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Maheu -- American Counseling Association Convention, March 21, 2012

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Learning Institute: Cybercounseling Legal & Ethical Social Media (full day workshop) ...

Learning Institute: Cybercounseling Legal & Ethical Social Media (full day workshop)

Donna Ford and Marlene Maheu at American Counseling Association Convention, San Francisco, California, March 21, 2012

The above event is sponsored by the TeleMental Health Institute, Inc. We are the premier professional training site for professionals seeking training in telehealth. Our courses are offered in a state-of-the-art, 100% online learning environment that is fully mobile compatible. Professional training is now available from your desktop of mobile device, 24/7, at your home or office.

To receive our FREE monthly newsletter related to telemental health, telecounseling, online therapy, telepsychology or telepsychiatry and telenursing, send an email to: tmhinews@aweber.com You will also receive notices of our bonuses and discounts for professional training for CEUs and CMEs.

See other offerings at www.telehealth.org
Send questions or comments to us at www.support.telehealth.org
Contact Dr. Maheu to speak at your next workshop or conference at: www.support.telehealth.org

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Maheu -- American Counseling Association Convention, March 21, 2012 Maheu -- American Counseling Association Convention, March 21, 2012 Presentation Transcript

  • Copyright 2012, TeleMental Health Institute, Inc. All rights reserved.
  • DONNA FORD, MSACA PRESIDENT 1999-2000  Best Practices for Online Counseling (Cybercounseling)  Ethical Code for Online Counseling  Cybercounseling and Cyberlearning: Strategies and Resources for the Millennium  Online Counseling Task Force Copyright 2012, TeleMental Health Institute, Inc. All rights reserved.
  • ACA RESOURCES ACA Ethical Standards: Technology http://www.counseling.org/Resources/Co deOfEthics/TP/Home/CT2.aspx Licensure and Certificates: http://www.counseling.org/Counselors/Licens ureAndCert/TP/StateRequirements/CT2.aspx Copyright 2012, TeleMental Health Institute, Inc. All rights reserved.
  • OREGON ADMINISTRATIVE RULES FORONLINE COUNSELING BOARD OF LICENSED PROFESSIONAL COUNSELORS AND THERAPISTS : DIVISION 90 DISTANCE COUNSELING http://arcweb.sos.state.or.us/pages/rules/oars_8 00/oar_833/833_090.html Copyright 2012, TeleMental Health Institute, Inc. All rights reserved.
  • ACA PUBLICATIONS Licensure Requirements for Professional Counselors: A State -By-State Report Office of Professional Affairs, 2010 edition The Counselor and the Law: A Guide to Legal and Ethical Practice, Sixth Edition
by Anne Marie “Nancy” Wheeler and Burt Bertram Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • DEFINITION OF COUNSELING “Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.” Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SEVEN PRINCIPLES FOR THE FUTURE Sharing a common professional identity is critical for counselors Presenting ourselves as a unified profession has multiple benefits Working together to improve the public perception of counseling and to advocate for professional issues will strengthen the profession Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SEVEN PRINCIPLES FOR THE FUTURE Creating a portability system for licensure will benefit counselors and strengthen the counseling profession. Expanding and promoting our research base is essential to the efficacy of professional counselors and to the public perception of the profession. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SEVEN PRINCIPLES FOR THE FUTURE Focusing on students and prospective students is necessary to ensure the ongoing health of the counseling profession. Promoting client welfare and advocating for the populations we serve is a primary focus of the counseling profession. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACES TECHNICAL COMPENTENCIES TECHNICAL COMPETENCIES FOR COUNSELOR EDUCATION: RECOMMENDED GUIDELINES FOR PROGRAM DEVELOPMENT http://files.acesonline.net/doc/2007_aces_tec hnology_competencies.pdf Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • TeleMental Health Institute, Inc.MARLENE M. MAHEU, PH.D.Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2011 TeleMental Health Institute, Inc.Social Networkingvs. OnlineCounseling Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 12
  • POPULAR SOCIAL NETWORKS Facebook, YouTube, MySpace, Twitter, Ning, Flickr, blogs, eBay, Craigslist, Skype, del.icio.ous, Second Life, LinkedIn, social bookmarking, wikis, vlogs, epinions, World of Warcraft, Google Groups, Youmeo, etc. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • • What’s Happening in Social Media & Cybercounseling • Legal & Ethical Issues • Paths to Profits from Social Media Copyright 2012 TeleMental Health Institute, Inc. 15Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ETHICS
  • PEW: SOCIAL NETWORKING SITES ANDOUR LIVES (JUNE 16, 2011) The number of people using social networking sites has nearly doubled since 2008, and the population of SNS users has gotten older. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Coming next… Evolutionary perspectiveCopyright 2012 TeleMental Health Institute, Inc. All rights 18 reserved.
  • RE-TOOLINGCopyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • 21Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012 TeleMental Health Institute, Inc.Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 22
  • Copyright 2010 TeleMental Health Institute, Inc.Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 23
  • REAL-TIME TELEMEDICINE Remote doctor examines a Patient in rural ER gets benefit of patient’s inner ear from a local care plus remote remote location. consultation with specialists. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2011 TeleMental Health Institute, Inc.Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 26
  • Coming next… What do mental health consumers Want online? .Copyright 2012 TeleMental Health Institute, Inc. All rights 30 reserved.
  • .CONSUMER DEMAND 31
  • Copyright 2009 TeleMental Health Institute, Inc. 32Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2009TeleMental Health Institute, Inc. 33
  • Coming next… What’s mHealth?Copyright 2012 TeleMental Health Institute, Inc. All rights 36 reserved.
  • Do you own any of these?Do you own one of these smart devices? Did you 10 yearsago?
  • SMART PHONE EXPLOSION Nearly half (46%) of American adults are smartphone owners as of February 2012, an increase of 11 percentage points over the 35% of Americans who owned a smartphone last May… Smartphone owners are now more prevalent within the overall population than owners of more basic mobile phones. (PEW, 2012) Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SMART PHONE EXPLOSION (CONT.)  Nearly every major demographic group—men and women, younger and middle-aged adults, urban and rural residents, the wealthy and the less well- off—experienced a notable uptick in smartphone penetration … last year…60% or more within several cohorts, such as college graduates, 18- 35 year olds and those with an annual household income of $75,000 or more. (PEW, 2012)  http://pewinternet.org/~/media//Files/Reports/2012/Smartphone%20ownership%202012.pdf Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • EFFECTIVE CONVERSATIONS? Different Professions / Professional Associations & Their Respective Ethical Codes:  Psychiatrists  Psychologists  Social workers  Counselors  Regular  Family & Child  Pastoral  Substance Abuse Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 40
  • Copyright 2011 TeleMental Health Institute, Inc. 41
  • TELEMENTAL HEALTH GUIDELINES & STANDARDS• 1998 American Psychiatric Association Telepsychiatry via Teleconferencing• 1999 (2005) American Counseling Association Ethical Standards for Internet On-Line Counseling• 2000 American Mental Health Counselors Association Code of Ethics of AMHCA, Principle 14, Internet On-Line Counseling• 2000 American Medical Association Guidelines for Patient-Physician Electronic Mail• 2001 National Board of Certified Counselors (NBCC) Center for Credentialing and Education The Practice of Internet Counseling• 2001 Canadian Psychiatric Association (CPA) Telepsychiatry Guidelines and Procedures for Clinical Activities• 2004 (2010) Australian Psychological Society Guidelines for providing psychological services and products on the internet• 2006 National Association of Social Workers & Association of Social Work Boards Standards for Technology and Social Work Practice• 2008 (2010) Ohio Psychological Association Telepsychology Guidelines• 2009 Canadian Psychological Association Ethical Guidelines for Psychologists Providing Psychological Services Via Electronic Media• 2009 American Telemedicine Association Evidence-based Practice for Telemental Health Practice Guidelines for Videoconferencing Based Telemental Health New “Desktop and Mobile Telemental Health Workgroup” (2011 -present) Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • POLICIES & GUIDELINES AMA Policy: Professionalism in the Use of Social Media Guseh JS 2nd, Brendel RW, Brendel DH. Medical professionalism in the age of online social networking. J Med Ethics. 2009;35(9):584-6. Social Media and the Medical Profession: A guide to online professionalism for medical practitioners and medical students. A joint initiative of the Australian Medical Association Council of Doctors-in- Training, the New Zealand Medical Association Doctors-in-Training Council, the New Zealand Medical Students’ Association and the Australian Medical Students’ Association. Gabbard GO, Kassaw KA, Perez-Garcia G, Professional boundaries in the era of the internet. Acad Psych. 2011;35:168-74. Brave New World of Social Media: Social networking is transforming the way medical students communicate with one another, but is online content meeting professional standards? The New Physician January- February 2010 Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2011 TeleMental Health Institute, Inc. OCPM: Online Clinical PracticeModel Online Clinical Practice Management (OCPM)Step 1: TrainingStep 2: ReferralsStep 3: Patient EducationStep 4: LegalitiesStep 5: AssessmentStep 6: Direct CareStep 7: Reimbursement Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 44
  • SOCIAL MEDIA IS NOT PRIVATE “…assume that anything you post will be seen, read, and open for comment. Anything you say, post, link to, comment on, upload, etc., can and may be used against you by your peers, colleagues, employer, potential employers, fellow members, and so on.” APA http://www.apa.org/about/social-media-policy.aspx Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Boundaries of Competence 46Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SOCIAL TIES & SOCIAL NETWORKING The more frequently someone uses the internet, the larger his network tends to be. The average person who uses the Internet at home several times per day, has a network of 732 ties, while someone who uses the Internet only once a day has a network of 616 ties. In addition, mobile phone users average 664 ties, and those who have internet access through a mobile device like a smartphone or tablet computer tend to have about 717 ties. PEW, 2012, “Social Networking Sites and Our Lives” http://www.slideshare.net/marketingfactsnl/pew- research-social-networking-and-our-lives Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WHO ARE YOU MARKETING? Women account for 85% of all buying decisions, spend 80% of the combined income of a dual-paycheck household, and are opening 70% of all new businesses. If you are focused on women as clients, are you attracting, honoring, and serving them as well as you could be? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • LINKEDIN Nearly twice as many men (63%) as women (37%) use LinkedIn. All other SNS platforms have significantly more female users than male users. PEW, (2012). “Social Networking Sites and Our Lives” http://www.slideshare.net/marketingfactsnl/pew-research-social- networking-and-our-lives Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012 TeleMental HealthInstitute, Inc. All rights reserved.
  • Copyright 2012 TeleMental HealthInstitute, Inc. All rights reserved.
  • Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005) Discuss time zone differences, local customs, and cultural or language differences that might impact service delivery. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • LINGUISTIC & CULTURAL DIVERSITY Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 57
  • Copyright 2009 TeleMental Health Institute, Inc.MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Canada  Singapore Netherlands  Greece United Kingdom  South Africa Australia  Malaysia Japan  Israel Germany  Belgium New Zealand  Sweden Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 58
  • Copyright 2012 TeleMental Health Institute, Inc.MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Malaysia  Ireland Israel  France Belgium  Russia Sweden  Spain Mexico  Brazil Finland  Austria Saudi Arabia  Poland 59
  • Copyright 2012 TeleMental Health Institute, Inc.MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Denmark  Thailand Argentina  Croatia Turkey  Indonesia Philippines  Norway Portugal  Romania Peru  Italy Hong Kong  United Arab Emirates Pakistan  Cyprus 60
  • Copyright 2012 TeleMental Health Institute, Inc.MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Brunei Darussalam  Bulgaria Latvia  Uruguay Ecuador  Former USSR Venezuela  Lithuania Mauritius  Kazakhstan Bosnia-Herzegovina  Ukraine Slovak Republic  Zimbabwe South Korea  Georgia 61
  • Copyright 2012 TeleMental Health Institute, Inc.MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Iran  Aruba Nicaragua  Qatar Guatemala  El Salvador Jordan Virgin Islands (USA)  Kenya  Papua New Guinea Macedonia  Dominica Netherlands Antilles  Madagascar Botswana  Malta Oman  Namibia 62
  • MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Andorra  Iceland Jamaica  Egypt Maldives  China Sri Lanka  Chile Faroe Islands  Czech Republic Zambia  Luxembourg Estonia  India Trinidad and Tobago  Colombia Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 63
  • Copyright 2012 TeleMental Health Institute, Inc.MULTICULTURAL/MULTILINGUAL ISSUESSELFHELPMAGAZINE.COM Taiwan  Moldavia Lebanon  Yemen Dominican Republic  Switzerland Yugoslavia  Bolivia Bermuda  Ethiopia Slovenia  Burkina Faso Hungary  Bahamas Costa Rica  Belarus 64
  • PRACTITIONER ADOPTION?  Over 1/2 million Google search results:  “online counseling” = 210,000+ searches  “online therapy” = 143,000+ searches  “online counselling” = 83,100+ searches  “online therapy” = 65,900+ searches  --------------  = 502,200 searches 65
  • ACA CODE OF ETHICS (2005) A.12.b. Assistance Counselors seek business, legal, and technical assistance when using technology applications, particularly when the use of such applications crosses state or national boundaries. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005) A.12.c. Inappropriate Services  When technology-assisted distance counseling services are deemed inappropriate by the counselor or client, counselors consider delivering services face to face. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • OCPM STEP 1: TRAINING  Boundaries of competence  Limits of technology  Authentication  How & when to respond, and when to use telephone instead  Role of research- based interventions and protocols Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 68
  • AUSTRALIAN PSYCHOLOGICAL SOCIETY(2010 PROPOSED REVISION OF INTERNET GUIDELINES) Research-based protocols  1.6 “Psychologists using the internet to provide a psychological service should be aware of the extent to which therapeutic interventions via the internet are supported by research or may be contra-indicated ….” Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 69
  • OCPM STEP 1: TRAINING  (i) A psychologist shall not practice outside his or her particular field or fields of competence as established by his or her education, training, continuing education, and experience. Cal. Bus. & Prof. Code 2915. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 70
  • OCPM STEP 1: TRAINING  Adhere to peer- reviewed research protocols before offering services to the trusting public  http://telehealth.org/biblio graphy  Look at:  funding sources  meta-analyses Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 71
  • OCPM STEP 1: TRAINING  Choice of Communication Channel (modality)  Responsibility of Professional?  Technology specific training/proficiency for each modality + combination of modalities  Confidentiality for each modality  Client authentication for each modality  Practitioner authentication for each modality Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 72
  • OCPM STEP 1: TRAINING  Training for each technology  Training for dealing with boundaries between multiple Internet technologies:  Email / Chat Rooms  Telephones / Cell Phones / “Apps” / Texting  Videoconferencing (Public / VPN / Cloud)  Websites / Forums / Social Networking  Which technology for which patient -- and when? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 73
  • . 74
  • Copyright 2011 TeleMental Health Institute, Inc. OCPM: Online Clinical PracticeModel Online Clinical Practice Management (OCPM)Step 1: TrainingStep 2: ReferralsStep 3: Patient EducationStep 4: LegalitiesStep 5: AssessmentStep 6: Direct CareStep 7: Reimbursement 75 Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • OCPM STEP 2: REFERRALS OR INTERNET MARKETING (IM)  Provider lists  Colleagues with telehealth training  Professional websites, blogs, appsCopyright 2012 TeleMental Health Institute, Inc. 76
  • FEDERAL TRADE COMMISSION (FTC) FTC Powers to Merchant-Advertiser Regulate Deception & Responsibility & Liability Unfairness Affiliate/Network FTC/AG Enforcement Responsibility & Liability Priorities Ad Substantiation Merchant-Advertiser/Affiliate Best Practice-Compliance Clear & Conspicuous Disclosure/Negative Tips Option Mobile Marketing FTC Endorsement Privacy Guidelines Copyright 2012 Affiliate Summit West 1
  • Copyright 2012 TeleMental Health Institute, Inc.ONLINE NORM VS. STANDARD OF CARE  Mostly Email & Chat vs. Video  Anonymity / No Patient Records  Avoid Responsibility w/ Website Disclaimers  No Clear Channels for Mandated Reporting No Contact with Other Treating Clinicians No Authentication of Consumer / Professional No Emergency Backup Procedures Misunderstanding of Clinical Processes (suicide) 78
  • Copyright 2011 TeleMental Health Institute, Inc. OCPM: Online Clinical PracticeModel Online Clinical Practice Management (OCPM)Step 1: TrainingStep 2: ReferralsStep 3: Patient EducationStep 4: LegalitiesStep 5: AssessmentStep 6: Direct Care Copyright 2012 TeleMental Health Institute, Inc. All rights reserved. 79Step 7: Reimbursement
  • ACA CODE OF ETHICS (2005) A.1.b. Records Counselors maintain records necessary for rendering professional services to their clients and as required by laws, regulations, or agency or institution procedures. Counselors include sufficient and timely documentation in their client records to facilitate the delivery and continuity of needed services. Counselors take reasonable steps to ensure that documentation in records accurately reflects client progress and services provided. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • BOARD OF BEHAVIORAL SCIENCES (BBS),CALIFORNIA The informed consent procedure shall ensure that at least … verbally and in writing: (1) ….option to withhold or withdraw consent at any time … (2) …potential risks, consequences, and benefits of telemedicine. (3) All existing confidentiality protections apply. (4) All existing laws regarding patient access to medical information and copies of medical records apply. (5) Dissemination of any patient identifiable images or information …shall not occur without the consent of the patient. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005)  A.12.a. Benefits and Limitations  Counselors inform clients of the benefits and limitations of using information technology applications in the counseling process and in business/ billing procedures. Such technologies include, but are not limited to, computer hardware and software, telephones, the World Wide Web, the Internet, online assessment instruments and other communication devices. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005)  A.12.g. Technology and Informed Consent  As part of the process of establishing informed consent, counselors do the following: 1. Address issues related to the difficulty of maintaining the confidentiality of electronically transmitted communications. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005) A.12.g. Technology and Informed Consent  2. Inform clients of all colleagues, supervisors, and employees, such as Informational Technology (IT) administrators, who might have authorized or unauthorized access to electronic transmissions. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • RATING SITES: YELP (KEELY KOLMES,PSY.D.) Your right /Gently discourage for these reasons: 1. The American Psychological Associations Ethics Code states that it is unethical for psychologists to solicit testimonials: Principle 5.05 "Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence." Since you may decide to return to therapy with me at a later date, I do not request testimonials from people who have ended therapy with me. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • RATING SITES: YELP (KEELY KOLMES, PSY.D.) 2. Unlike other business owners who may respond to their Yelp reviews, as a psychologist, I must provide confidentiality to my clients. This means I am restricted from responding in any way that acknowledges whether someone has been in my care. Thus, I do not intend to respond to any reviews. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • RATING SITES: YELP (KEELY KOLMES, PSY.D.) 3. I hope that if we work together, we can discuss your feelings about our work directly and in person. This may not always feel comfortable, but the discussion of positive and negative reactions to our process can be an important part of your therapy. If it is simply a matter of poor fit, Im always happy to help you find a therapist who is a better match. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • RATING SITES: YELP (KEELY KOLMES, PSY.D.) 4. If you still choose to write something about my practice on Yelp, remember that this is a public forum and you may be sharing personally revealing information with a wide range of readers. To preserve your privacy, consider using a pseudonym that is not linked to your regular email address or friend networks.
  • INTERNET RATINGS: WHERE ARE WE GOING?  Expect ratings and quality surveys by healthcare providers to become standard operating procedure by smartphone app users.  Yelp  They can rate you but you can’t fully defend yourself without violating confidentiality
  • INFORMED CONSENT & SOCIAL MEDIA POLICYSAMPLES http:telementalhealth.com/sit es/default/files/Informed_Co nsent.pdf http://drkkolmes.com/for- clinicians/social-media- policy/ Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2011 TeleMental Health Institute, Inc. OCPM: Online Clinical PracticeModel Online Clinical Practice Management (OCPM)Step 1: TrainingStep 2: ReferralsStep 3: Patient EducationStep 4: LegalitiesStep 5: AssessmentStep 6: Direct CareStep 7: Reimbursement 94
  • AllExistingLegalandEthicalRulesApply
  • DUTY TO REPORT / DUTY TO WARN (v) Failing to comply with the child abuse reporting requirements of Section 11166 of the Penal Code. (w) Failing to comply with the elder and adult dependent abuse reporting requirements of Section 15630 of the Welfare and Institutions Code. CA Business and Professions Code Sections 4989.54 (cont.) Copyright 2012 TeleMental Health Institute, Inc. 98
  • . 99
  • Practicing OverState Lines Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • CROSS-BORDER PRACTICE Licensing Boards that may assert jurisdiction:  The one in your state  The one in the patient’s state  Both Safest:  Provide services only where licensed  Require pt to attest to his or her citizenship there Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • QUESTION I’m ok if my malpractice carrier says they cover me online, right? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • QUESTION So what harm am I doing if I practice over state lines? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • . 104
  • APA ETHICAL PRINCIPLES OF PSYCHOLOGISTS Principle A: Beneficence and Non-malfeasance  Psychologists strive to benefit those with whom they work and take care to do no harm. Principle B: Fidelity and Responsibility  Psychologists establish relationships of trust with those with whom they work. They are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • QUESTION Is the licensing issue the same if no money is exchanged? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • AUSTRALIAN PSYCHOLOGICAL SOCIETY (2010PROPOSED REVISION OF INTERNET GUIDELINES)  Research-based protocols  1.6 “Psychologists using the internet to provide a psychological service should be aware of the extent to which therapeutic interventions via the internet are supported by research or may be contra- indicated for a particular disorder or psychological problem.” Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • OCPM STEP 1: TRAINING Training for maneuvering in and out of multiple technologies:  Email  Chat Rooms  Voice Over IP Audio  Telephones / Cell Phones / “Apps” / Texting  Videoconferencing (public and VPN and/or Cloud)  Websites / Forums / Social Networking Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • QUESTION What can we do to move this forward with the authorities?  Contact them  Volunteer if they need help  Get their newsletters  Follow the literature  Get trained so you know which questions to ask Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • LEGAL SUGGESTIONS Let’s pull together  Put everything in writing System is obviously  Communicate often to straining your local, state and Counsel each other national professional Document those associations conversations  Write to your Don’t refer to people malpractice carrier and who you know are ask them to clearly tell practicing illegally or you what will happen unethically Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • So what? WHY USE SOCIAL MEDIA?Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SOCIAL MEDIA CAN SERVE YOU IN MANY WAYS1. Spread Your Message2. Give Back3. Learn4. Connection / Community / Support5. Collegiality / Mentoring6. Exposure  Profits
  • PSYCHOTHERAPY VS. PSYCHOEDUCATION?  Psychotherapy defined: a method of working with patients and clients to assist them to modify, change, or reduce factors that interfere with effective living (Corsini, 1998).  Psychotherapy - 5 commonalities:  1) the development of a therapeutic contract in which the patient has an active role (including purpose, format, terms, and limits),  2) therapeutic interventions (confrontation, immediacy of affective expression, etc.),  3) resulting emergence of a therapeutic bond (also termed therapeutic alliance),  4) the patients self-relatedness (lack of defensiveness), and  5) therapeutic realizations and impacts in-session. (Orlinsky and Howard (1986) Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PSYCHOEDUCATION Anywhere, anytime Serve more people Part time Practice generator Lower risk Non-therapeutic relationship Clearer legal/ethical mandates Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • 6 REASONS TO GET ONLINE NOW Reach people worldwide 24/7 Make profits while you sleep Multiple streams of income Low overhead Social media is established and effective Very little competition Far fewer legal/ethical mandates Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005) A.12.h. Sites on the World Wide Web Counselors maintaining sites on the World Wide Web (the Internet) do the following: 1. Regularly check that electronic links are working and professionally appropriate. 3. Provide electronic links to relevant state licensure and professional certification boards to protect consumer rights and facilitate addressing ethical concerns. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • ACA CODE OF ETHICS (2005) A.12.h. Sites on the World Wide Web 6. Strive to provide a site that is accessible to persons with disabilities. 7. Strive to provide translation capabilities for clients who have a different primary language while also addressing the imperfect nature of such translations. 8. Assist clients in determining the validity and reliability of information found on the World Wide Web and other technology applications. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • DIRECTORY & BROCHURE WEBSITES  Are they social media?  Are they subject to legal and ethical codes? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • WEBSITE LEGALITIES  Website Disclaimers: face validity  Discuss the Limits of Confidentiality  Protectconfidentiality of consumers in forums, articles, blogs, etc.  Confidential Information in Databases  Terms & Conditions  Understand limits of disclaimers  Privacy  Copyright Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBSITE LEGAL AGREEMENTS Copyright Notice Terms of Service (TOS) or Terms and Conditions (T&C) Privacy Policy Code of Conduct Affiliate Agreement Developer Agreement  Work for hire Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEB DEVELOPMENT AGREEMENTS  Search for comments about potential hires and partners online  Work with trusted colleagues  Work “for hire”  Retain copyright of everything  Obtain all access codes, original images in their licenses, and make copies of your web pages Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WORDPRESS Easy to use Free Can buy “themes” Have them installed by a reputable company who understands your limits Use a service such as manageWP.com for managing multiple blog sites, too Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Legally & Ethically Copyright 2012 TeleMental Health Institute, Inc. All
  • 6 MYTHS Social media is a waste of time It takes a long time to make a product to promote with social media Need a book Need to understand technology Need to be the authority in an area There are no ethics or laws related to online product development by professionals Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PATHS TO MULTIPLE STREAMS OF INCOMEIN MENTAL HEALTH Start w/specialty area Do market analysis Boil down concept Get best domain name Outline Product Path Organize Content Re-purposed content  Blog / Webinar  Newsletter / Youtube  Other Social Media Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PATHS TO MULTIPLE STREAMS OF INCOME IN MENTAL HEALTH Content  Handouts  Presentations / Webinars / Podcasts  Blogs / Articles  Book Chapters  Video Training Promotion Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PATHS TO MULTIPLE STREAMS OF INCOMEIN MENTAL HEALTH Front End  Back End  eBook, OR best chapter  Continuity Program of your book  Go for the “thud factor”  Up-sells  Individual Treatment  The more the better  Consultation  Bonus: “Organize your ADD child checklist”  Free Webinar  Easiest is to not take live calls  Ask for questions to be mailed in Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PATHS TO MULTIPLE STREAMS OF INCOMEIN MENTAL HEALTH  Promotion  Quality & professionalism (media & other ethics / legal issues)  Website  Shopping cart  Blog  Podcast  Video  Front end - eBook  Back end – Continuity  “Up-sells” Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • RE-PURPOSE YOUR MATERIAL Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • APA ETHICS CODE – STANDARD 5  5.01 Avoidance of False or Deceptive Statements -- ads, endorsements, resumes, CVs, published materials  5.02 Statements by Others -- we remain responsible, do not compensate media, clearly identify paid ads – webmasters and plagiarism  5.03 Descriptions of Workshops and Non-Degree- Granting Educational Programs – accurate  5.04 Media Presentations – based on literature and practice  5.05 Testimonials – not from current clients  5.06 In-Person Solicitation – protect others from our undue influence Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • FEDERAL TRADE COMMISSION (FTC)  What is an unfair ad?  When it is likely to cause substantial consumer injury (physical or economic).  It is not reasonably avoidable by consumers themselves.  And it is not outweighed by benefits to consumers or competition. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • FTC - When is an Ad Deceptive? When a claim or omission would materially mislead consumers acting reasonably in the circumstances. Strict Liability – • Intent to Deceive not required. Knowledge of Deception also not required except for money judgments against principals, which require proof of knowledge or reckless indifference to truth or falsity • -- Dean Graybill, Federal Trade Commission, Assistant Director, Western Region, San Francisco Copyright 2011 Affiliate Summit West 2
  • DOT COM DISCLOSURES: FTC BUSINESSEDUCATION/GUIDANCETO MAKE DISCLOSURES CLEAR AND CONSPICUOUS,ONLINE ADVERTISERS SHOULD:  Place disclosures close to the triggering claim.  When using hyperlinks to disclosures, make the link uniform and obvious, label the type of information it leads to, and monitor click-through rates for effectiveness.  Disclose material purchase terms on order page, near order button, as well as in Terms & Conditions. Copyright 2011 Affiliate Summit West 12
  • Competent and ReliableScientific Evidence What It Isn’t What It Is Anecdotal evidence from  Methodologically sound consumers tests, studies, scientific research Popular press articles  Based on expertise of professionals in field Sales materials from manufacturer  Objectively conducted by qualified people Low return rate  Using procedures accepted as accurate Money-back guarantee  Yielding statistically significant results Copyright 2011 Affiliate Summit West 9
  • “NEW” FTC SUBSTANTIATION STANDARD?  Weight Loss Claims – at least 2 controlled clinical studies on advertised product by separate, independent researchers Copyright 2011 Affiliate Summit West 10
  • REVISED FTC ENDORSEMENT GUIDES  Testimonials still must represent what consumers “typically” will achieve  BUT: if they don’t, “Results not typical” disclaimer no longer suffices, clear & conspicuous disclosure of “generally expected results” now required, unless advertiser can prove consumers don’t think the results are typical. No FTC enforcement of this yet but cases can be expected Copyright 2011 Affiliate Summit West 16
  • REVISED FTC ENDORSEMENT GUIDES(CONT.)  Disclosure of material connections between advertisers and lay (non-expert) endorsers must be made. This now applies to bloggers endorsing products, who also can be held liable for making false claims, and to celebrities endorsing products in unconventional formats (i.e., talk shows) or social media where consumer may not think celebrity is being paid. Advertiser principally liable for failure to disclose. Copyright 2011 Affiliate Summit West 17
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  • PATH #1: WRITE A BOOK Advantages  Positions you as an expert  Gives you highest credibility  TV shows  Radio  Easy to sell  Low resistance Disadvantages  Time  Cost  Printing  Fulfillment  Agent/Publicist Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • BOOK VS. EBOOK Zero delivery costs No printing No inventory No shipping Instant access Can charge premium prices List on Amazon Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • EBOOK APPROACHES Ebook  Weight loss  Outline Method  Positive Facts  5 major topics  Mind Games  Divide each one into 5 subtopics  Nutrition  Write 3-5 pages for  Exercise each subtopics  Strength training  = 100 page book  Cardio  Put pictures  Stories  Goal  1 subtopic a day, 3-5  Start with your favorite pages = less than 30 days topic Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • PATH #2: HIRE HELP Hire someone, research, layout or record content for you (fiverr, odesk, elance, guru etc.)  Royalty-free books, papers, articles  YouTube Links  Images  Quotes Use as a lead generator on Your Newsletter Subscription Sign-up Box (on your website) Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • GIVE VALUE - MAKE IT MEANINGFUL Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • KEEP IT SIMPLE Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • USE POWERFUL IMAGES Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • NEGOTIATING FOR HIRED HELP  $2k - $10k “Looking for 100 page book, here’s my budget,” then wait for bids  Carefully review samples  Behavioralsample  Can match your work flow  Contract  “Work for hire”  You own copyright  Get a copy of everything in WORD and PDF Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • PATH #3: INTERVIEW AN EXPERT  Interview on telephone  Have some one ask you questions, or you ask them questions related to your topic  Record  Make it a webinar (live or recorded)  Transcribe / PDF  eBook Cover  Sell from website  Email list Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PROCESS TIPS FOR INTERVIEWS, WEBINARSAND PODCASTS Content  Outline + Q&A Technology  WebEx, GotToMeeting, InstantTeleseminar Transcripts  Pay an expert – roughly $.50 a page Guests, Editors or Readers  Friends or family for 1st few times  Ask for feedback
  • WEBINAR / PODCAST FORMULAS Music clips  Itis pirating to just take a clip from any album  Must buy a commercial podcast license  Some record labels allow you to obtain free music for non-commercial podcasts (educational)  Use music that is royalty-free Breaking Up Show Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBINAR / PODCAST FORMULAS Clear sound Music in background that surfaces to create transitions Ask questions for audience to consider Then transition music Then answer the questions you posed earlier Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBINAR / PODCAST FORMULAS  Voice Tone  Modulate  sound alive  Google “voiceover”  Go to fiverr and buy “voice over” professional Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBINAR / PODCAST FORMULAS Recording Behaviors to Avoid  Sniffling  “Ahhhh”s  Scratching  Shifting in chair  Anything rubbing microphone - sleeve  Tapping fingers  Shuffling papers  Typing  Pen chewing  Filing nails Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBINAR / PODCAST FORMULAS Equipment Issues: Audio Clarity & Continuity  Equipment Quality  Type of Microphone  Headsets vs. Free Standing  Microphone Placement  Speaker Location Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBINAR / PODCAST FORMULAS  Reverberation  Sound Absorbers:  Carpeting  Plush couches  Drapes / Pillows  Noise pollution  Sign on Door  Overhead Planes  Traffic  Barking dog  Phone ringing, tea kettle Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WEBINAR / PODCAST FORMULAS  Make duplicate recordings  Your own hard drive, iTunes, Amazon S3  Online Radio Stations  UStream  Edit  Sony Soundforge, Audacity, Goldwave  Get transcript first – then pay someone to make edits Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • LOOK FOR CONTRIBUTORS  Paid  HelpaReporter -- want a site with some traffic  Ebay – authors with products for sale  Amazon.com / TURK  Answers.yahoo.com  Clickbank – mention you in their book for crosspromotion  EzineArticles.com  RTIROnline.com – experts pay to be interviewed  Volunteers – interns & colleagues  LinkedIn – mental health or coaches Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012 TeleMental Health Institute, Inc. All rights
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  • Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SELFHELPMAGAZINE (SHM) CYBER-INFIDELITY SURVEY IN 1998 Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • Repurpose a Blog Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • NEWSLETTER DISSEMINATION  Email Newsletter  Aweber  Constant Contact  PHPList  Where to Promote  Have opt-in box on your website Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
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  • PATH#5 PROCESS REVIEW What were the directions? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PATH #5 PROCESS REVIEW Blog LinkedIn Newsletter Facebook Twitter YouTube Consumer Portal / PPC / Sponsorships Courses *** Consultation ***
  • Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • EBOOK COVER & EBOOK LAYOUT Not home-made  99designs.com  eBook cover $5 at Fiverr.com Google “book layout”  Inside chapters & headers  $5 - $20 per page independent designers  $.50 per page at Fiverr.com (high end) Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • POWER OF TITLES, IMAGES, KEYWORDS &COLORS Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WHICH WOULD YOU BUY? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • WHAT’S THE DIFFERENCE? Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • CREATE YOUR CONTINUITY PROGRAM The 4X Role = should be worth at least four times your price High perceived value of at least $20 a month if you have a $5 a month membership site Make a list of all the materials you created  Articles / Book Chapters / Audios / Videos Get a coach to keep you on task Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PRICING YOUR FRONT END PRODUCT eBook – Usually $4.95 to $10.58  You never know until you split test! Bottom Line:  The more people you get into the front end, the more people will buy your continuity program, courses, Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • EXAMPLE Step-parenting Program Promotion  Parenting is another very hot topic for potential profits  “We just finished a new video the world’s top expert in raising stepchildren” More work than evergreen  Great experience for your members  Increases viral buzz Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • CONSUMER SWEET SPOT  Keep costs low ($4.95)  Provide value  Retain members over time Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • VIDEO PRODUCTION Use video as much as you are comfortable  Search engines prefer video, blogs then articles Hire someone to do parts for you  Opening Scene  Interviewer Inexpensive camera Edit recording through fiverr, odesk, elance, etc.  Intro & extro music Disseminate on YouTube and Traffic geyser
  • CREATE POWERPOINT PRESENTATIONW/ VOICEOVER  Camtasia (PC) ($200??)  Screenflow (Mac) ($100)  Burn to DVD  Burn it on DVD or Digital Download Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • FREE PRESS RELEASE WEBSITES 1888PressRelease.com  PageRelease.com AddPR.com  PR.com BizEurope.com  PR9.net eCommWire.com  PR-Inside.com Express-Press-Release.com  PRCompass.com Free-News-Release.com  PRlog.com Free-Press-Release.com  PRurgent.com Free-Press-Release-Center.info  PRzoom.com FreePressIndex.com  PressAbout.com FreePressRelease.co.cc  PressBox.co.uk FreePressReleases.co.uk  PressFlow.co.uk i-Newswire.com  PressMethod.com IndiaPRWire.com  PressRelease.com MediaSyndicate.com  PressReleasePoint.com MyFreePR.com  TechPRSpider.com NewswireToday.com  TheOpenPress.com Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • AFFILIATE MARKETING  Multiple authors contribute/Interviewees  Promote to their mailing lists if they have a list  Don’t share lists but rather cross-refer, or cross-promote  Classic editor-model  Instant credibility Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • MHEALTH Mobile phones are the predominant form of communication in 3rd world countries  landlines are extremely limited  broadband lags behind in development Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • SMARTPHONE “APPS” At Mobile World  “By 2015, worldwide Congress recently in shoppers will spend Barcelona, Google about $119 billion on CEO, Eric Schmidt, goods and services said that smartphones bought through mobile are a “mega-scale” device” -- ABI Research opportunity. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • MENTAL HEALTH APPS Copyright 2012TeleMental Health Institute, Inc. All rights reserved.
  • INFORMED CONSENT, SOCIAL MEDIA POLICYETC.For documents and access to FREE telephone/ webinar follow-up session on March 30 at 1 PM Pacific (4 PM Eastern)go to:http://telehealth.org/aca2012 Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • RESOURCES www.telehealth.ORG/bibliography
  • COMMENTARIES Farnan JM, Paro JA, Higa JT, et al. Commentary: The relationship status of digital media and professionalism: it’s complicated. Acad Med. 2009;84(11):1479-81. Greysen SR, Kind T, Chretien KC. Online Professionalism and the Mirror of Social Media. J Gen Intern Med. 2010 Nov;25(11):1227-9. Chretien KC. A doctor’s request: please don’t friend me. (Opinion-Editorial). USA Today. June 10, 2010. Mostaghimi A, Crotty BH. Professionalism in the digital age. Ann Intern Med. 2011;154(8):560-2. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • PAPERS Chretien KC, Greysen SR, Chretien JP, Kind T. Online posting of unprofessional content by medical students. JAMA. 2009 Sep 23;302(12):1309-15. Thompson LA, Dawson K, Ferdig R, Black EW, Boyer J, Coutts J, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008 Jul;23(7):954-7. Lagu T, Kaufman EJ, Asch DA, Armstrong K. Content of weblogs written by health professionals. J Gen Intern Med. 2008 Oct;23(10):1642-6. Garner J, O’Sullivan H. Facebook and the professional behaviours of undergraduate medical students. Clin Teach. 2010;7(2):112-5. Kind T, Genrich G, Sodhi A, Chretien KC. Social Media Policies at US Medical Schools. Med Educ Online. 2010 Sep 15;15. doi: 10.3402/meo.v15i0.5324. Chretien KC, Goldman EF, Beckman L, Kind T. It’s your own risk: students’ perspectives on online professionalism. Acad Med. 2010;85(10)S1-S4. Farnan JM, Paro JA, Higa J, Edelson J, Arora VM. The YouTube generation: Implications for medical professionalism. Perspectives in Biology & Medicine. 2008;51(4):517-24. Chretien KC, Azar J, Kind T. Physicians on Twitter. JAMA. 2011: 305(6):566-8. Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.
  • QUESTIONS? Donna Ford, MS Email: DonnaFord@aol.com Marlene M. Maheu, Ph.D. TeleMental Health Institute, Inc. Email: mmaheu@telehealth.ORG Copyright 2012 TeleMental Health Institute, Inc. All rights reserved.