New Zealand Model of Internet Guidelines

8/3/2019 New Zealand Model of Internet Guidelines

1/15

NE WZEALAND- .. :..:IPSYCHOTOCISTSBOARD

PSYCHOLOGISTSOARDDiscussionoper owordsdevelopingguidelines:Psychology ervicesdeliveredvio the interneftFebruory2011Whymight we needguidelines on this topic?"Behoviourolteleheolthso ropidlyevolving ield hat offers reol promise nd roises ignificontrisk".2 he opidgrowthof lelecommunicolionsnd occess o these echnologi es rechonging he woyspeople communicoleond inleroct, ncluding he delivery f professionolpsychology ervices.Th eBoord'sCode of ElhicsstheCode) ond the CoreCompelenciesatheCompefencies)provide he oundolionsor his ocument. nyguidel ineshol moy subsequent lye publishedwould be supplementoryo thoseprimory ocuments.n he event of ony opporenidiscreponcy etweensuchguidelines nd the Code or Competenciesn rodilionolmodesofprofessionolctivity, he Code ond lh e usuol tondords f compelencewould okepreceoence.In developingguidelineshe Boordwouldwont lo ochieve he following bjectives:

. Toolertoll psychologistso the possible cenorios enerotedby technologicolodvonces nd chonging otterns f communicot ionn sociely.. To oise woreness iih regord o lhe ethicolchollengeshot moy be posedby thesecommunicotion orms, swell os he opportunitieseneroted.. Toexpond horizons f prociice o includewhol moy be preferred ommunicotionmedio or someclienls,whileolsomiiigoting ny odditionol iskshol moy opply.. To provideo regulotoryromeworko ensure of eprociicewhile he reseorch videncefor he efficocyof inlerventionselivered io he internet vo lves nd consolidoies.. To meet tsslolutory bligotion f ossuringhe publicof sofeproctice.

A coulionorynole:Any guidelineshe Boordmightpublishwould qddress he risks oisedby theuse of lhe inlernel o deliverpsychologicolservices. heBoorddoes nol inlend o condone orencouroge he use of such echnologieso deliverservicesos n focl ils posilion sone ofproceedingcouliously,given he relolive ock of reseorchevidence on lhe efficocy of someservices.A fundomentolprinciple s hof ony psychologicolservicedeliveredvio lhe internelshouldmeel lhe equivolenlsfondordsof core oswould be provided n o foce-lo-foce consullotion.Psychologistsrociisingvio lhe inlernelmusl uphold he requiredstondordsof compelenceond conducl os expecled in olher ormsof servicedelivery, ncludingociing in occordoncewith the Code of Elhicsond toking professionol ork o supervision.f the quolityof core is ikelylo be compromisedby the deliverymedium, hen he proclilioner s urged o reconsider heI ThePsychologistsoordopproved thisdiscussionoper fo r publicotion n Februory 01 . lt will be re visiiedoter n the yeor fo rconsiderotionor reworking s bestproctice guidelines.2Koocher,G. ond Morroy,E..2000, egulotion f Telepsychology: Survey f StoteAttorneysGenerol.ProfessionolPsychology: eseorch nd Proctice, ol 31,No 5 , 503508 poge 507)3Code of Ethics or Psychologistsorking n Aoteoroo/ New Zeolond, 002I Core Competencies or h e Procticeof Psychologyn New Zeolond, uly2O0B


2/15

wisdom of delivering services vio lhis melhod. Theseguidelines opply io oll slreoms ofprofessionol psychologicql services.What servieeswould theseguidelines address?Theguidelines ould refer o ony type of professionolsychology ervice hot mokesuseofonl ine echnologieso connectpsychologistsnd their cluolor polent iol ew cl ienls.Psychologicolctivitymoy nclude bu t snot imiied o) interoction s on odjunct o otherfoce-lo-focework,stondolone ontocl, online esting, oreercounselling,he provision finformoiion r other esources,dvisory ervices r reseorch.i moy nclude he developmentof resourcesor clienis o work hroughonline-self-helprogrommes, ith or without hepsychologisl'sirect nvolvemenl.Psychologicolervices oy usecompuiers,opiops,mobilephones, ideo comero ive eedond hond helddevices s he medium f communicot ion.he ommunicot ion oy beunilolerol r bidirectionol nd mov occurvio:r Emoil.r Texting.. Videoclips.. Messogingsynchronousr osynchronous). Chotrooms.. Onlinemessoge oords.. Onlinephonesystemswithor wilhoutcomerolor voiceoptions uchos Skype r

Oovoo).Theuseof online echnologies rovideslexible nd chongingcommunicotion othwoys.Scenorios oy nclude bu l or e not restricted o):

. Contoci by emoilor texl to moke oppoinlments r to co nveybriefmessoges.. Onlineossisted roclice,e.9.,using nline echnologieso focilitote nd support oce-to-foceprocticesuchos clientschecking n' vio extor sending n emoilof support rto reinforce o mework.. Onlineossessmenlnd consullotion sport of on orgonisolionolsychology ervice.. Professionolounsellingelolionshipsith clientsmoy slorfonlineon d then shifi o foce-lo-foce. A clienlmoy be onlineexclusivelyor some ime before h ey con feelcomfortobleenough o come to o foce-to-focemeeting.Fo rexomple, ne proctitionerwho workswith clientswho hove difficulties ith childpornogrophy oted hot oflenself-referringlienlswillwonl lo oskquestions nlinebeforedropping heirononymity ocome to o sessionn person.. Professionolounsellingelolionshipsith clients sloblished y foce-to-foceconloctmoy be supporiedor coniinuedwilh online essions,uchoswith peoplewho trovelfrequently r hove heolth ssuesho t prevenl hem coming o foce-lo-focesession n oraar r lnr hncic. Professionolounsellingelotionshipsith clienlshot sioyonlineexclusivelynevermeetfoce-to-foce).

A psychologist'snvolvemenln groupcommunicotions oses dditionolelhicolchollenges.The onge of servicesho t moy be offered ncludesnternet-bqsed nlinegroups uchosbulletin oords, hot roomsupport roups, nd newsond discussionroups.Suchgroupsmoyhove on "osk-the-expert"imension. hepsychologist oy hove o roleof initioting group, orexomple, or supportpurposes, ul ihen hol groupconiinuesndependenily.n eochcircumstoncehe psychologisthould eclore heir ole,on d the imiis f thol role, o corefullymonoge expectotions.Professionolervicesnvolvepurposeful nd directedcontoct betweeno psychologistnd oclientor potenliolclient or he objectiveof mokingon oppoinlmenl,delivering n intervention,under ioking n ossessmentr engogingn o consultot ion.his xcludes logging nd sociolnetworking hereone of the portiesnvolved oppens o be o psychologist.hese uidelinesolsowould not oddress nli ne ervices hich ore relotivelympersonol ut moy ncludeossessmenind odvice of o psychologicol oturesuchos websiies ffering heseopportunilies.


3/15

SectionA: Regulatory ssuesPsychologicolervices elivered io the nternet oseodditionol hollengeso the regulotorbecouseof the need to clorifyurisdiction,he odditionol iskshol moy orise romdeliveringservices io thismode,on d becouseof the lock of reseorch n efficocy.These re consideredseporotely.1. Telepsychologymay be practisedwhilenot being n the samegeographical reaor countryas the client.o) Protection f the title "psychologist"TheHeolthProctilioners ompetenceAssuronce ct 2003 theAct) slotes hoi o proctitionermoy represent im-or herself s o psychologisl nl y f registeredn New Zeolond, ut thiswouldbe difficuli o monitoror opply o overseos osedservice roviders ho or e orgetingNewZeolonders nline.TheAc t is ntended o opply o proclitioners ho proctisen New Zeolond,but section7 of the CrimesAct l96l5slotes hot for he purposes f urisdiciion, hereony octor omissionormingporl of ony offence,or ony eveni necessoryo the complelionof onyoffence,occurs n New Zeolond, he offenceshollbe deemed to hove been commilted nNew Zeolond,wheiher he person horgedwilh the offencewos n New Zeolondor no t of thetime of ihe oc t, omission,r event.

b) New Zeolond egisieredpsychologislsworking n cyberspoceEthicolly, ny NewZeolond egistered sychologist ho wisheso workvio he internet houldregistern ony urisdictionro mwhich hey recruit l ients.f yo uenter he stoteor counlryvi otechnology, ou moy be deemed to be proctisingn thot couniry.Psychologislsho or eregisteredn New Zeolondwh o proctisewilh clients nlineore odvised o ensure hey reseorchthe legol ond regulotory bligoti ons f thot geogrophicol ocoiionprior o occepling clientsfrom ho t locolion.Althought s ikelyhot he HPCA ct con onlybe opplied o prolect he "public" persons)nNewZeolond, nder ect ions ond 8 of the HPCA ci i f o proct i t ionersbosed n NewZeolondond cloims o be o psychologisl ble ond enlitled o proctisen New Zeolond notwithstondingthot theirproposed lientelemoy be bosed overseos)hen hismoy be sufficiento supportchorgesunder he Act (unlesshe proclitioner osexpresslytoted hot the offerof servicesnol ovoiloble o New Zeolond esidents r citizens nd doesnot ntentionolly ondleony offeror provideony service).c) Overseospsychologislsworking with clienls n New ZeolondAny overseos sychologist ho knowingly ets ut to proctisen New Zeolond hould egislernNew Zeolondprior o commencing hot prociice.Anypsychologicol ervice elivered ocl ienls ho ore n NewZeolondsdeemed o b e "proct is ingn NewZeolond" nder he HPCAAct, which regulotes roctitionerso ochieve he objecliveof sofeguordinghe New Zeolondpublic.However n prociice hi swouldbe difficult o monitor nd enforce. lt spossiblehol oproviderworkingonlinemoy nol know he geogrophicol ocotionof o clienl.d) Deolingwithcomploinlsorising rom onlinepsychologicolservicesA service eliveredover he nternet oiseshe possibilityf o complointoccurring n oneiurisdiclion ut beingheord n onother. nmony urisdiclionshen o comploi nt smode it s heploceof residence f the cl ient hot sossumedo be the ur isdict ionhol oppl ies, nd t sogoinsthose tondords nd egolobl igot ionshot he proct i t ioner 'sroct icewouldbemeosureo.Whereo comploinont esides eyond New Zeolond's orders, New Zeolondprcctilionermoybe exposed o rules nd regulotionsmposed n thot oiher urisdiction. hether r not holwouldhoveconsequences ithinNewZeolond oulddependon he legol elol ionshipsSectlon of the Summory roceedings ct ensuresho t sections - 7 of the Crimes ct opply o the offenceprovisionsnder heHPCAAct.


4/15

belween New Zeolondond lhe othercountry. heNew Zeolondproctilionermoy olsobeoffected f rovelling o iho t country.Accordingly, snoted obove, New Zeolondprociitionersshould cquoint hemselves ith he requirementsf olhercountries eforedelivering ervicesthere.Comploints bout o New Zeolond e gisiered sychologisi ho isproctisinghrough he nternetmoy be referred o the New ZeolondPsychologistsoord rom onother urisdiclion. nyossessmentf thot psychologist 'sompetence nd conductcouldbe undertoken y theBoordon d itsogents, uchos o ProfessionolonductCommittee PCC).Communicoiionwiththe comploinont ouldbe conducted io echnology.In New Zeolond he Boordcon onlyoccept o comploint f l concerns psychologist ho is orwos of the relevoni ime)on itsRegister,hereos he Heolthon d Disobility ommissionerouldlookof o comploint romo non-registeredrofessionol.As other urisdiciionsre chollengedby the someethicolon d reguloloryssuesoisedby theuseof the inlernel o deliver sychologicol ervices,n ime here moy be 'memorondum funderstonding'MOU) evelopedbetweensimilorurisdictionso monoge his ssue. heBoordcould nitioteMOUswith oiherpsychologyegulotory uthoritieso hot psychologistsorkingocrossurisdiclionson be heldoccounloble or heirproclice.Fo rexomple, he New ZeolondPsychologistsoordcould receiveo comploinl romo New Zeolond lientobout o foreign-bosedproctitioner nd followogreed protocolsn colloboroting ith hot proctitioner'sregislering ody to processhe comploint n he psychologist'surisdiciion. ilhouisuchonMO U he Boordmoy hqve no, or imiled, biliiy o receiveond oct on ony comploints y oNew Zeolond lieniogoinsto foreignpsychologisl.

2. s therea role or the Internet n the professional racticeofpsychology?Perceived benefitsAdvocotes of the use of th e computer delivered psychologicol servicesemphosise poientiolbenefiis.Online servicesmo y offer:

l . Increosedoccess or both c l ien lsond psychologis is,ncluding. servingpeople with lessmobility.. those in remote or rurol oreos or who hove reloc oted io onother counlry wherethere ore longuoge or culturolborriers.. lhose wh o ore disobled physicollyor psychologicolly (e.9.,sociol phobios).. informol coregivers, .e., coretokers of ihose fomily members who requireextroordinorysupport ond cor e through disobil ity, l lness r dementio.. giving more choice of psychologist or those in oreos with few services, ndincreosing he ovoilobil i lyof speciolisedservices.. providing increosed occess for t ime reslrictedpeople wh o connot eosilycome to oiypicol doy lime proctice, e.9., shiftworkers,people without reody childcore.o th e ovoilobil ityon d convenience of being oble to send ond receive messogesotony t ime of the doy or nighl.. providing increosed occess to ihose who wont lo opprooc h for help (o r enquire)but ore to o emborrossed or troumotised to do so in person,or who feel usingpsychologicol services ssligmotising.2. Reduced relionce on leoving messogeswith intermediories, oicem oil or ploying"telephone tog" .3. A theropeutic octivity for those wh o experience lh e processof writ ing os helpful.The octof writ ing mcy enhonce self-reflection y ollowing opportunit ies or review of whot ho sbeen written ond therebv increose he ownership of issues.


5/15

4. A recordof communicotionso refer o loter.5. Discrete ccess o odvisory nd ossessmentervicesor coreerdevelopmentpurposes.6. A servicewhich someclienls eel s essnhibitinghon in person.7. Enhonced l ient utonomy y ncreosinghoiceond control. or ome he nternetrelotionship oy reduce he powerdifference etweenclientond psychologist.8. A form of communicotionwhich s ess mbiguous r confusedby porolinguisticue s(such s body onguoge, ccent or physicol ppeoronce) nd thereforemoy be omorecleorwoy of communicotingnformotion.9. Morecullurolly ppropriote ervicesor somegroups n society, .9.,gomers, eoplewho use he nlernel lot , echnologicol lydvoncedpeople,peoplewho work n hetechnology ndusiry.t couldolsobe moreollroctive or somegroups uchos eenogerswho ore very omilior nd comfortoblewiih communicotion io the nlernel.,l0. Eosier ccess o supplementorynformotion nd resourcemoteriol.I l. Focilitotion f supervisorynd educotionolopportunities.PolenlioldsksPotentiol isksmoy orisewilh regord o:l . Assessmenl. The eductionof informolion uchos he lockof non-verbols oy eod toimportont uesbeing missed, r he reol ssues vodingossessmenl.ideo inksmoy help ncreose he informotion voiloblebu t constroints n observoii onsmoy remoin.

. Thegreotererrormorginond lock of physicol ue smoy meon o confidentdiognosisonnotbe mode or dif ferent ioliognosesonnotbe el iminoted.2. Miscommunicol ionnd misunderstonding. Emoils nd textsmoy be more ikeposlcordshon elters, nd moy hereforeincreose he polentiol or misunderslonding.. The educed opportunily or spontoneous lorificotionmoy further eighten hisrisk, orticulorlyor hoseclientswith pooreg o strenglh,hosewithself-esteemissues r hosewith ooronoid endencies.. Cross ullurol ommunicolionmoy ncreose he risk f misunderstonding.f olheropyprocesss ikelyo significontlyompromisehe client'sneeds t moy bebeller to nol storton the engogemenl.Similorlyf on ossessmentr consultoiionof on industriol-orgonisotionolsychology oiureneedscoreful nterpretotion rsignificoni onsequencesmoy orise, ore o mitigotesuch isk hould eexercised.3. Boundoryssues. The educedcuesmoy ncreosehe ikel ihoodf the cl ient mposingontosy rlronsference n to o lheropeutic elotionship.hi smoy requireodditionol kill nlhe port of the psychologisto oddresshese ss ues nd to moinloin heropeulicboundories.. Extro ore moy be needed to mointoin leorond predictobleboundorieso lhetheropeuiic elotionship.. Texting nd emoil esponses oy elicit essormolond shortened xpressi onswhich moy corryo risk f erodingboundories.. Clientsmoy be moreprone o "overdisclose", s he normolchecksondbolonces n orming ruslore not there.Thismoy hove o disinhibiiingffect or

olternotelymoy resultn on unheolthy reokdown n psychologicol efences.4. lssueseloled o time. Unexpected r unforeseenime deloysmoy eod the client o speculoieoboullhe meoningof the deloyor ncreose nxiety.. Deloymoy occur hrough he echnologyoi l ing r he Internet ot beingovoiloble or o while.Suchcircumstonce hould e plonned or prooctively, itho bockupplonogreedof lhe outsel


6/15

5. Technologicolssuesmpoctingon professionolontocl. Cotostrophic quipment oilure, .9., he computerhorddrivemoy becomecorruptedbeyond etrievol,moy meon hot conioct informotion,iles, nddetoils f clients r the obility o contoct hem is osl.. Messoges oy nol be received, .9.,by being sent o the wrongoddress, r bygoingunnoticed, r by foilure o deliver o on overloodedmoilbox.. Confidentiolity oy be breoched,by inlernethockers r by others cce ssingheemoiloccount or computer.Fo rexomple, he lottermoy occur by olherpersonswho hove o l egitimote ight o occess he computersuchos porents, ortners rotherswithownership r shoredownership f ihe compuieror device.. The lientmoy hove o incur xtroexpenseo use he onl ine echnology verond obove whot they ore poying he psychologisl,nd difficulties oy orisefrom not being oble to offord hesechorges, or exomple, unning ut of crediton theirphone, r hoving 'copped' doto plonon heir nlernet ccess lhome.. Th eclientmoy onlyhove portiolor restricied ccess e.9.,using friend'scomputeror o cyber cofe). Likewise psychologist ightnoi hove he ievelofconsistencyf occess heymightneedorwonl,e.9. .mobilephonebeingout ofronge of home or onweekend,no internet ccessol workelc.

6. Monogementof crises. There re ncreosed isksn he event of ony crisis rising hich moy hreoten hesofetyof eiiher he clientor onolherperson.. Esloblishinglient denlitymoy be difficuli nline.Professionolnline heropymoy moke dentifyinghe porties nd emergency onloct informolionprerequisiteor ntoke,bu t thismoy be difficul to verify.

7. Legol ssues. Legolond ethicolombiguity rises s echnologyouislrips rofessionolegulolionond guidel ines.8. Limilotionsf texl bosedpsychologicol ervices. Communicotions re slower.. Touse ex l bosedservices ffeclively, lieniond psychologistoi h need to hovehigh evelof iterory kill.

3. Whatshould be done o mitigate isk?Thepsychologists esponsibleor miiigoting iskso the beslof theirobility.Given he ropidevolution f technology, ny guidelineshe Boordmoy developwould be generic other honbeing directed o specific ypesof services.hekeyprinciples ould be ociive risk ssessmentond review; he need forgood ossessment;nd chonnelling ervicesnt ooppropriote eliverymedio.Risk ssessmenfRegordlessf the communicolionmediumond regordlessf the notureof the psychologicolservice, eslproctice equires psychologisto oclivelyossessis k nd to remoinmindful fony chonges o the risk rofile.Riskmitigotionmoy require he psychologisto reconsiderwhetheror not t sodvisoble o deliver ervicesio onlineechnology oro porticulor lient ntheirspecific ircumstonces.Adequole ossessmenlWithinmenlolheolth ervices,ncluding nl ine ounsell i ng,sychologislshould t tempt oscreenoui clientswith severe sychiotric isorders,orderline ersonolity isorder,houghtdisorder, uicidoldeolion,or unmonitoredmedicolconditions. psychologisthould emindful hot dicgnosis nd ossessment oy be compromised ver he nternel hrough helimitotions n the nformotion voiloble.


7/15

Keyquest ions oy be:. How con lhe ossessmentnformolion e omplified e.9.,using sychomelric ssessmenttools, eeking olloterolnformolion ith permission)o reduce ombiguity nd improvethe quoli ty f the formulot ion?. A fullossessmenton onlybe undertokenn o foce-to-foce ituotion. re hereimportontdecisions risingrom he ossessmenlhich ndicole he need foro foce-io-foce meet ing?r Are herespecific eolures f lh e preseniingnformotion hich couseconcernoboutthe sofety f the cl ientor otherpeople n he cl ient 's or ld?Motching serviceswilh oppropriole deliverymedioKe yqueslionsmoy be:. ls he mediumof service elivery ikely o significontlympoct on the odequocy of theconsullolion r the efficocyof the nlervenlion?. Does he psychologisl ove he oppropriote kil lsor hispreseniingssue nd lo use histechnology?. Does he psychologist ove he necessory iscipline nd troining o mointoinodequoteprofessionoloundories hiledelivering nlinepsychologicol ervices?. Psychoeducolion nd lhe useof structured sychologicolnlerveniionsend hemselveslo service elivery y the internet.Con this ervice e deliveredn thol form?. Would he clientoccept referrolo o foce-lo-foceservice eilher s he primory erviceor os o supplement) r would he wilhdrowolof onlineserviceikely esultn the clienlhovingno service?

4. Does esearch vidence upportservicedelivery hrough he internet?The eseorchiteroture n thismode of proctice ssiil l f on eorlysioge of developmen t.Reseorch n communicolionprocessesndicotes hot the mediumof delivery nd contextdoeshove o signi ficonlmpoct on how people behoveond expresshemselves. eseorch nthe effectivenessf interventionssing lectronicmediowithspecific isorderssol voryingslogesof developmenl.Forexomple, omeprogrommes tilising struciured ockoge ofCogniiiveBehoviour heropy, sycho-educotion,nd/or onlinegroupsupport or cerioinspecificheolthconcerns r mentolheolth ssues ove been shown o be generolly ffeclive.There s ess eseorch vidence o show hot directcounselling erviceson be deliveredeffectively io the nterneihowever, opsychologistshoosing o prociise n hiswoy must okegreol core 1omonitor heirworkwith ndivi duol lients nd to evoluole heirprociice.Clienisshouldbe informedobout ihe l ock of (o r imiied)evidence egording he efficocyof osuggestedntervenlion son integrolport of the nformed onsenlprocess.Progrommes iih litt ledirect nput romo psychologisf,or exomple hoseodvertised n onopen websile, oise ifferent thicolchollenges ith regord o the occountobility f th epsychologislor screening lients.

SectionB: Ethical principlesAny guidelineshot the Boordmoy developwould be supplemenloryo the Code of Ethics.Delivering sychologicol ervices io he inlernetposes dditionolethicolchollenges, hichore discussednder he fol lowing ub-heodings:

o) Compelence.b) Informed onsent.c) Responsibleore.d) Intokeprocedure.e) Third oriies.f) Confidentiolity.S) Recordkeeping.


8/15

h) Tr iolper iod.i) Complointsrocedures.j) Offeringoliernoiives.k) Groupethicolprinciples.l) Working ith children.m) Culturolssues.n) Reguloloryobl igol ions.o) Avoilobility.p) Psychometricesting.q) Moinloining oundor ies.r) Legol isksor he psychologist.

a) CompetenceA psychologisthould ove he educotion, roining/orienlolionnd on-going ontinuingeducotion professionolevelopment o ensurehe ypossesshe necessory ompetenciesorih e sofeprovision f quolilyservicesn heirspeciolty reo.A psychologist us lonlyproctisewithin heirdomoin{s) f compelence ond shouldnol ottempt o deliver lecironicollyservicen which hey hove not demonstroled ompetence n o foce-to-foce ituotion.Psychologistsroviding erviceshrough he internet hould lsohove he necessorytechnology ompetencies.Compelent procliceolso equireshot the ntendedserviceseffectivewhen deliveredn hechosenmodolily,within he imilolions f the technology. Psychologistsroclisinghrough heinternet hould eep obreostof the evolving eseorch n efficoc'r.b) Informed consentProctitionershould ffercomoleteond honest isclosurebout themselvesnd theirservices:whot quolificolions re held, egislrotionlotus ondho w this on be verified),nvolvementnprofessionolrgonisotions,reosof speciolty, nd theirgeogrophicol ocotion.A cleorslotement hould e mode regordingwhot con be offeredoswelloswhot connol beoffered such s unovoilobilityf foce-to-foceconloct, emergency ontocl, ondpsychophormocologicoleferrol).Th eclientshould e informed ullybeforeconsentingo receiveonlinepsychologicol erviceswith regord o:

processssues,ncluding cknowledginghe possibilityf misunderstondingshroughreducedvisuol r verbolcues,mokingexplicit he expected urnoround ime whenconloct isosynchronous,nd mokingexplicit ny expectotions r resirictionsnrecordingor copying.the polentiol isks nd benefils f lhe service.sofeguords goinst he risk f confidentiolityeing breoched,suchos by requesiing"relurn eceipt"possword ccess.Encryptionmoy be usedbu t smoredifficulto setup .olternotive erviceshe clienicould occess, uc hos consulting psychologistn o foce-lo-foce situotion, eekinghe ossistonce f others,nformotion, xercise,meditotion rdoingnothing.. consent by proxy,where evidence should be provided lo verify he ideniity of thotperson,e.9. , he porenl , legol guordion or legol represenlot ive.th e explicii understonding hot the professionol elolionshipcon be ierminoied of onysToge.how o com ploint could be lodged, should hot become relevont .ihe c horges for services onducled eleclronicolly. Feespoyoble should be clorif ied ondogreed ol the s lort of the professionol ngogemenl.r on olternotemeonsof contocting he psychologist,hould herebe o breokdown nelectronicmeons f communicol ion.Best rociice equires sychologistso providewrilien nformotion rior o signing conlroct orclorifyinghe termsof engogementwitho client.Theestoblishmentf professionoloundoriesbetween he psychologistnd the client scommunicotedby the formolity f orrongements.

Oa

aa


9/15

wrilten nformolion heelond signed onsent orm help o define he professionolelotionshipond the boundor iesefween he cl ient nd the psychologist .c) Responsible careA prospective lientshould e ossessedirsl. hepsychologisthould onsider equestingfoce-lo-foceossessment,f need be vio proxy, hould hereexist ny concerns risingrom heinitiol ssessmentbout the suitobility f thisopprooch or o client.Proctilionersre urged o provideo soundcourseof oction bosedon best-proclice. vidence-bosedsfondords f professionolervice dopted to clienlneed, oking nto occount resirictionsor imilotions f ovoiloble esources.lf the psychologistses n opprooch thot issignificontlyifferent,hen he proclitioner houlddocumeni he reosonsor hot voriotion n he client ecord.Corefully onsidered lons or heprofessionolntervention emonslroling onsultotion ith colleogues r supervisor oy helpdocument "thoughiful rofessionolism"n the evenl of on odverse venl.Reosonoble onitor ing nd outcomeossessmenthould e undedoken oulinely.d) Intake procedureThe ntokeproceduremoy require n odditionol evelof scruiiny, s compored o foce-to-foceservices,o ensure lients re ntellectuolly,motionolly nd physicolly opoble of usingonlineservices. hose ho or e deemed unsuitoble houldbe screenedoul ond re-redirecledo moreoppropriole ervices.Thedecisionwhetheror not the clientond preseniingssue re suiloble or nternet ssessmentond interventionmcy require he psychologisto ensurehot:

. The l ienthosoccess o technology,ncluding p to dote equipment nd sof iwore, swellos he f inonceso run his.. The l ienthos he onguoge, eoding nd comprehensionki l lso enoble his pprooch.. Thepsychologistsculturolly ompetent o workwiih thot porticulor lienl.. Theservicesoccessible nd enobling or o c lientwilh disobility.. Theclientdoesno t suffer rom o psychiotric onditionwhich ncludes oo r reolity estingor cognit ivempoirment.The ntokeprocedure hould rooctivelymitigotepotentiol isk y formuloting rocesseso befollowed n he evenl of crisis, isunderstondingnd unovoilobility.hepsychologislhouldoltempt to identify n oppropriotelyroinedprofessionolho con provide ocolqssistonce,including risisntervention,f needed. Psychologistshould xploin o clients ow to cope withpotentiolmisunderstondingshen visuol uesdo nol exist nd exploinollernotivemodesofcommunicot ionf echnologyoi ls.e) Third partieslf hirdporties re billed orservices elivered y electronicmeons,proctitioners uslcleodyindicote hot on the bill ingorm. f o ihirdportywos misled hot the interoction ccurred n vivooscompored o electronicol ly,hen hot couldomount o f roud.f) ConfidentialityA stotementon the limitotions f confidenliolity houldbe developedond provided o clienlsof the slortof the professionolelotionship.his houldnclude eference o ony constrointsnconfidentiolily s normollynherent n he professionolelolionship nd olso he specificprivocyissues risingrom he electronic ronsmission.here so possibilityf inierception r misdirectionof inlernet ronsmission.Theremoy be less ontrolof the confidentiolity f informotion ver he internet. heremoy bedeliberoteor nodvertenl ovesdro pping r emoilsmoy be reod by peopleolher hon heintended ecipienl. hepsychologist oy not be oble o verify hot o responses rom he client


10/15

or moy inodvertently iscloseo o thirdportyby referringo moteriolpreviouslyiscussedioemoil .Becouse f lhe eoseof tronsfer f electronicmoteriol,he psychologist ust oke porticulorcore o promoieconfidenliolity f internei ounsellingelolionships.g) Record keepingTheusuolowsond regulot ionsboutkeeping ecords nd the cl ienl 's ight o occess hoserecords pply o psychology ervices eliveredhrough he internet s much os o foce-to-foce contoci. C lient ecordsmoy ncludeemoils, sychometricest esults,udio/videosessionrecordings,essionoieson d psychologist/supervisorommunicotions.f the records ncluderecordingsf communicoi ionsith he cl ienl,he cl ient hould e informed.Recordkeepingshould ncludeprovisionor bock-upstoroge o meet egolobligoiionso keeprecords or 10yeorsa.f kept electronicolly,sychologisls us tensurehe records emoinoccessibles echnology dvonces.h) Trial periodA psychologist oy offero triolperiod o ollow he client o delerminewhether his so usefulservice.f counselling io he internet snot suitobleor hot client, he psychologist oy odvisehow to seekoppropriote ore hroughmore rodilionol honnels.i) Complaints proceduresPoienliol lie nts houldbe informedhow o complointcon be mode osport of the roulineinformed onsentprocess. his hould e included n ony nformolion heetsupplied l thebeginning f lhe professionolelotionship.j) Offering alternativesWhenopproprioie, he psychologisthould elp he clienl ocote freepublicoccesspoints othe nternet or nformotion nd inslructionolesources.k) Group ethical principlesAlthoughgroup heropy n the troditionol ensesno t possible soccess suncontrolled,heinternet s o communicotionmedium ends tself o group orums ul theseposeodditionclethicol hol lenges.lf porticipoting s on expert, onsultont, oordinotor, r reseorcher psychologisi oy hove oconslontly efine heir ol eos new-comers ould not necessorilyove occess o eorlier oledefinitionse.g.,he psychologist oy routinely seo signoturemessoge iscloimero clorifythis sofferedos odvice or educolionon d thol this ommunicotion hould ot be confusedwilh mentolheolth reotment).f subscriberso the groupore known, ndividuoloiners ould beolerted o the foct it so public orumond nol o privote hercpeuiic elolionship.lf he groupcontextollowsndividuolso forwordquestions,l should e mode explicit hoi suchquestions on onlybe occepted if bolh the queslion nd response re mode public, o ovoidinodvertenily reolingo reolor perceivedpersonolheropeutic elotionship.hepsychologistshouldnclude discloimertol inghe constrointsr imilot ionso ony suchodvice.l) Working with ch ildrenSomementolheolth elecommunicolion ervicesoryoungpeoplehove been shown o beboth effectiveond porticulorly ccessible ecouseof lheircompotibility ith youthculture(e.g. ,elephone nd internel elp ines nd cr is iservices).f he psychologisistobl ishesholo clienl so minor t soptimol hot consentof o porenlor guordionwould be sought. heremoy be circumstonceshere his snot possibleue o lhe noture f the present ingroblem.ldentifyingeol-world upport ervices round he young personmoy be on importontport ofony heropeutic ntervention.

6l noccordonce with Heol ih (Retentionof Heol th nformol ion)Regulotions1995

t0


11/15

m) Cultural ssuesThe eed orcullurolompelence oybe heighlenedyclienls homoy ommunicotendifferentonguoges,ive n differenl ime zones, r hove uniqueculturol erspeciives. ocolconditions nd evenlsmoy mpoci on the client.Culturol orrierso receiving oce-io-foceservicesmoy moke onlinepsychologymoreoitroctive or someclients.n) RegulatoryobligationsBefore mborking n workwith o client, he procliiioner hould eviewcorefully ll relevontlegislot ion,uidel ines,nd codesof elhics r conduct n he cl ient 'sur isdict ionswellos hosepertoining o lh e psychologist'surisdictionf residence. heproctitioner hould oy porficulorottention o locolcusloms e.9., ge of consent, hildobuse eporting, nd recordkeepingrequirements)o ensurenternet sychologicol ervices re conducted ethicolly nd legolly.Th e nternetpsychologist'sebsite hould rovide inkso websiles f oll oppropriolecertificotion oordson d licensure oords o focilitote onsumer roiection.A psychologisthouldno t provide erviceso clientsn stotes r countries here doing sowouldviolote ocol icensureow sor regulotions.o) AvailabilityA psychologisthouldmoke odequote plons oroccessing nd respondingo messogesefi byclientsn electronic ormduring imes hot the psychologistsunovoiloble ue lo il lness rincopocity.p) Psychometric testingPsychologistshould ol odminisler lectronicolly ny psychologicolestswhere heodminislrotion ould pu i the security f the ossessmenlechniques f risk r would violoteonycopyright estrictions.f o copyrighled es l snot qvoiloble n on electronic orm, hen t shouldnot be converted o on ele ctronic ormwilhout he permissionf lhe publishers.Psychometricests sedshould e interpretedn he lightof normolivedolo for he populolionto which he clienlbelongs. f he culturoldeniityor geogrophicol ocolionof the client sno tknown,or thereore no selsof normotive oto for hot populotion, hen thot iso constroint nthe inlerpretoiion f lhol testond should e sloied explicitly.q) Maintaining boundariesBoundoriesn clinicolprocticegive he theropeutic romeslructure, iobility, nd predictobilityon d therebycreoie sofety or he emolionoldisclosure hich scommonlyo feotureofcommunicotion etween he clientond ihe psychologisi. oundoriesre esloblished yinformed onsent, dherence o the ogreed controct,on d the psychologistoking core toovoid duol roles. hepsychologisihould voidusingnformol ommunicolions, ve n f theclientusesexlsond obbreviotion s sore common n emoils.Psychologisishouldmointoin hesomeprofessionoloneond longuogen emoils s n he off ice.Emoil ommunicotionmoy generotemore ntense ronsference nd counter-lronsferencereoclions s compored o foce-to-focemeetings, risingromunchecked ontosies nd thereduction n nformol ive ensory olo which moy olherwise ove providedo reolity heck.Communicotions oy be stripped own to keyessenliolsnd occur n o "ropid ire"diologue.An informolone ond on unexpressedesire or closeness oy chollenge heropeuticboundor ies.Emoils r olheronl ine ommunicot ionshould e discussednd ncorporotednloony on-going heropeuticprocess. oth he electronic ommunicotions nd ony processing f thoicommunicotion re o be retoinedosport of the clienl's ecord.r) Legal risks for the psychologistOnline rocl icemoygenerote ddit ionol legoliskso the psychologist :

t l


12/15

Proctit ioners houldconsult heir professionol iobil ity nsuronce provider o ensure heirinlended oclivity iscovered prior o emborking on the octivity. deolly his should be inwrit ing.Psychologisls hould consider th e wider implicolionsof deoling wilh unsolicitedemoilsseeking odvice. Fo rexomple, professionol dvice (even without o fee) moy be held toestoblisho psychologist-clienl elotionshipond o duty of core when it is oreseeoble hoithe cl ienl wi l l fol low hol odvice.Advertisingon o website moy be considered lo offer on explicil worronty in oniniervenlion developed on ihe strengthof it.Psychologists oy be held occountoble fo r diognoseson d treqtmenis bosed oninsufficientor misleoding nformotion.Emoils onstitutewritten records hot con be used to os sess ompeience or stondordsof core.It moy be diff icult1o estoblish he fees for service,given lhe diff icultyof estim oiing oroverseeing he iime spent on elecironic communicotions. The obsence of oversightond slondords moy moke it diff icult or the clien t to gouge lhe foirness f o fee or tocompore rotes ocrosspsychologists.It s not possible o onticipole th e potentiol securitybreoches thot moy orise rom usingtelecommunicotions 1o deliver confidentiol services.Precoutionoryprinciplesshould befollowed, with full use of computer securitymeosures.

SectionC: Dealing with emergenciesPlonningor emergencycommunity-bosed ockup or crisisnlervention ervicesmusibeunderioken oulinely nd in odvonce, o ovoid o theropeutic ocuum or ock of sofetynet,should he need orise.Th epsychologisthould eekcl the outseto locolheolthproctilioner ondrecord heirnameond elephone umber) ho preferobly lreody nowshe cl ienl such s heirGP)ond whocould be referred o in emergency.Psychologisisre normolly nobled o dischorgeheirpublicsofetydutiesby beingknowledgeoble f the lows, ulhorities,nd procedures ertoiningo their urisdiction,s orexomplewhen here so risk f horm o lhe clientor othersn he client'sworld. Theyolsodevelopworking elolionshipsnd neiworks ith keypersonnel. owever his sunlikelyo opplyif o psychologistsworking nternotionolly.urf ermore, ithin he nternet ullure ndividuolsoften usecode nomesor moinloinononymily. hereforehe psychologist oy noi hoveoccurole detoils o reportso ho t ocolouihorities nd sociol esources on locote he personshould crisis rise. hepsychologisthouldmoke extroeffortso offset he risks risingromtheseootentiol cenorios.Prcctitionershould rovideoll clienlswilh cleorwritlen nstructionss o whot o do in onemergency e.g.,where here sc suicide isk) nd to discussheseorrongementsn theirsuoervision.Lowswilh regord o mondotory eportingwilldiffer ver urisdiclions,swillobligotionso thirdportieso protecl rom horm.Psychologistshould omiliorisehemselves ith he relevont ow sin on y urisdictionn which hey oreworking i.e.,where heirclients re iving).

SectionD: Otherrelated r'ssuesThe eody ovoilobility f informotionhrough he nlernel sollering he boundories nd privocyof both psychologistnd client.Whotmoy hove been privoteconduct n he post s ncreosinglyecomingoccessible n theinlernet, nd therefore ublic.Clienismoy seekpersonolnformotion boul psychologistsnthe internet. his honges he nolureof lhe division etween he professionolif eof the

tl


13/15

psychologistnd theirprivole ife. ncreosing mounts f informotion bout ndividuolpsychologislsr roinees oy be ovoi loble nl ine,ncluding ot ingbehoviour, logging, ndreferenceso professionolctiviiy.There re ethicol mplicotions risingromo psychologislhecking or nformotion boul theirclienlon the internel, ncluding or exomple,possible ints f suicidolnclinotionsrdysfunctionol oting behoviour. ctingon informoiionhot the person osno t provideddirecllymoy be inconsislent it ho respecl or he individuol's rivocyond ouionomy.Acodemic psychologistsr those nvol ved n troiningmoy wish1oscreenoppliconis or oprofessionolsychologyroining ourse y seorchingheirnome on ihe internel.Lecturers oywish1o ncreoseroinees' woreness f lhe poientiol mpocl on theirwork f theypostdoto oboul themselves n onlinechot roomsor Focebook, ui moy be reluclont o odmitto reseorching n lhe n ei, or be reluclont o be unduly ntrusiven their ives.lf nformotionsobtoinedobout o cl ientor o c olleogueon d ihot informotions hen usedos obosisor decision-moking,he psychologislhould eclore he sourceof thot informotion ndgive he client, iudent, r colleogueon opportunilyo correctony n occurocies nd/or odiscusshe contenl. Full isclosuref ossessment ethods nd the opportunityo speok oconcerns oisedby ossessmentrocessesre essentiolor ronsporency nd nolurol ustice.

SectionE: ConsumerguideTheNew ZeolondPsychologistsoordneither romotes or odvises goinslseekingpsychologicol erviceshrough he inlernet.However,he Boordencouroges ny userofpsychology ervices elivered hrough he nternel o proceedcoutiously, iven he relotivelock of reseorch videnceon lh e efficocyond sofeiyof someservices.Consumer uidel ines oy nclude cleorstolemenihot :. Foce-to-foce ounsellings he trodilionolly referredmelhod bul it should lsobeocknowledged hot online ommunicotionmedio moy be lh e preferred pprooch ofsomeclienis.. Consumershould xpect on equivolent tondordof core to thot delivered n o moretroditionol elling.. Consumershouldbe informed hot there s ess eseorch n ihe effectivenessf

psychologicol ervices eliveredhrough he internet.. Consumershouldbe odvisedhow o proceedwith o complointshould hot becomerelevont.. Consumershouldbe olerted o the focl thol there sno recoursef the psychologistsunreguloted, nidentified r out of reoch of lhe Bocrd.. Fees houldbe discussed nd ogreed beforesupplying redil cord informolion.. Thepsychologisthouldprovide nformotion nd guidoncewith regord1oemergencyservices.Clients ould olsobe odvised o:. be honestobout their deniitv, ocolionond noiureof problemor concerns.. knowwhot they hoveogreed o poy.. be owore of the limits f internel ounselling.. oskquesl ionsnyt ime, nd especiol lyf the beginning.. obtoin he psychologist 'selephone umber.. odvisehow he psychologisthoulddentify imor herself hen colling.. be owore of lheir ighls s o consumer nd proceedcouliously.

l3


14/15

ReferencesACTPsychologistsoord.Stondords totemenl: elepsychology.orworded 2 April2009.AmericonAssociolion f StoteCounseling oords 2004).Internetounselling:s t right oryou?Aguide or he consumer.Downlooded27 )uly2009:http://www.ooscb.org/ossociotions790 filesinternetcounselin.pdfAmericonCounseling ssociotion2006). ode of Ethics: thicol seof technology ncounsell ing.ownloode 27July OO9:http://www.counselin.org/Resources/CodeOfthics/TPlHome/CT2.ospxAmericonMenlolHeolth ounselorsssociot ion2000). odeof Ethics:Pr inciple4: lnternetonlinecounsellin. Downloode 27 July2009hltp: www.omhco.org/code/AmericonTelemedicine ssociotion2007). ore stondordsor elemedicine perotion.Downloode 27 July 009: tlp://omericontelemed.orgAustrolion sychologicolSociely2008). uidelinesor providing sychologicolservicesndproduclson the internel.Forworded23 Morch 2009Behnke, . 2008). thicsn he oge of the nternet . onitor n Psychology,PAOnline ol39,no7, downlooded25 Morch 2009Berg, . (2002) ihics nd E-medicine.einOnline,ol46,6l-83Colifornio sychologistsoord.Notice o Colifornion onsumersegording he procticeofpsychology n lhe iniernet.Downlooded23 Morch2009:http://www.psycboord.co.g vlconsumers/inlernet-thpyCenlore,A. ond Milocci,F. 2008). studyof mentolheolthcounselors' seof ond perspectiveson distonce ounsell ing.ournol f MenlolHeolthCounselingol30No3 poges267-282Federolion f SloteMedicolBoords 2002). odelguidelinesor he oppropriote seof iheinlernet n medicolproctice.Downlooded27 July2009: ederolion f SloteMedicolBoordsGriffiths, . (200'l)Online heropy:A couse or concern?British sychologicolociety hePsychologisi,ol l4 no (5),244-248Gutheil, .ond Brodsky, . (2008) revenling oundory iolotionsn clinicolproctice.GuilfordPress, ewYork.Humphreys, .,Winzelberg, . ond Klow,E. 2000.) sychologists'thicolresponsibilit iesninternel-bosed roups:ssues,trotegies nd o coll or diologue.Professionolsychology:Reseorch nd Proctice olume3,l,no 5, 493-496Koocher,G. ond Morroy,E. 2000). egulotion f Telepsychology:survey f StoteAttorneysGenerol.Professionolsychology,olume3l, No 5, 503-508lnlernotionol ocietyor MenlolHeolthOnline 2009). uggested rinciplesor he onlineprovision f mentolheolthservices. ownlooded25 Morch2009:http://www.ismho.org/sugestlons.ospNolionolBoord or CertifiedCounselors.heProctice f inlernet ounselling. ownlooded24 July2009ht tp: www.nbcc.orglethicsNeimork,G., wen,M. ond DiGiocomo 2006). he nternelos colloterolinformont.heAmericonJournol f Psychiotry,ol I 63no I0,poge 1842.

t4


15/15

Nickelson, ( , l998).eleheolthnd he evolving eolth oresystem:Strotegicpportunit iesorprofessionolpsychology.rofessionolPsychology:eseorchnd Proct icevol29 o 6,527-535OhioPsychologicol ssociotion2008). elepsychologyuidelines. ownlooded7 August 009:hltp://www.ohpsych.org/TelepsychologyGuidelinesAproved04 08.pdfPsychologislsoordof the Northern errilory2008). sychologicolservicesiotelecommunicotionsolicy.EffectiveNovember2004, eviewedMorch2008.Psychologistsoordof Queenslond 2008). tolement n urisdiclionolissuesnd consullotion iotelephone.Forworded 3 April 009.Recupero, .ond Roiney, . 2005).nformed onsent o E-lheropy. mericonJournol fPsychoiheropy.ol 59 ,No 4,319-331Rochlen, ., Zock.J. ond Sp eyer, . (2004). nlineheropy:Review f relevonldefinitions,debotesond currenlempiricol upport. ournol f ClinicolPsychology,ol 50,no 3,269-283Rosik, . ond Brown, . 2001). rofessionolseof he internel: egol nd elhicol ssuesnamember ore environmenl.ournol f Psychologynd Theology,ol29no 2,pg 106-120.SoulhAuslrolio sychologistsoord 2004). elepsychology.ownlooded23 Morch 2009:htlp://www.sopb.sooords.com.ou/psychuide.htmYborro,M. ond Eoton,W. (2005.nternel osedmentolheol ihntervent ions.eniolHeolihServices eseorch, ol 7, no 2,75-87

Documents

New Zealand Model of Internet Guidelines