Approved by the ACA Governing Council, October 1999
These guidelines establish appropriate standards for the use of electronic communications over the Internet to provide on-line counseling services, and should be used only in conjunction with the latest ACA Code of Ethics & Standards of Practice.
a. Privacy Information.
Professional counselors ensure that clients are provided sufficient information to adequately address and explain the limitations of (i) computer technology in the counseling process in general and (ii) the difficulties of ensuring complete client confidentiality of information transmitted through electronic communications over the Internet through on-line counseling. (See A.12.a., B.1.a., B.1.g.)
1. SECURED SITES: To mitigate the risk of potential breaches of confidentiality, professional counselors provide one-on-one on-line counseling only through "secure" Web sites or e-mail communications applications which use appropriate encryption technology designed to protect the transmission of confidential information from access by unauthorized third parties.
2. NON-SECURED SITES: To mitigate the risk of potential breaches of confidentiality, professional counselors provide only general information from "non-secure" Web sites or e-mail communications applications.
3. GENERAL INFORMATION: Professional counselors may provide general information from either "secure" or "non-secure" Web sites, or through e-mail communications. General information includes non-client-specific, topical information on matters of general interest to the professional counselor's clients as a whole, third-party resource and referral information, addresses and phone numbers, and the like. Additionally, professional counselors using either "secure" or "non-secure" Web sites may provide "hot links" to third-party Web sites such as licensure boards, certification bodies, and other resource information providers. Professional counselors investigate and continually update the content, accuracy and appropriateness for the client of material contained in any "hot links" to third-party Web sites.
4. LIMITS OF CONFIDENTIALITY: Professional counselors inform clients of the limitations of confidentiality and identify foreseeable situations in which confidentiality must be breached in light of the law in both the state in which the client is located and the state in which the professional counselor is licensed.
b. Informational Notices.
1. SECURITY OF PROFESSIONAL COUNSELOR'S SITE: Professional counselors provide a readily visible notice that (i) information transmitted over a Web site or e-mail server may not be secure; (ii) whether or not the professional counselor's site is secure; (iii) whether the information transmitted between the professional counselor and the client during on-line counseling will be encrypted; and (iv) whether the client will need special software to access and transmit confidential information and, if so, whether the professional counselor provides the software as part of the on-line counseling services. The notice should be viewable from all Web site and e-mail locations from which the client may send information. (See B.1.g.)
2. PROFESSIONAL COUNSELOR IDENTIFICATION: Professional counselors provide a readily visible notice advising clients of the identities of all professional counselor(s) who will have access to the information transmitted by the client and, in the event that more than one professional counselor has access to the Web site or e-mail system, the manner, if any, in which the client may direct information to a particular professional counselor. Professional counselors inform clients if any or all of the sessions are supervised. Clients are also informed if and how the supervisor preserves session transcripts. Professional counselors provide background information on all professional counselor(s) and supervisor(s) with access to the on-line communications, including education, licensing and certification, and practice area information. (See B.l.g.)
3. CLIENT IDENTIFICATION: Professional counselors identify clients, verify identities of clients, and obtain alternative methods of contacting clients in emergency situations.
Professional counselors require clients to execute client waiver agreements stating that the client (i) acknowledges the limitations inherent in ensuring client confidentiality of information transmitted through on-line counseling and (ii) agrees to waive the client's privilege of confidentiality with respect to any confidential information transmitted through on-line counseling that may be accessed by any third party without authorization of the client and despite the reasonable efforts of the professional counselor to arrange a secure on-line environment. Professional counselors refer clients to more traditional methods of counseling and do not provide on-line counseling services if the client is unable or unwilling to consent to the client waiver. (See B.1.b.)
d. Records of Electronic Communications.
Professional counselors maintain appropriate procedures for ensuring the safety and confidentiality of client information acquired through electronic communications, including but not limited to encryption software; proprietary on-site file servers with fire walls; saving on-line or e-mail communications to the hard drive or file server computer systems; creating regular tape or diskette back-up copies; creating hard-copies of all electronic communications; and the like. Clients are informed about the length of time for, and method of, preserving session transcripts. Professional counselors warn clients of the possibility or frequency of technology failures and time delays in transmitting and receiving information. (See B.4.a., B.4.b.)
e. Electronic Transfer of Client Information.
Professional counselors electronically transfer client confidential information to authorized third-party recipients only when (i) both the professional counselor and the authorized recipient have "secure" transfer and acceptance communication capabilities, (ii) the recipient is able to effectively protect the confidentiality of the client confidential information to be transferred; and (iii) the informed written consent of the client, acknowledging the limits of confidentiality, has been obtained. (See B.4.e., B.6.a., B.6.b.)
ESTABLISHING THE ON-LINE COUNSELING RELTIONSHIP
a.The Appropriateness of On-Line Counseling.
Professional counselors develop an appropriate in-take procedure for potential clients to determine whether on-line counseling is appropriate for the needs of the client. Professional counselors warn potential clients that on-line counseling services may not be appropriate in certain situations and, to the extent possible, informs the client of specific limitations, potential risks, and/or potential benefits relevant to the client's anticipated use of on-line counseling services. Professional counselors ensure that clients are intellectually, emotionally, and physically capable of using the on-line counseling services, and of understanding the potential risks and/or limitations of such services. (See A.3.a., A.3.b.)
Professional counselors develop individual on-line counseling plans that are consistent with both the client's individual circumstances and the limitations of on-line counseling. Professional counselors shall specifically take into account the limitations, if any, on the use of any or all of the following in on-line counseling: initial client appraisal, diagnosis, and assessment methods employed by the professional counselor. Professional counselors who determine that on-line counseling is inappropriate for the client should avoid entering into or immediately terminate the on-line counseling relationship and encourage the client to continue the counseling relationship through an appropriate alternative method of counseling. (See A.11.b., A.11.c.)
Professional counselors provide clients with a schedule of times during which the on-line counseling services will be available, including reasonable anticipated response times, and provide clients with an alternate means of contacting the professional counselor at other times, including in the event of emergencies. Professional counselors obtain from, and provide clients with, alternative means of communication, such as telephone numbers or pager numbers, for back-up purposes in the event the on-line counseling service is unavailable for any reason. Professional counselors provide clients with the name of at least one other professional counselor who will be able to respond to the client in the event the professional counselor is unable to do so for any extended period of time. (See A.11.a.)
d.Boundaries of Competence.
Professional counselors provide on-line counseling services only in practice areas within their expertise and do not provide on-line counseling services to clients located in states in which professional counselors are not licensed. (See C.2.a., C.2.b.)
e. Minor or Incompetent Clients.
Professional counselors must verify that clients are above the age of minority, are competent to enter into the counseling relationship with a professional counselor, and are able to give informed consent. In the event clients are minor children, incompetent, or incapable of giving informed consent, professional counselors must obtain the written consent of the legal guardian or other authorized legal representative of the client prior to commencing on-line counseling services to the client.
Professional counselors confirm that their liability insurance provides coverage for on-line counseling services, and that the provision of such services is not prohibited by or otherwise violate any applicable (i) state or local statutes, rules, regulations, or ordinances; (ii) codes of professional membership organizations and certifying boards; and/or (iii) codes of state licensing boards.
Professional counselors seek appropriate legal and technical assistance in the development and implementation of their on-line counseling services.
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