Heinlen, K. T., Elizabeth, R. W., Richmond, E. N., & Rak, C. F. (2003). The scope of WebCounseling: A survey of services and compliance with NBCC standards for the ethical practice of WebCounseling. Journal of Counseling and Development : JCD, 81(1), 61-69. London, M. (2010). Ethical & Legal Considerations of Online Counseling are Ongoing. Online therapy institute. Retrieved November 16, 2013, from http://www.onlinetherapyinstitute.com/wp-content/uploads/2010/02/earmay10OTI.pdf National Board for Certified Counselors. National Board for Certified Counselors (NBCC) Code of Ethics” (2012). Retrieved November 16, 2013, from http://www.nbcc.org/assets/ethics/nbcc-codeofethics.pdf Read More