The recent past has seen the world undergo a major and one of the most unprecedented technological evolutions. Each and every aspect of our lives has been directly or indirectly affected or influence by these changes. The use of cellular phones, fax, teleconferencing, e-mails and online chats have become part of our daily lives. Probably this is because the internet gives the opportunity for confidential, unlimited communication over geographical borders as well as instant communication. All this coupled with its relatively low cost and accesses are paving their ways into the mental health sector.
This essay examines the ethics and issues related to the use of the internet to provide mental health services. It as well seeks the guides of American Psychological Association and the National Association of Social Workers code of ethics and their guidelines on the same. Lastly, we have looked at the positions on practicing in states where the provider is not licensed and the risks and benefits for the client and the professional.
The mental health services that are done through the internet have come to be known by different names; e-mail therapy, e-therapy, internet based therapy and the online counseling among other technical terms. This kind of therapy may be given either in combination with the traditional forms of treatment or may be initiated and done all by itself without any form of offline therapy.
Just like any other health service the aspect of informed consent is of paramount importance in this case. Before the client can make a decision on whether to take or not to take online therapy, it is ethical that the service provider varnishes him or her with full information on the process involved. He should be aware of not only the benefits but also the risks involved. The client must be made to realize that this system of treatment is completely different from the normal offline process. Misunderstandings are likely or have higher chances of occurrence as contact is limited. The non verbal cues are definitely lacking in this case.
For this processes to be seen as transparent and as ethical as possible then timeline are more than important. There should be clear guidelines as to when to except feedbacks and response. This timelines should be adhered to and not just on paper.
Privacy must be upheld through the whole process. Privacy is not only important for keeping the information confidential but helps build confidence of the client. The client feels secure and knows that her information is well safeguarded.
Although this field is relatively new some professional organizations have developed a clear guideline on code of ethics on the same. American Counseling Association code of Ethic has devoted a whole separate section i.e. A. 12 to deal with technological application. This section provides direction on limitations, informed consent, access and general use of the web regarding the e-therapy.
The American Mental Health Counselors Association (AMHCA 2010) code of ethics has devoted principle 6: Technology – Assisted Counseling. Here the mental counselors take deliberate steps to shield the clients from harm.
The National Association of Social Workers code of ethics is not elaborate on the ethical issues regarding the internet health services. It only touches briefly on the informed consent; it stipulates that social workers providing or involved electronic services ought to let their clients know of the benefits and risks associated with these services.
The American Psychological Association gives no specific guidelines on the same. However it clearly states that those therapies in use of internet or telephone should adhere to ethical guidelines as those of offline therapy. Thus the principles of benefinece and non maleficence, integrity, fidelity, justice and respect for people rights and dignity should be abided with.