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| ====== LMHC Laws, Regulations, Codes of Ethics ====== | ====== LMHC Laws, Regulations, Codes of Ethics ====== | ||
| + | |||
| + | ===== Board Policy ===== | ||
| + | |||
| [[LMHC Board Policy FullText|Full text of the LMHC Board's "Policy on Distance, Online, and Other Electronic-Assisted Counseling: Policy No. 07-03"]] | [[LMHC Board Policy FullText|Full text of the LMHC Board's "Policy on Distance, Online, and Other Electronic-Assisted Counseling: Policy No. 07-03"]] | ||
| - | The Board for LMHCs's [[https://www.mass.gov/policy-advisory/board-policies-and-guidelines-allied-menta | + | Some relevant excerpts for MA-licensed LMHCs seeing patients IN Massachusetts: |
| - | l-health#policy-on-distance-online-and-other-electronic-assisted-counseling-policy-no-07-03|"Policy on Distance, Online, and Other Electronic-Assisted Counseling: Policy No. 07-03"]] (Note the official version is truncated, and the full version can be found [[https://telementalhealthtraining.com/massachusetts#counselors|on an unofficial site here.]]: | + | |
| + | > This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law | ||
| - | > The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on November 16, 2007 to adopt the following Policy Guideline. **This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law,** as would a Massachusetts General Law or a Board rule or regulation. However, **the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.** | ||
| - | > | ||
| - | >Policy No. 07-03 | ||
| - | > | ||
| - | > Purpose: | ||
| - | > | ||
| - | >The Board acknowledges that therapy and counseling are increasingly being provided at a distance, making use of the internet, telephone and other electronic means of communication. The emergence of new clinical procedures is necessarily accompanied by uncertainty about legal and ethical obligations. The purpose of this policy statement is to offer guidance to Licensees regarding the ethical obligations and standards of conduct in the use of distance, on-line, and other electronic assisted counseling. | ||
| - | > | ||
| - | >Policy: | ||
| - | > | ||
| >The Board's policy with regard to all distance or electronic-assisted provision of clinical services is as follows: | >The Board's policy with regard to all distance or electronic-assisted provision of clinical services is as follows: | ||
| > | > | ||
| - | >1. The services offered by licensees of this Board across a distance by electronic means, fall within the jurisdiction of the Board just as traditional, face-to-face services do. Therefore all Board policies and regulations will apply to these services. | + | > 1. The services offered by licensees of this Board across a distance by electronic means, fall within the jurisdiction of the Board just as traditional, face-to-face services do. Therefore all Board policies and regulations will apply to these services. |
| - | > | + | |
| - | >2. Distance delivery of counseling and therapy is considered to occur in two locations: where the client is located and where the clinician is located. | + | > 7. Licensees are encouraged to carefully review the way in which the structure of their relationships with clients will be impacted by distance-therapy or counseling to ensure compliance with Board regulations and standards of practice. |
| - | > | + | |
| - | >3. Therefore, the provision of counseling and/or therapy to individuals located within Massachusetts at the time services are occurring, are considered to fall under the jurisdiction of the Board, regardless of the location of the provider. | + | |
| - | > | + | |
| - | >4. Mental health professionals licensed by any jurisdiction other than Massachusetts, and not licensed by any Massachusetts Board or not eligible for an exception to Massachusetts licensure, are considered unlicensed by this Board for practice in Massachusetts. | + | |
| - | > | + | |
| - | >5. Mental health professionals licensed by other jurisdictions who wish to provide services to clients within Massachusetts, are encouraged to apply for Massachusetts licensure. Some, licensees may find the following helpful: | + | |
| - | > | + | |
| - | >a. Mental Health Counselors: 262CMR 2.03, (1) Licensure for CCMHC's in good standing with NBCC</p> | + | |
| - | >b. MFT's: 262 CMR 3.04 Licensure by Reciprocity for MFT's. | + | |
| - | > | + | |
| - | >6. Board licensees who wish to provide services via electronic means to clients located outside of Massachusetts are urged to ensure that they meet the requirements for practice within the jurisdiction where the client is located. | + | |
| - | > | + | |
| - | >7. Licensees are encouraged to carefully review the way in which the structure of their relationships with clients will be impacted by distance-therapy or counseling to ensure compliance with Board regulations and standards of practice. | + | |
| > | > | ||
| >8. The following are some areas of practice that licensees should carefully consider: | >8. The following are some areas of practice that licensees should carefully consider: | ||
| Line 46: | Line 27: | ||
| > | > | ||
| >e. Avoiding harm | >e. Avoiding harm | ||
| - | > | + | |
| - | >f. Fees and financial arrangements | + | |
| - | > | + | |
| - | >g. Advertising | + | |
| - | > | + | |
| >h. Abandonment of clients | >h. Abandonment of clients | ||
| - | > | + | |
| - | >i. Handling requests for obtaining clinical records | + | |
| - | > | + | |
| >9. The Board expects licensees to understand and overcome the significant challenges inherent in providing counseling and therapy without face-to-face contact with the client. | >9. The Board expects licensees to understand and overcome the significant challenges inherent in providing counseling and therapy without face-to-face contact with the client. | ||
| > | > | ||
| Line 60: | Line 35: | ||
| > | > | ||
| >a. Full disclosure with regard to potential risks to confidentiality, including computer hacking and/or archiving of communications. | >a. Full disclosure with regard to potential risks to confidentiality, including computer hacking and/or archiving of communications. | ||
| - | > | + | |
| - | >b. Full disclosure of the limits to confidentiality in the jurisdictions where the client, and where the clinician are located. | + | |
| - | > | + | |
| - | >c. Full disclosure of mandated reporting requirements in the jurisdictions where the client, and where the clinician are located. | + | |
| - | > | + | |
| >d. Full disclosure with regard to the potential disadvantages or limitations of electronic-assisted clinical services. | >d. Full disclosure with regard to the potential disadvantages or limitations of electronic-assisted clinical services. | ||
| > | > | ||
| Line 70: | Line 41: | ||
| > | > | ||
| >f. Full disclosure with regard to fees and billing practices. | >f. Full disclosure with regard to fees and billing practices. | ||
| - | > | + | |
| - | >g. Full disclosure with regard to licensing, credentials and areas of expertise. | + | |
| - | > | + | |
| >h.Screening and local referral for critical and urgent problems | >h.Screening and local referral for critical and urgent problems | ||
| - | > | + | |
| - | >i. Verification of the identity and age of the client. | + | |
| - | > | + | |
| - | >j. Obtaining consent to provide services by a guardian for minors or other vulnerable clients. | + | |
| - | > | + | |
| >k. Management of any misunderstanding or compensation for any missing information, resulting from the lack of visual or auditory cues. | >k. Management of any misunderstanding or compensation for any missing information, resulting from the lack of visual or auditory cues. | ||
| > | > | ||
| Line 86: | Line 51: | ||
| > | > | ||
| >n. Procedures for contacting the clinician when he/she is offline | >n. Procedures for contacting the clinician when he/she is offline | ||
| - | > | + | |
| - | >11. The Board expects that licensees providing any form of distance counseling will comply with all of the guidelines of ethical practice that apply to traditional, face-to-face counseling. | + | ===== AMHCA Code of Ethics ====== |
| - | > | + | |
| - | >12. The Board expects that licensees will practice distance counseling in a manner that is consistent with any existing guidelines provided by their professional associations. | + | [[https://higherlogicdownload.s3-external-1.amazonaws.com/AMHCA/2%20AMHCA%20Code%20of%20Ethics-2020-2.pdf?AWSAccessKeyId=AKIAVRDO7IEREB57R7MT&Expires=1583401111&Signature=Nlz7Y1Ma6Ppb7DjmhHmzR%2FHqN8s%3D|AMHCA Code of Ethics, 2020, PDF]] |
| - | > | + | |
| - | >13. The Board expects that licensees providing any form of distance counseling will ensure that they are properly trained to manage the specific challenges of this form of counseling and will regularly participate in sufficient continuing education activities that maintain and update the required skills. | + | The primarily relevant section is B.6. "The Use of Technology Supported Counseling and Communications (TSCC)", which starts on page 12. |
| - | > | + | |
| - | >14. Unlicensed providers of electronic-assisted counseling will be treated by the Board in the same manner as providers of unlicensed counseling in traditional settings. | + | Some particularly relevant excerpts: |
| - | > | + | |
| - | >Authority: | + | > CMHCs recognize that technology has become culturally normative worldwide and may employ modern technology communications judiciously, attentive to both the benefits and risks to clients and to the therapeutic process of using technologies to arrange, deliver, or support counseling. |
| - | > | + | |
| - | >M.G.L. Chapter 13, Section 90; and 262 CMR 8.00 et seq. | + | > b.CMHCs recognize that federal, state, and local laws prevail and that the standard of care for TSCC is expected in the same manner as face-to-face and in-office counseling. Continuity of care is crucial and, at times, may conflict with local laws and regulations. CMHCs should employ a solid ethical decision-making model to secure continuity of care. |
| + | |||
| + | > d.CMHCs only provide telehealth or distance counseling when they have had sufficient training which can be gained through education, supervision, or other appropriate activities (see the TSCC section of AMHCA Standards for the Practice of Clinical Mental Health Counseling in Appendix B of the “Essentials of the Clinical Mental Health Counseling Profession” text or online atwww.amhca.org/publications/standards) | ||
| + | |||
| + | > f.At the beginning of a course of distance counseling, CMHCs acquire the contact information for emergency services in the location of the client and develop a procedure to follow in the event of a psychiatric or health emergency. | ||
| + | |||
| + | > g.In states where there is a legal requirement that CMHCs must include in the client record client communications through TSCC, CMHCs inform the client of that fact. | ||
| + | |||
| + | Also note, in the Preamble to the CoE, it states: | ||
| + | |||
| + | > In their professional duties, CMHCs may encounter conflicts between the AMHCACode of Ethicsand the law, or between local regulatory statute and state law. CMHCs attempt to resolve these conflicts when they occur. When dealing with such conflicts, CMHCs always consider the client’s best interest, including continuity of care. When conflicts are unresolvable, CMHCs may adhere to the requirements of the law. | ||
| + | |||
| + | ===== AMHCA Standard for the Practice of Clinical Mental Health Counseling ===== | ||
| + | |||
| + | [[https://higherlogicdownload.s3-external-1.amazonaws.com/AMHCA/1%20AMHCA%20Standards-5.pdf?AWSAccessKeyId=AKIAVRDO7IEREB57R7MT&Expires=1583408745&Signature=JItqO%2F%2FyaBc2Tu0CLh7OxXpCsWw%3D|The AMHCA Standards, 2020, PDF]] | ||
lmhc_law_reg_coe.1584326604.txt.gz · Last modified: 2020/03/16 02:43 by vlayne
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