6. The Use of Technology Supported Counseling and Communications (TSCC)
CMHCs recognize that technology has become culturally normative worldwide and may employ modern technology communications judiciously, attentive to both the benefits and risks to clients and to the therapeutic process of using technologies to arrange, deliver, or support counseling.
a. CMHCs understand that the uses of TSCC in counseling may be considered to fall under the following categories:
i. The use of TSCC as the medium for counseling, also called “telehealth” or “distance counseling,” which includes but is not limited to the delivery of counseling by video call (e.g., internet, video chat), by voice (e.g., telephone), by synchronous text (e.g., chat or SMS), or by asynchronous text (e.g., email)
ii. The use of TSCC as an adjunct to counseling (i.e., for arranging, coordinating, or paying for counseling services), including the use of payment processing services that are integrated with TSCC (e.g. PayPal, Stripe, Zelle) for receipt of payment for counseling services
iii. The use of online “cloud-based” services for the storage of counseling records
iv. Marketing, educational forums, and other TSCC to include blogs, webpages, chatroom, etc.
b. CMHCs recognize that federal, state, and local laws prevail and that the standard of care for TSCC is expected in the same manner as face-to-face and in-office counseling. Continuity of care is crucial and, at times, may conflict with local laws and regulations. CMHCs should employ a solid ethical decision-making model to secure continuity of care.
c. CMHCs are not required to provide services via TSCC or may decide not to offer services based on appropriateness.
d. CMHCs only provide telehealth or distance counseling when they have had sufficient training which can be gained through education, supervision, or other appropriate activities (see the TSCC section of AMHCA Standards for the Practice of Clinical Mental Health Counseling in Appendix B of the “Essentials of the Clinical Mental Health Counseling Profession” text or online at www.amhca.org/publications/standards).
e. CMHCs need to be familiar with state laws and regulations in both the state in which the CMHC is licensed and the state in which the client is presently located.
f. At the beginning of a course of distance counseling, CMHCs acquire the contact information for emergency services in the location of the client and develop a procedure to follow in the event of a psychiatric or health emergency.
g. In states where there is a legal requirement that CMHCs must include in the client record client communications through TSCC, CMHCs inform the client of that fact.
h. Unless email and text messages are encrypted or otherwise secured or confidential, the client should be informed of the risks and discouraged from using as a means to disclose personal information.
i. Chat Rooms: Typically, unsecured, open chat rooms are discouraged as a platform for communicating with clients.
j. CMHCs may maintain professional profiles that are kept separate from personal profiles. CMHCs need to be aware of their impact on clients should personal information or opinions be disclosed in a public platform. When applicable, CMHCs educate clients on confidentiality, implications for client activity on these pages, and appropriate channels for contacting CMHCs.
k. CMHCs only seek information about their clients through internet searches for the purpose of determining their own or their client’s safety, as necessary to conduct a forensic evaluation, or at the client’s request.
- AMHCA Code of Ethics (Revised 2020). American Mental Health Counselors Association.
When does CMHCs provide telehealth or distance counseling? Record the letter of the correct answer the .