Technology & Counseling

1. Technology & Counseling Emily Warren & Kerry Avakian

2. Technology • New technology constantly being released • How do we utilize technology to maximize client progress while minimizing risk? • Privacy is #1 concern with new technology.

3. Association for Counselor Education and Supervision Competencies • Be able to use productivity software to develop web pages, word processing documents (letters, reports), basic databases, spreadsheets, and other forms of documentation or materials applicable to practice. • Be able to use such audiovisual equipment as video recorders, audio recorders, projection equipment, video conferencing equipment, playback units and other applications available through education and training experiences. • Be able to acquire, use and develop multimedia software, (i.e., PowerPoint/Keynote presentations, animated graphics, digital audio, digital video) applicable to education, training, and practice. • Be able to use statistical software to organize and analyze data. • Be able to use computerized and/or internet-based testing, diagnostic, and career decision-making programs with clients. • Be able to use email. • Be able to help clients search for and evaluate various types of counseling-related information via the Internet, including information about careers, employment opportunities, educational and training opportunities, financial assistance/scholarships, treatment procedures, and social and personal information. • Be able to subscribe, participate in, and sign off counseling related listservs or other internet based professional communication applications. • Be able to access and use counseling-related research databases. • Be able to use the Internet to locate, evaluate, and use continuing education, professional development and supervision options in counseling. • Be able to perform basic computer operation and maintenance tasks. • Be knowledgeable about legal, ethical, and efficacy issues associated with delivery of counseling services via the internet.

4. Guidelines for Ensuring Client Privacy: TELEPHONES • ACA Code of Ethics (2005) • Discuss private information of clients “only in settings in which they can reasonably ensure client privacy”. • Why are telephones risky in terms of confidentiality? • Train staff on how to maintain confidentiality.

5. Guidelines for Counselor Telephone Use (Remley & Herlihy, 2010) • Do not acknowledge clients are receiving services or give out client info to unknown callers. • Attempt to verify you are talking to the right person in calls where confidential information will be discussed. • Be conscious of the fact that your conversation could be recorded or monitored by an unauthorized person. • When discussing confidential information about a client stay professional at all times, do not say anything “off the record”. • Be mindful that the phone company will have a record that this call was made. • Do not say anything during the conversion you would not want your client to hear or would not say under oath in legal proceeding.

6. Answering Machines, Voice Mail, and Answering Services • Influence of a poor economy • Use of answering machines • Concerns with voice mail and answering services • Calling a client’s cell phone

7. Fax Machines • Welfel’s (2006) Five Strategies for Faxing Private Material

8. Office Security • Security Cameras • Guards / Doormen

9. Computer Storage • Computers vs. File Cabinet • Are deleted files really gone? • 11 Guidelines for computerized records

10. E-Mail • Each message is recorded • Once sent, cannot be retrieved • Misinterpretation • Easy to make errors • Messages can be forwarded and altered • Ease of use encourages informality

11. Internet • Source of Information for Clients • Internet Counseling • List Servs and Profile Sites

12. NBCC • Internet Counseling Relationship • 1. In situations where it is difficult to verify the identity of the Internet client, steps are taken to address impostor concerns, such as by using code words or numbers. • 2. Internet counselors determine if a client is a minor and therefore in need of parental/guardian consent. When parent/guardian consent is required to provide Internet counseling to minors, the identity of the consenting person is verified. • 3. As part of the counseling orientation process, the Internet counselor explains to clients the procedures for contacting the Internet counselor when he or she is off-line and, in the case of asynchronous counseling, how often e-mail messages will be checked by the Internet counselor. • 4. As part of the counseling orientation process, the Internet counselor explains to clients the possibility of technology failure and discusses alternative modes of communication, if that failure occurs. • 5. As part of the counseling orientation process, the Internet counselor explains to clients how to cope with potential misunderstandings when visual cues do not exist. • 6. As a part of the counseling orientation process, the Internet counselor collaborates with the Internet client to identify an appropriately trained professional who can provide local assistance, including crisis intervention, if needed. The Internet counselor and Internet • client should also collaborate to determine the local crisis hotline telephone number and the local emergency telephone number. • 7. The Internet counselor has an obligation, when appropriate, to make clients aware of free public access points to the Internet within the community for accessing Internet counseling or Web-based assessment, information, and instructional resources. • 8. Within the limits of readily available technology, Internet counselors have an obligation to make their Web site a barrier-free environment to clients with disabilities. • 9. Internet counselors are aware that some clients may communicate in different languages, live in different time zones, and have unique cultural perspectives. Internet counselors are also aware that local conditions and events may impact the client.

13. NBCC • Confidentiality in Internet Counseling • 10. The Internet counselor informs Internet clients of encryption methods being used to help insure the security of client/counselor/supervisor communications. Encryption methods should be used whenever possible. If encryption is not made available to clients, clients must be informed of the potential hazards of unsecured communication on the Internet. Hazards may include unauthorized monitoring of transmissions and/or records of Internet counseling sessions. • 11. The Internet counselor informs Internet clients if, how, and how long session data are being preserved. Session data may include Internet counselor/Internet client e-mail, test results, audio/video session recordings, session notes, and counselor/supervisor communications. The likelihood of electronic sessions being preserved is greater because of the ease and decreased costs involved in recording. Thus, its potential use in supervision, research, and legal proceedings increases. • 12. Internet counselors follow appropriate procedures regarding the release of information for sharing Internet client information with other electronic sources. Because of the relative ease with which e-mail messages can be forwarded to formal and casual referral sources, Internet counselors must work to insure the confidentiality of the Internet counseling relationship.

14. NBCC • Legal Considerations, Licensure, and Certification • 13. Internet counselors review pertinent legal and ethical codes for guidance on the practice of Internet counseling and supervision. Local, state, provincial, and national statutes as well as codes of professional membership organizations, professional certifying bodies, and state or provincial licensing boards need to be reviewed. Also, as varying state rules and opinions exist on questions pertaining to whether Internet counseling takes place in the Internet counselor's location or the Internet client's location, it is important to review codes in the counselor's home jurisdiction as well as the client's. Internet counselors also consider carefully local customs regarding age of consent and child abuse reporting, and liability insurance policies need to be reviewed to determine if the practice of Internet counseling is a covered activity. • 14. The Internet counselor's Web site provides links to websites of all appropriate certification bodies and licensure boards to facilitate consumer protection.

15. Multicultural Considerations • Equal access to all? • Concerns for the future

16. ACA Code of Ethics • Inform clients of benefits and limitations of technology • Use technology only if appropriate for that client • Provide access to computer applications when distance counseling is being provided • Follow laws related to distance counseling • Seek legal advice when crossing state or national boundaries when providing services through technology • Provide client with extensive information before engaging in technology-based counseling.

17. ASCA Code of Ethics • A.10. Technology • Professional school counselors:a. Promote the benefits of and clarify the limitations of various appropriate technological applications. Professional school counselors promote technological applications (1) that are appropriate for students’ individual needs, (2) that students understand how to use and (3) for which follow-up counseling assistance is provided. • b. Advocate for equal access to technology for all students, especially those historically underserved. • c. Take appropriate and reasonable measures for maintaining confidentiality of student information and educational records stored or transmitted through the use of computers, facsimile machines, telephones, voicemail, answering machines and other electronic or computer technology. • d. Understand the intent of FERPA and its impact on sharing electronic student records. • e. Consider the extent to which cyberbullying is interfering with students’ educational process and base guidance curriculum and intervention programming for this pervasive and potentially dangerous problem on research-based and best practices.

18. Legal Implications • Is internet counseling permitted in states where counselors must be licensed to practice? • Where does it take place: location of client, counselor or both? • Lawsuits will clarify these questions in the future.

19. Research- Mallen, Vogel & Rochlen (2005) • Online counseling is predicted to increase • Cost of web-conferencing • The importance of continuing education • Graduate education • Certain skills do transfer more effectively to online setting (CBT)

20. Research-Carlson, Portman & Bartlett (2006) • Most school counselors are comfortable with using computers; however, a majority of these professionals are anxious about using a variety of software. • The majority of school counselors in the study had a high comfort level with using e-mail and indicated that they were at least somewhat comfortable with all aspects of e-mail use. • The most common type of technology reportedly used by the respondents was a VCR and monitor (85%). • The most popular type of computer training reported by this sample included outside or continuing education courses. The implication for this finding is twofold. First, school counselor preparation programs must begin to include training in technology usage for their students to be effective school counselors and second, that professional organizations must be cognizant of selecting or soliciting technology training workshops for their annual conference programs. • The affective variable of comfort with use of technology appeared to be a more critical determinant of school counselor use of computers than age or years of experience. • School counselors with greater comfort levels and more training were more apt to use a variety of software. Thus, exposure and experience appear to increase usage.

21. The Case of Brandon • Brandon works as a school counselor at a local high school. One of his clients, a sixteen year old named Jane, has been out of school for two weeks because of a surgery and subsequent recovery and is expected to return to school in one month. Jane came to counseling 3 months ago looking for help coping with depression and self-mutilation, and saw Brandon on a weekly basis. Brandon saw improvements in Jane’s affect and she had reported that she had not self-mutilated for three weeks when she had left school. Jane’s mom called Brandon to say that Jane was crying frequently, has been fighting with her younger brother much more than normal, and that she suspected that Jane was at risk to cut again. She requested that he continue to work with Jane either over the phone or through Skype in order to prevent Jane from regressing to her previous depression. Brandon is concerned that Jane might already be cutting if her behavior is as her mother describes, and is worried that it will only worsen over the next month without some sort of intervention. However, Brandon has never done counseling over the phone or Skype, and has concerns about its effectiveness and ethical implications.

22. The Case of Brandon • What are the ethical and/or legal issues involved in this case? • What specific standards in the ACA Code of Ethics and the ASCA Ethical Standards for School Counselors are pertinent to the case, and what guidance do these codes offer? • What recommendation(s) do you make for resolving the dilemma? • What is your rationale for this recommendation and how did you come to this decision?