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I


n 2009, C. Hawn published an article in the journal of Health Affairs entitled “Take Two As- pirin and Tweet Me in the Morning: How Twitter, Facebook, and other Social Media are Reshaping


Health Care.” In it, he reviews the potential impact of these new communication sites on health care delivery and the implications for health care sys- tems and healthcare practitioners. Since that time, there have been additional advances in communi- cation technology and we continue to adjust to life in a digital world where distance is no longer a bar- rier to communication. Within the helping profes- sions, there is increased use of the many technolo- gies to deliver or to enhance the delivery of pro- fessional services.


TECHNOLOGY & COUNSELLING TODAY


The diverse modes of technologically mediated services are advancing and changing more quickly than our understanding of the associated benefits and risks. Also, it is faster than the development of regulatory statutes, policies, and changes to our practice standards necessary to govern their use. I was reminded of the circumstance by several re- cent consultations regarding counsellor use of email communication with clients. In one situation, a counsellor was both surprised and challenged by a judge’s demand that a considerable volume of emails with a client be delivered to the court be- cause the judge saw them as part of the client’s counselling record. Another counsellor had also generated a great deal of email correspondence with a client and was now wondering if it was pos- sible to invoice the client for what was now being seen, in retrospect, as the use of professional time on behalf of the client. A psychologist shared with me an email that had arrived when she was attend- ing to a sick relative and had not checked emails for several days. The message from a client said something like the following: “...today, I’m feeling down and I am not sure if it’s worth continuing with the work we have been doing.” The counsellor was quick to view this as a potentially suicidal thought. She immediately connected with the client and apologized for the delay, and found out that they were okay. She did wonder what her liability would have been if her client had acted on such a thought and also because she had not provided an emer- gency contact number.


THE CANADIAN COUNSELLING AND PSYCHOTHERAPY ASSOCIATION SUMMER 2019


PRACTICES & GUIDELINES


So for this Notebook, I decided to focus on the question: what are some practices and guidelines that could help us to manage our email communi- cation with clients consistent with our ethical obli- gations and fiduciary duty. At the outset, members are advised to consult both the CCPA Code of Ethics and Standards of Practice for some direction. Article B17 of the code is titled Services using Dis- tance Delivery, Social Media and Electronic Tech- nologies. It obligates CCPA members to engage in an intake process with sufficient disclosure and discussion to support client informed consent to any intended use of electronic technologies includ- ing email communication. For email use, this in- cludes providing an orientation about “security pro- tocols and ethical risks, limits to content and fre- quency of checking email transmission and anticipat- ed response time, and strategies clients can use to improve the security of their communications.”


GUIDANCE FOR THE USES OF TECHNOLOGY IN COUNSELLING & PSYCHOTHERAPY


As some of you may know, at the 2019 CCPA Annu- al Conference held in Moncton from May 13-16, the CCPA Technology and Innovative Solutions Chapter adopted a comprehensive report entitled Guidance for the Uses of Technology in Counsel- ling and Psychotherapy. For email use, the guide- lines in this report are as follows:


Have a secured and separate email address for clients.


All email used to communicate with clients should be encrypted. To quote Ray Huggins of Personcenteredtech.com—”encryption is the cyber-equivalent of sound-resistant walls, closed doors and noise machines in the hall- way.” It is a strong tool, but it is only a tool. You need to use and maintain it properly.


There are options to consider:


 You can encrypt or password-protect a document that you are sending to a client;


 You can encrypt or password-protect the email itself;


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