Updated: Apr 27
To continue with our very interesting topic, we will get deeper into the confidentiality issues that might put our service and for extension our clients at risk.
However, with a bit of guidance and proper protocols in place, the security required to offer a proper online counselling service can be met adequately.
I also work in private practice, and the focus of my practice is now going towards offering online counselling through different mediums – live or asynchronous messaging, Zoom video call, Zoom/Telephone voice call, and soon also email.
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When we talk about personal matters, confidentiality is a must.
This rule applies to online counselling too. Especially online counselling, with all the safety issues that might compromise the content of our sessions.
Prior to start offering online counselling, therapists need to make sure they can provide a safe and confidential online space.
We do this by using very high-end protocols.
These days, where technology offers unlimited options, finding the best way to provide safety and confidentiality should be straight forward.
Let’s go through the most known options.
It’s easy to use. Many of us use it to keep in touch with friends and family. with a handset, microphone and speaker we are ready to go.
I (Karin) still use Skype for some sessions but am aiming to move everyone over to Zoom.
There is a major issue with Skype, that is enough to warrant moving to a more GDPR/HIPPA compliant platform, like Zoom or VSee (there are many others that are good too!)
The Issue: Skype is encrypted, but once you’ve signed the terms and conditions, you give up the rights to your sessions’ content.
An alternative to Skype, but safer as it’s encrypted and your content is secure.
It’s great for one-to-one meetings, which have unlimited time, so it’s great for individual counselling sessions.
If you have a group meeting, the free version only allows 40 minutes per meeting.
Another great thing about zoom is that it can be used to record video conferences, present webinars and share your screen to show a PowerPoint presentation and others.
There are lots of other applications out there that could offer the encryption required to secure the confidentiality, but we won’t get into all of them here.
As a provider of a mental health service, such as online counselling, confidentiality is an ethical concern (Read BACP’s guidance here).
The fundamental intent is to protect a client’s right to privacy by ensuring that matters disclosed to a professional are not relayed to others without the informed consent of the client.
Of course, there are exceptions as to where confidentiality could be broken or not applied (risk to self or others for example).
This is easier to establish with face-to-face clients but is also necessary to establish the boundaries with online clients.
Sometimes, we might not have the information necessary to call emergency services and direct them to the client’s premises.
We might even be in different countries!
Some online services don’t take more than email and client’s name.
Online therapists might have an online counselling clause that states the limitations of how they can support their clients, providing information on services that might be able to support them in case of crisis or additional support.
Keeping ourselves safe as therapists is important. It keeps clients safe as a direct consequence. Which is a great thing!
Online counselling should offer the same frame of security, confidentiality and trust as face-to-face counselling.
There are so many more things to take into account regarding confidentiality and client safety when working online.
By providing anonymity to the client, the disclosure of emotional content and thoughts could be easier, but this disinhibition effect might mean the client might be opening up to a lot more than they would face-to-face, and in a very short period of time, with the potential risk increasing.
Before starting any online sessions with a new client, therapists should check that the client is a good candidate for online counselling at this point in time.
This means checking for risk, which is important because we won’t have as many details from the client if they want to keep their anonymity.
This limits our chance to keep them safe from a distance.
We might need to refer on to someone in their local area.
As you can see from this post, we back up our claims that online counselling is a great alternative to face-to-face counselling, but there are limitations to the work we can do when it comes to assessing risk and considering confidentiality issues.
Hopefully, our options for platforms and ethical suggestions will help you with your search for an online counsellor; for therapists, we hope this gives you more insights into how the counselling therapy world works.
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