This document discusses various ethical considerations related to technology and counseling. As technology advances, counselors must develop new ethical boundaries. There are concerns regarding confidentiality with different forms of communication like phones, email, and online counseling. Ensuring client consent, assessing appropriateness of computer programs, and validating assessment tools are important. Regulations for telehealth and distance learning are still developing.

1. Ethics and Technology

2. Innovation
Over the past several decades, technology has
advanced at an amazing rate.
As new technology develops, professionals are
challenged to create new and innovative ethical
boundaries to accommodate the advancement.

3. New Technology
There are numerous examples of ethical considerations
for technology
Telephones
Cell Phones
Internet
 Chat Rooms
 Private vs. semiprivate email accounts
Personal Computers

4. Ethical Management
ACA states counselors must protect every client
and their rights to confidentiality.
Food for thought:
 Standards of confidentiality for printed information
apply to those for electronic media.
 Fax machines often transmit confidentially.
 Electronic information is not always as private as
necessary.
Ex: email
 Confidential information should not be discussed on
cell phones.

5. Telephones
Considerations
 State that the phone has a confidential line and/or
voicemail.
 Always state on voicemail at the end of your greeting:
“If this is an emergency, please hang up and dial
911, or go to the nearest emergency room.”

6. Cell Phones
Cell phones have been found to lack security
regarding the transmittal of confidential
information
 Avoid the use of cell phones when discussing
confidential information
 Occasionally, conversations on cell phones can be
picked up on other electronics
Ex: BVRCC

7. Electronic Media
Personal Computers
 Hardware: hard disk, disks, CD-ROM’s, etc…
Hardware can be protected with a mechanical
lock/key.
The hardware should be locked when unattended or
not in use.
 Software: Microsoft Word, Excel, Medisoft, etc…
The documents created with software can be
protected with passwords for authorized personnel.
Authorized personnel should “log off” when the
computer is unattended.

8. Email and Fax Machines
Email
 Confidential information transferred by email should
only be transmitted to secure locations
Password controlled systems
Mechanically locked systems
Psychologists' Use of E-mail with Clients: Some Ethical
Considerations
Fax Machines
 Counselors must attempt to send facsimiles to secure
locations
Do not send to centrally located machines
Provide a cover letter with a Confidentiality Statement

9. Computer-Assisted Counseling
Career Counseling
 Programs such as System for Guidance and
Information-Plus (SIGI-PLUS) have been found to be
useful with highly motivated clients.
Clients with lower levels of motivation were found to benefit
less.
Clinicians need to assess the appropriateness of such
programs according to each clients level of motivation.

10. Computer-Assisted Counseling
Rehabilitation
 Clients with traumatic brain injury began receiving
cognitive retraining with computers in the 1970’s.
 Cognitive Retraining System (CACR)
The NeuroScience Center
 Computers made it easy to record and track a patients
improvement

11. Computer-Assisted Counseling
Other Uses
 Various software has been developed for
psychoeducation in a number of ways
AIDS education
Drug and Alcohol abuse education
Sexual Dysfunction
Distress
Smoking

12. Computer-Assisted Counseling:
Is it Effective?
Does computer-assisted counseling devaluate
the client/counselor relationship?
 Psychodynamic and humanistic counselors believe
face-to-face interaction is imperative to the counseling
relationship.
Computer-assisted counseling allows clients to:
 Learn new behaviors
 Express emotions
 Hone insightful capacities
 Gain feedback
 Practice interaction with individuals

13. Appropriateness for Clients
It is important to identify
which interventions are
most appropriate for each
client
 Determine if a particular
computer program is right
for the client
 Assess the client’s level of
function and cognitive
capabilities

14. Validation of Programs
APA and ACA require that assessment software
be validated prior to use with clients
Also required that clinicians are competent and
trained to administer the assessment
This guideline is not in place for computer-
assisted programs
 Not tested for reliability or validity
 No training required for administration
 At present, anyone can administer it!

15. Ethical Dilemmas
ACA has some standards for computer-assisted
counseling.
 Ethics -Section A.12.g
The counselor must ensure that each client:
 Is capable of using the program
Emotionally, cognitively, and physically
 The program must be appropriate for the client
 Comprehends the purpose of the program
 Receives a follow-up session(s) to preserve the intent
of the program
Correct any misconceptions
Determine if misuse has taken place
Assess for alternate interventions

16. Online Counseling
Forums
 Very recent advancement in counseling
 Ethical boundaries are still fuzzy
Internet
 Email
Counselors should be careful of transmitting confidential
information
Often, this information can be intercepted
Clients typically use email to ask mental health professionals
specific questions

17. Online Counseling
Future applications
 Advertising for services in the mental health
field
 Real-time video conferencing
Ethical Implications
 Need technological applications to protect
clients
Video signal scrambling
Data encryption

18. Development of Ethical Policies
Telehealth
 Allows professionals to communicate with consumers
from remote locations
Ex: Videoconference
Office for the Advancement of Telehealth - Welcome
Perks for Providers
 Many professionals are eligible for reimbursement
from Medicare
 Federal Communications Commission (FCC) offers
grants

19. NBCC Efforts
WebCounseling
 The NBCC created WebCounseling in an
effort to better serve clients
 It is a way for mental health professionals to
communicate with clients with remote access.
NBCC News (1997)
 Standards-pg. 3
 http://www.nbcc.org/extras/pdfs/recert/newslet
ters/newsnotes_14-2.pdf

20. ACA’s Efforts
Created standards for practice in online
counseling in 1999
ACA Code of Ethics
 A.12.h
 Ethics
 Cybercounseling and Cyberlearning: Strategies &
Resources for the Millennium
 Bloom & Walz, 2000
A handbook discussing various web references and
professional experiences with cybercounseling
http://images-
eu.amazon.com/images/P/155620180X.01.LZZZZZZZ.jpg

21. Telepsychology Regulation
In 1997, a study looked at pertinent
information regarding regulation according
to each state’s Attorney General
The Survey Says!:
 Only 7% of all 50 states had regulations
regarding telehealth in 1999.
 Only 7% of all licensing agencies had defined
regulations for telehealth.

22. Telepsychology Regulation
Future development of policies was only
addressed 17% of the time in the agencies with
regulations.
Much of the regulations created are developed
out of necessity
 Litigation

23. Telepsychology Regulation
How should we address professionals who
practice across state lines?
 There are 51 jurisdictions
Is it possible to be aware of and comply
with all regulations?
 45% said professionals should be held
accountable to the laws of the states in which
their practices are offered.

24. Examples of Cybercounseling
What is wrong with each of these websites?
http://sgoldsmith1.tripod.com/id13.html
ONLINE COUNSELING & Psychotherapy by
seasoned professionals
What is right about these?
http://www.williamscounselingservices.com/
Online therapy and online counseling at
HelpHorizons

25. Computer-Assisted Assessments
Purpose
Administer, score, and interpret information
Examples of computerized assessments:
 Wechsler Adult Intelligence Scale-III (WAIS-III
(subtests))
 Wonderlic Personnel Test
 MMPI-2

26. Computer-Assisted Assessments
Benefits
 Quick
 Reliable
 Non-repetitive
 Minimizes human error
Concerns
 Unqualified individuals may try to administer these
assessments
 Providers must be competent in the administration of
these assessments
Adequate training

27. Computer-Assisted Assessments
Limitations
 Examinees should be observed during testing
Stimulus control, unfavorable conditions
 SES
Lack of available technology for clients with little or
no financial means
 Cannot be used as a replacement for
professionals

28. Computer-Assisted Assessments
Reports
Too much reliability on the technology to
interpret the findings of the assessment
 Ex: Qualitative data
Data should be reviewed by the counselor
Agencies may be pressured to use under-
qualified individuals for testing
 Lack of funding
 Lack of time

29. Computer-Assisted Counselor
Education
Supervision and Practica
Benefits
 Email as a form of communication between
professionals
Share ideas
Concerns
 Neglects the nonverbal communication
between supervisor and supervisee
Ex: Crossed arms, smiling, furrowed eyebrows

30. Computer-Assisted Counselor
Education
Distance Learning
 Convenient
 Consistent quality to all users
 Those in remote areas have access to education
 Time limitations are minimized
 Limited mobility individuals have equal opportunity

31. Computer-Assisted Counselor
Education
Modalities for online education
 Asynchronous
Curricula are available continuously
Ex: Web CT, Blackboard
Blackboard 6 | Sam Houston State University
 Synchronous
Curricula are available for a discrete period of time
Ex: Timed online exams, assignments

32. Distance Learning
Ethical Concerns
 Lack of personal contact
 Prerecorded lectures lack an opportunity Q &
A time
 Discourages active participation in class
 Limited collegial interaction
 Cost may hinder some students
 Clarification of information is limited

33. Development of Distance Learning
Curricula
Mission
 Review the goals of the distance learning program
Populations, structure, procedures
Delivery of distance learning
 Video conferences
 Prerecorded tapes
 Discussion forums

34. Development of Distance Learning
Curricula
Instructors
 Need competencies related to technology
 Understand troubleshooting procedures
 Property rights of curricula
Resources
 Texts should be complimentary to online
applications
 Interactive workbooks to encourage students
to process the learned material

35. Development of Distance Learning
Curricula
Support for Students
 Students should be screened for capacity to succeed
 Career counseling
 Registration
 Financial aid
 Selection of coursework and load
 Need low student/teacher ratio
10:1 (CACREP)

36. Development of Distance Learning
Curricula
Evaluation of Programs
 Course evaluations from students
 Quality
 Assignment completion and punctuality rates
Computer-Assisted Instruction (CAI)
 Used to present specific concepts/information
 Can help illustrate specific constructs

37. Technoanxious vs. Technocentered
Technoanxious
 Uncomfortable with technology
 Often perceives technology as a negative influence
Computers, cell phones, CAI, etc…
Technocentered
 Comfortable with technology
 Willing to utilize technology for the advancement of the
profession

38. Software: Ethical Concerns
Pirating
 Use of software without consent/compensation from
the owner
 Law suits have heightened society’s awareness
 Created legislation as a result of law suits
Ex: Napster,Metallica

39. Case Scenario #1
Suzie is a counselor at the Happy Hearts Counseling Center. She has
just finished an intake session with a new client and received consent
from the client to share information with her psychiatrist. The patient
gave Suzie all of her psychiatrist’s contact information; however,
Suzie failed to confirm the information prior to faxing off the consent
form and confidential client information. She also neglected to include
a cover sheet with a confidentiality statement. The confidential
information made its way to the incorrect location, a centrally located
fax machine in a very busy office. Everyone near the fax machine saw
the client’s identifying information and where she was seeking
services.
How can this situation be rectified? How can it be prevented in the
future?

40. Case Scenario #2
The Happy Hearts Counseling Center recently hired a new
administrative assistant. Unfortunately, due to time constraints, the
individual who was assigned to train the new employee failed to
cover all necessary information about confidentiality requirements.
Due to this lack of training, the employee did not learn the specific
guidelines for sharing confidential information via the internet. The
employee emailed another counselor confidential information about
a specific client (including the clients full name and presenting
problem) to the counselor’s personal email address. Much to the
counselor’s surprise, when he checked his email that evening in his
living room he found the document containing sensitive information.
Some members happened to be nearby when he checked his email.
What are some ways this problem could have been prevented?
What steps should the counseling center take to correct the
problem?

41. References
ACA Code of Ethics (2005). Retrieved June 6,
2006, from http://www.counseling.org.
Bloom, J., & Walz, G. (2000). Cybercounseling and
cyberlearning: Strategies and resources for the new
millennium. Alexandria, Virginia: American
Counseling Association.
Bracy, O. The NeuroScience Center. (2006). Retrieved
June 5, 2006, from
http://www.neuroscience.cnter.com/.
Goldsmith, S. (2005). Retrieved June 6, 2006, from
http://sgoldsmith1.tripod.com/id13.html.
HelpHorizons.com. (2006). Retrieved June 6, 2006, from
http://www.helphorizons.com/.

42. References
National Board for Certified counselors. (1997).
Guidelines for the new world of webcounseling.
NBCC NewsNotes, 14(2), 1-2. Retrieved June 6,
2006, from
http://www.nbcc.org/extras/pdfs/recert/newsletters/n
ewsnotes_14-2.pdf.
Office for the Advancement of Telehealth. (2006).
Retrieved June 5, 2006, from
http://telehealth.hrsa.gov/welcome.htm.
The WebCounseling Site. (2006). Retrieved June 6,
2006, from http://webcounseling.tripod.com/cgi-
bin/in.pl.
Williams Counseling Services. (2006). Retrieved June 6,
2006, from
http://www.williamscounselingservices.com/.