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Distance Counseling Options and Informed Consent

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Traditionally, students expect face-to-face counseling within an office setting. Yet, students who are taking the majority of their classes on-line or find travel within conventional business hours difficult, distance counseling may provide a valuable option. We offer counseling through secure technology-assisted means known as Telemental Health. This allows counseling to be provided through Doxy-me, secure email, or telephone. Although we prefer to see students face to face to facilitate trust and rapport building, distance counseling can be quite effective for those who are homebound, taking online courses only, or who live a considerable distance from campus. For students who struggle with disclosure concerns, distance counseling may help students talk about difficult issues with a degree of anonymity.

Telemental Health is defined as follows:“Telemental Health means the mode of delivering services via technology-assisted media, such as but not limited to, a telephone, video, internet, a smartphone, tablet, PC desktop system or other electronic means using appropriate encryption technology for electronic health information. Telemental Health facilitates client self-management and support for clients and includes synchronous interactions and asynchronous store and forward transfers.” (Georgia Code 135-11-.01)

Telemental Health is a relatively new concept despite the fact that many counselors have been using technology-assisted media for years. Additionally, there are several other factors that need to be considered regarding the delivery of Telemental Health services in order to provide you with the highest level of care. Therefore, our counselors have completed specialized training in Telemental Health. We have also developed several policies and protective measures to assure your information remains confidential.

The Different Forms of Technology-Assisted Media Explained

Landline and Cell Phones:
It is important for you to know that telephones may not be completely secure and confidential. There is a possibility that someone could overhear or even intercept your conversations with special technology. Be aware that individuals who have access to your phone or your phone bill may be able to see who you have talked to, who initiated that call, how long the conversation was, and where each party was located when that call occurred. If this is a problem, please let your counselor know, and you she will be glad to discuss options.

Email:
Email is not a secure means of communication and may compromise your confidentiality. However, we realize that many people prefer to email because it is a quick way to convey information. Nonetheless, please know that it is our policy to utilize this means of communication strictly for appointment confirmations and/or rescheduling. Please do not bring up any counseling content via email to prevent compromising your confidentiality. You also need to know that we are required to keep a copy or summary of all emails as part of your clinical record that address anything related to therapy. With your permission and without breaching confidentiality, we can send psychoeducational material to you as email communication or attachment.

We also strongly suggest that you only communicate through a device that you know is safe and technologically secure (e.g., has a firewall, anti-virus software installed, is password protected, not accessing the internet through a public wireless network, etc.). If you are in a crisis, please do not communicate this via email because we may not see it in a timely manner. Instead, please see below under “Emergency Procedures.”

Electronic Record Storage

Your communications with us will become part of a clinical record of treatment, and it is referred to as Protected Health Information (PHI). Your PHI will be stored electronically with Titanium a secure storage company which is HIPAA-compliant.

Your Responsibilities for Confidentiality & Telemental Health

Please communicate only through devices that you know are secure as described above. It is also your responsibility to choose a secure location to interact with technology-assisted media and to be aware that family, friends, employers, co-workers, strangers, and hackers could either overhear your communications or have access to the technology that you are interacting with. Additionally, you agree not to record any Telemental Health sessions.

Communication Response Time

We are required to make sure that you’re aware that we are located in Georgia and we abide by Eastern Standard Time. Due to law, we can only provide services to students who are physically in Georgia at the time of sessions. Our practice is considered to be an outpatient facility, and we are set up to accommodate individuals who are reasonably safe and resourceful. We are not available at all times and not available after 5:30 pm or on weekends. If at any time this does not feel like sufficient support, please inform your counselor, and she can discuss additional resources or transfer your case to a counselor or clinic with 24-hour availability. We will return phone calls, emails or secure messages within 24 hours. However, we do not return any form of communication on weekends or holidays. If you are having a mental health emergency and need immediate assistance, please follow the instructions below.

In Case of an Emergency

If you have a mental health emergency, we encourage you do one or more of the following:

In Case of Technology Failure

During a Telemental Health session, you and your counselor could encounter a technological failure. The most reliable backup plan is for the counselor to return to the session via phone. Please make sure you have a phone with you, and your counselor has that phone number.
If you and your counselor get disconnected from a video conferencing session, end and restart the session. If you are unable to reconnect within ten minutes, your counselor will call the phone number you designated in the Consent to Inform.

Limitations of Telemental Health Therapy Services

Telemental Health services are an alternative form of therapy, and involve limitations. Primarily, there is a risk of misunderstanding one another when communication lacks visual or auditory cues. For example, if video quality is lacking for some reason, your counselor might not see you tear up. Or, if audio quality is lacking, he or she might not hear the crack in your voice that he or she could have easily picked up if you were in our office. In addition, not all non-verbal cues are visible.

There may also be a disruption to the service (e.g., phone gets cut off, a cell phone battery loses power, or video drops). This can be frustrating and interrupt the normal flow of personal interaction.

Please know that we have the utmost respect and positive regard for you and your well-being. We would never do or say anything intentionally to hurt you in any way, and we strongly encourage you to let your counselor know if something she has done or said upset you. We invite you to keep the communication with your counselor open at all times to reduce any possible harm.

Consent to Telemental Health Services

Please review the Telemental Health services you considering. You and your counselor will ultimately determine which modes of communication are best for you. You may withdraw your authorization to use any of these services at any time during the course of your treatment just by notifying us in writing. We will let you know if our distance counseling practices are expanded.

  • Email
  • Doxy-me Video
  • Cell or Landline Phone

In summary, technology is constantly changing, and there are implications to all of the above that we may not realize at this time. Feel free to ask questions, and please know that we are open to any feelings or thoughts you have about these and other modalities of communication and treatment.

Please refer to the Informed Consent document. You will be asked electronically sign your name indicating that you have read and understand the contents of this form, you agree to these policies, and you are authorizing us to utilize the Telemental Health methods discussed. You will also be asked to provide your phone number, your physical address, a contact name and number in the event we feel you might be of danger to yourself or others. Additionally, if you are under the age of 18, we request that you get consent for counseling from your parent(s) or guardian.

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