INFORMED CONSENT FOR TELEHEALTH
This Informed Consent for Telepsychology contains important information focusing on psychotherapy using the phone or the Internet. Please read this carefully and let your therapist know if you have any questions. When you sign this document, it will represent an agreement between you and your therapist at Associates in Health Psychology (AHP)
Benefits and Risk of Telepsychology
Telepsychology refers to providing psychotherapy services remotely using telecommunications technologies, such as video conferencing or telephone. One of the benefits of telepsychology is that the client and clinician can engage in services without being in the same physical location. This can be helpful in ensuring continuity of care if the client or clinician moves to a different location, takes an extended vacation, or is otherwise unable to continue to meet in person. It is also more convenient and takes less time. Telepsychology, however, requires technical competence on both our parts to be helpful. Although there are benefits of telepsychology, there are some differences between in-person psychotherapy and telepsychology, as well as some risks. For example:
- Risks to confidentiality. Because telepsychology sessions take place outside of my private office, there is potential for other people to overhear sessions if you are not in a private place during the session. On my end, I will take reasonable steps to ensure your privacy. But it is important for you to make sure you find a private place for our session where you will not be interrupted. It is also important for you to protect the privacy of our session on your cell phone or other device. You should participate in therapy only while in a room or area where other people are not present and cannot overhear the conversation.
- Issues related to technology. There are many ways that technology issues might impact telepsychology. For example, technology may stop working during a session, other people might be able to get access to our private conversation, or stored data could be accessed by unauthorized people or companies. I will take steps to minimize this risk by using a HIPPA compliant platform for video conferencing. conversation.
- Crisis management and intervention. Usually, AHP will not engage in telepsychology with clients who are currently in crisis requiring high levels of support and intervention. Before engaging in telepsychology, we will develop an emergency response plan to address potential crisis situations that may arise during our telepsychology work.
- Efficacy. Most research shows that telepsychology is about as effective as in-person psychotherapy. However, some therapists believe that something is lost by not being in the same room. For example, there is debate about a therapist’s ability to fully understand non-verbal information when working remotely.
We will decide together which kind of telepsychology service to use. You may have to have certain computer or cell phone systems to use telepsychology services. You are solely responsible for any cost to you to obtain any necessary equipment, accessories, or software to take part in telepsychology. Please note that most insurance companies only reimburse for video conferencing.
I will only use email and text communication with your permission and typically for administrative purposes. This includes things like setting and changing appointments, billing matters, and other related issues. You should be aware that I cannot guarantee the confidentiality of any information communicated by email or text. For any clinical information or other confidential communication, use the Associates in Health Psychology voice mail (302-428-0205) system. Also, I do not regularly check my email or texts, nor do I respond immediately, so these methods should not be used if there is an emergency.
Treatment is most effective when clinical discussions occur at your regularly scheduled sessions. My voice mail is available 24 hours a day, 7 days a week if you would like to leave a message for me. I will try to return your call within 24 hours except on weekends and holidays. If an urgent situation or emergency arises, please follow the procedures listed on EMERGENCY PROCEDURES FOR TELEHEALTH SERVICES. If I will be unavailable for an extended time, I will discuss with you ahead of time options for services in my absence.
I have a legal and ethical responsibility to make my best efforts to protect all communications that are a part of our telepsychology. However, the nature of electronic communications technologies is such that I cannot guarantee that our communications will be kept confidential or that other people may not gain access to our communications. I will try to use updated encryption methods, firewalls, and back-up systems to help keep your information private, but there is a risk that our electronic communications may be compromised, unsecured, or accessed by others. You should also take reasonable steps to ensure the security of our communications (for example, only using secure networks for telepsychology sessions and having passwords to protect the device you use for telepsychology.
The extent of confidentiality and the exceptions to confidentiality that I outlined in my Office Policies still apply in telepsychology. Please let me know if you have any questions about exceptions to confidentiality.
Appropriateness of Telepsychology
From time to time, we may schedule in-person sessions to “check-in” with one another. I will let you know if I decide that telepsychology is no longer the most appropriate form of treatment for you. We will discuss options of engaging in in-person counseling or referrals to another professional in your location who can provide appropriate services.
Emergencies and Technology
Assessing and evaluating threats and other emergencies can be more difficult when conducting telepsychology than in traditional in-person therapy. To address some of these difficulties, we have created an emergency plan that will also need to be reviewed and signed. I will ask you to identify an emergency contact person who is near your location and to sign a separate authorization form allowing me to contact that person as needed in the event of a crisis or emergency.
If our telepsychology session is interrupted and you are not having an emergency, disconnect from the session and I will wait two (2) minutes and then re-contact you via the telepsychology platform on which we agreed to conduct therapy. If you do not receive a call back within two (2) minutes, then call me on the phone numbers I provided you.
The same fee rates will apply for telepsychology as apply for in-person psychotherapy. However, your insurance may not cover sessions that are conducted via telecommunication. If your insurance does not cover telehealth services, your therapist will discuss this with you. AHP requires a credit card on file prior to telepsychology unless other arrangements have been made with your therapist or the office staff.
The telepsychology sessions shall not be recorded in any way unless agreed to in writing by mutual consent. I will maintain a record of our session in the same way I maintain records of in-person sessions in accordance with my policies