| 1 The fictional Frasier Crane does it on the radio; so | | | | anywhere in the world |
| does the real life Dr. Laura Schlessinger, and before | | | | may well be the norm, as long as we both have |
| her Dr. Susan Forward. To some extent Dear Abby | | | | compatible technology and |
| and her twin sister, Ann Landers, also do it. What is it | | | | all systems are go.Counselors who have webpages |
| all these folks have in common? They all give counsel | | | | nication |
| and advice to people they don't know and will | | | | |
| probably never meet. Do you, or will you, as a | | | | * Participate in a chat room live, either with an |
| Christian counselor, use electronic means to practice | | | | individual or a group (synchronous) |
| your profession? If you have ever picked up the | | | | |
| telephone to change an appointment with a client or | | | | * Use CUseeme sessions. A counselee or client can |
| to follow up on a counselee, you have, at one level, | | | | also initiate the modalities of a letter, a phone call, |
| participated in electronic counseling. Technology brings | | | | text e-mail, and posting on a listserv. Many people |
| new means of communication for all of us, counselors | | | | have formed chat rooms or listservs around common |
| and counselees included, not just in our work lives | | | | problems and concerns without having a counselor |
| but in our day to day living as well. The medical | | | | participatean online |
| profession already operates in the realm of tele | | | | self-help group. Most counselors use the telephone |
| medicine and telehealth. These programs were | | | | or written communications as an adjunct to F2F |
| developed out of a recognized needpatients in rural | | | | therapy. I have never heard these practices |
| areas who do not have access to specialists, who | | | | questioned. However, cybercounseling brings a host |
| tend to congregate in urban areas. The most used | | | | of ethical considerations, which are generally not yet |
| modality has been electronic transmission of data, | | | | resolved. The following is a list of potential potholes |
| such as X-rays or fetal monitoring. | | | | for cybercounselors: |
| The other modality has been the use of live audio | | | | |
| and video, called by some CUseeme technology. A | | | | * Who is your client? You only know what the |
| doctor and patient are online live with the specialist | | | | person tells you by text. |
| who then consults in the patients treatment. Each | | | | |
| state in the U.S. has regulations for how out-of-state | | | | * Is there anyone else present in the room? This |
| doctors can consult in the state. It is worth noting | | | | could be a real issue if someone who has a potential |
| that these regulations are by no means uniform and | | | | to harm your client can access their e-mail. |
| are an ongoing source of confusion. It is a point to | | | | |
| pay attention to because it could portent what might | | | | * Is your clients confidentiality protected? Are you |
| occur for counseling regulations if cyber counseling | | | | using encryption that is sufficient for protection? |
| ever becomes a norm. While counseling encompasses | | | | |
| a range of modalities of service delivery, cyber | | | | * What are your back-up means if your client is of |
| counseling refers to using the computer in some | | | | danger to self or others? |
| form for delivering counseling services. A counselor | | | | |
| can: | | | | * Will you be violating any laws if you are counseling |
| | | | | someone in another state, either because you are |
| * See an individual or group in a live session (face to | | | | not licensed in that state, or because that state |
| face, referred to as F2F) | | | | prohibits cybercounseling? The risks are even greater |
| | | | | for a counselee: |
| * Write a letter | | | | |
| | | | | * What are your counselors Professional mental |
| * Telephone a client | | | | health provider organizations have not yet modified |
| | | | | their ethical codes to include cybercounseling.The |
| * Send text e-mail, one to one, to a client in an | | | | average website has many more viewers than actual |
| asynchronous mode | | | | participants in a counseling agreement. No counselor I |
| | | | | know of has given up a F2F practice to devote all of |
| * Send text e-mail on a listserv to a number of | | | | his or her time to cybercounseling. |
| clients, who will all see the same commuqualifications? | | | | |
| How can you verify them? | | | | Some sites have already closed down from the time |
| | | | | I first did research on them, because of lack of |
| * Does the counselor hold an unrestricted license, | | | | business or because the counselor felt that there |
| that is, not under any sanction from any state? | | | | were too many unresolved ethical issues at present. |
| | | | | New sites are |
| * Does the counselor have any kind of training to | | | | constantly springing upsome more qualified and |
| specifically conduct cybercounseling? | | | | ethical than others. It is truly a market of let the |
| | | | | buyer (and to some extent, the provider) beware. |
| * What are your avenues of recourse if you believe | | | | |
| that your counselor has acted unethically or caused | | | | |
| you harm? | | | | |
| | | | | Professional mental health provider organizations have |
| * How do you know you are receiving services from | | | | not yet modified |
| the actual counselor and not someone without | | | | their ethical codes to include cyber counseling. Very |
| qualifications delegated to answer e-mails? In addition, | | | | few states have addressed the issue in their |
| the basic unanswered question is, Is cybercounseling | | | | regulations. As Christians, we need to proceed |
| really counseling or is it advice giving?I have given a | | | | carefully. Even if we offer a Christian counseling |
| lot of e-mail and | | | | service on the Internet, we must heed the same |
| phone advice to my sons who live in other cities | | | | cautions as anyone else. I recently spoke with |
| from me. I have given | | | | someone who was putting up such a service. I asked |
| advice to alumni of our program who communicate | | | | if the organization used to check credentials of |
| with me by these same means. I would never call | | | | potential providers verifies with the states that the |
| any of it counseling. Some would argue that | | | | licenses are not under sanction. Find a therapist for |
| counseling can occur through text means, either | | | | immediate help. |
| synchronous or asynchronous. The jury is still out on | | | | He did not know it was an area that did not occur to |
| this one, and, for the record, so am I. I do believe | | | | him. We have an obligation first of all to our |
| that when the CUseeme technology is common, | | | | counselees to act with their welfare and benefit in |
| perhaps within 510 years, and problems of broader | | | | mind, and in venturing forth we must not overlook |
| bandwidths and video-audio streaming are solved, we | | | | important issues.Perhaps an appropriate motto for |
| will be a lot closer to the practices of telemedicine | | | | Christian cyber counselors is the following: Wisdom is |
| and then the argument will be moot. Cybercounseling | | | | supreme; therefore get wisdom. Though it cost all |
| with | | | | you have, get understanding(Prov. 4:7). |
| me at my desk in Virginia Beach and the counselee | | | | |