INFORMED CONSENT FOR TELEPSYCHOLOGY

This document contains important information focusing on providing psychotherapy remotely using the telephone or videoconferencing. Please read this carefully, and let me know if you have any questions.  When you sign this document, it will represent an agreement between us.  

Benefits and Risks of Telepsychology

One of the benefits of telepsychology is that the client and clinician can engage in services without being in the same physical location. This can be helpful in ensuring continuity of care if the client or clinician moves to a different location, takes an extended vacation, or is otherwise unable to continue to meet in person. It is also may be more convenient and reduce commuting time. Telepsychology, however, requires technical competence on both our parts to be helpful.  Although there are benefits of telepsychology, there are some differences between in-person psychotherapy and telepsychology, as well as some risks.  For example: 

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• Risks to confidentiality.  Because telepsychology sessions take place outside of the therapist’s private office, it is important for you be in a private place during the session where you will not be interrupted and others cannot overhear the conversation. I also take reasonable steps to ensure your privacy. If we begin our session and you are not located in a private space, we may not be able to continue the session. It is also important for you to protect the privacy of our session on your cell phone or other device. You should take care to only use Internet connections that are secured with a password. 

• Issues related to technology.  There are ways technology issues might impact telepsychology.  For example, technology may stop working during a session, other people might be able to get access to our private conversation, or stored data could be accessed by unauthorized people or companies.

•  Crisis management and intervention.  Usually, I will not engage in telepsychology with clients who are currently in a crisis situation requiring high levels of support and intervention. We will develop an emergency response plan to address potential crisis situations that may arise during the course of our telepsychology work. Assessment of telepsychology appropriateness is an ongoing process.  We will both continue to assess whether meeting this way offers a good option for your care.

• Preference. Most research shows that telepsychology is about as effective as in-person psychotherapy. However, some therapists and patients believe that something is lost by not being in the same room. For example, there is debate about a therapist’s ability to fully understand nonverbal information when working remotely. Or, some patients report feeling a better connection to their therapist in-person. 

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Electronic Communications 

I use TheraLink or FaceTime, which are both private and confidential according the regulations set out by HIPPA. You will need a mobile device or computer and high-speed internet or a mobile data plan to use telepsychology services. You are solely responsible for any cost to you to obtain any necessary equipment, accessories, or software to take part in telepsychology. 
 
Between sessions, I only use email and text messaging with your permission and only for administrative purposes (setting and changing appointments or billing matters), unless we have made another agreement. You should be aware that I cannot guarantee the confidentiality of any information communicated by email or text. Therefore, I will not discuss any clinical information by email or text and prefer that you do not either. I typically check my emails once daily. While I do check texts more frequently, I am often not able to respond immediately. So, these methods should not be used if there is an emergency. 
 
Treatment is most effective when clinical discussions occur at your regularly scheduled sessions. But, if an urgent issue arises, you should feel free to attempt to reach me by phone. I will try to return your call within 24 hours except on weekends and holidays.  If you are unable to reach me and feel that you cannot wait for me to return your call, contact your family physician or the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact in my absence if necessary. 

Confidentiality 

The same confidentiality protections, limits to confidentiality and rules around patient records apply to video therapy sessions as they would to in-person sessions. I have a legal and ethical responsibility to make my best efforts to protect all communications that are a part of our telepsychology.  However, the nature of electronic communications technologies is such that I cannot guarantee that our communications will be kept confidential or that other people may not gain access to our communications. I will try to use updated encryption methods, firewalls, and back-up systems to help keep your information private, but there is a risk that our electronic communications may be compromised, unsecured, or accessed by others.  You should also take reasonable steps to ensure the security of our communications. For example, only using secure networks for telepsychology sessions and having passwords to protect the device you use for telepsychology.