Discussing personal feelings with a counselor is always a little scary, but telling them over a screen can be even more intimidating— especially for seniors. Since older adults can benefit tremendously from online therapy, we’d like to discuss all the steps that counselors take to ensure telehealth clients receive the same confidentiality as in-person clients.
If you can’t find anything stating that an online mental wellness provider abides by HIPAA regulations, keep scrolling to the next site. All healthcare providers, including those in the mental health field, should follow the rules stated in the Health Insurance Portability and Accountability Act (HIPAA), meaning they can’t share any of your private information including your:
Specifically pertaining to online therapy, HIPAA set federal guidelines that therapists must comply with in order to protect their clients’ privacy online. Your chosen counselor should use HIPAA-compliant counseling platforms and should not use Facebook Live, Twitch, TikTok, and similar video communication applications that are public facing. Your counselor should also use high-grade encryption services to protect electronic data such as psychotherapy notes and bills, so if you’re concerned about this, ask them what they are using.
Any other unique qualifiers
Medical record numbers
Social security number
Birthday or treatment dates
Most licensed counselors have taken an oath to follow the ACA’s Code of Ethics. These include some guidelines that pertain specifically to online counseling:
Possible denial of insurance benefits
Contact information and emergency procedures to follow when the counselor is not available
The location of the physical practice
Distance counseling credentials
Risks and benefits of engaging in the use of distance counseling and technology
Counselors should make clients aware of online counseling features including:
Counselors must ensure that electronically administered assessments function properly and provide clients with accurate results. There should be a backup plan if technology fails during the session.
Counselors must develop online therapy knowledge regarding technical, ethical, and legal considerations.
Counselors must not engage in personal virtual relationships with clients. This includes becoming “friends” on social media platforms.
Counselors must verify a client’s identity at the beginning and throughout the therapeutic process.
Online mental health providers should have clients sign a disclosure agreement before beginning therapy. The agreement states that the information discussed in therapy won’t be shared with anyone else without written permission, however, just as with in-person counseling, an online therapist is bound by law to contact proper authorities if suspected harm or danger is revealed. Heidi Donald, Licensed Clinical Social Worker at Renew Mind and Body Wellness in Columbia, Illinois, says all therapists must let their clients know this before beginning treatment.
“I tell my clients that I have three rules when it comes to breaking confidentiality,” said Donald. “If I suspect someone is hurting you, if I suspect you may harm yourself, or if I suspect you may harm someone else, I cannot keep those things private.”
Remember, the purpose of any form of counseling is to achieve overall wellness, and a reputable therapist will do everything possible to make that happen.