Legal, Jurisdictional and Ethical Issues
There are considerable legal, jurisdictional and ethical issues in providing therapy via the Internet. For instance, how to abide by state laws governing mental-health service practices and insurance. Therapists must be licensed in every state in which they practice and, since most mental-health professionals are licensed only by the state in which they reside, counseling an online client who resides elsewhere might be construed as practicing without a license--and breaking the law. Additionally, while most malpractice-insurance providers don’t specifically ban online therapy, their coverage is contingent on adherence to state licensing laws. The risks of using an out-of-state therapist may pale compared with the risk of using an unlicensed therapist.
At this time, there is no governing body that can monitor the quality of care provided online, or the competency of the professionals providing treatment. The ethics department for the American Psychological Association constantly gets a great number of calls from people who are thinking of online therapy--calls from therapists who are contemplating offering the service, as well as from consumers who are wondering about how effective and how ethical online therapy is. They ask “incredibly thoughtful and complicated questions that we simply don’t have answers to.”
In an effort to try to limit legal and ethical constraints, some online therapists offer a disclaimer in which they refer to the services they provide as “psychoeducational” in nature. Such disclaimers should not be viewed as offering blanket protection in the United States, however, since courts and state regulators do not look to the defining words of the therapist when determining whether or not a therapeutic relationship has been created, but instead look to the reasonable expectations of the client. It could be very difficult in court to disavow the therapeutic intent or impact of online “psychoeducational” interventions, and the distinction between “advice” and “directive psychotherapy” may be very difficult to determine.
At this time, there is no governing body that can monitor the quality of care provided online, or the competency of the professionals providing treatment. The ethics department for the American Psychological Association constantly gets a great number of calls from people who are thinking of online therapy--calls from therapists who are contemplating offering the service, as well as from consumers who are wondering about how effective and how ethical online therapy is. They ask “incredibly thoughtful and complicated questions that we simply don’t have answers to.”
In an effort to try to limit legal and ethical constraints, some online therapists offer a disclaimer in which they refer to the services they provide as “psychoeducational” in nature. Such disclaimers should not be viewed as offering blanket protection in the United States, however, since courts and state regulators do not look to the defining words of the therapist when determining whether or not a therapeutic relationship has been created, but instead look to the reasonable expectations of the client. It could be very difficult in court to disavow the therapeutic intent or impact of online “psychoeducational” interventions, and the distinction between “advice” and “directive psychotherapy” may be very difficult to determine.
