Informed Consent For Distance Counseling

Every day I speak to therapists who are interested in growing their practices. Many are exploring the possibility of providing distance counseling. I’m happy to have Lauren Ostrowski back with us again this week to share with you her thoughts about the informed consent process that is unique to distance counseling.

(If you are interested in writing a guest post, check out the guidelines here. )

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A Guest Post by Lauren Ostrowski, MA, LPC, NCC, DCC

Informed consent is arguably one of the most important parts of the counseling process and requires one of many professional documents you will need in private practice. Typically, an informed consent form is lengthy, includes a lot of different information, and is largely dependent upon ethical codes specific to a particular mental health discipline. When your practice includes distance counseling,* there are special considerations that must be addressed in your informed consent form.

Please note that this guest post only discusses elements of informed consent that are unique to distance counseling and are not sufficient for your entire informed consent process or document.

My informed consent document has not been reviewed by an attorney. It was written with requirements from each of the following in mind: the American Counseling Association’s Code of Ethics (2005), the Code of Ethics for the National Board for Certified Counselors (2013), the National Board for Certified Counselors Policy Regarding the Provisional Distance Professional Services (2013), and the Online Therapy Institute’s Ethical Framework for the Use of Technology in Mental Health.

Informed Consent in Distance Counseling

Sounds complicated, doesn’t it? It took me quite some time to make sure that I had satisfied all of the requirements for each of them.

General Information

Adding information related to distance counseling into an already lengthy informed consent makes it almost unwieldy. I explain this at the beginning of my document and specifically say that it is important for the clients to read the document at their own pace and ask questions as needed. This guest post specifically focuses on internet counseling, as this will constitute a large majority of my client interactions. It is important to be mindful of phrasing – a lot of what is being addressed is highlighting the negative aspects of distance counseling so balance is key.

Confidentiality and Distance Counseling

Clients are responsible for the confidentiality of their own environment. (This statement constitutes its own paragraph in my informed consent because it is incredibly important).

In face-to-face counseling, the counselor can do a fair amount to make changes to increase privacy in the therapeutic environment. This is not possible when doing distance counseling. Related to confidentiality in distance counseling, you will also want to discuss the following with your client:

Other Important Concepts

What other questions do you have about distance counseling and informed consent? Did you learn anything that you could incorporate into your already existing document?

* Distance counseling refers to counseling that transpires through the use of technology. Technology can include the telephone, texting, internet-based interactions, and others. Actual counseling interaction must take place in a HIPAA-compliant environment and distance counselors typically have a separate website to advertise their services and discuss other practice-related information that is not confidential. The Distance Credentialed Counselor (DCC) is the credential is offered for mental health professionals through the Center for Credentialing &Education. The training for this credential is provided through ReadyMinds and Associates.

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About the Author: Lauren C. Ostrowski, MA, LPC, NCC, DCC is a counselor in a community mental health agency in Pennsylvania. She is also a Distance Credentialed Counselor and is excited about beginning a limited private practice using distance (online) counseling.