Ethics and Professional Conduct in Counseling
Ethical Issues in Online Services
While online services can be useful for some clients, there are a variety of problems that can accompany them. When we use online therapy, there runs the risk of a third party accessing the information discussed in the sessions as well as the payment information, if the client chooses to pay online. In addition, the counselors working with a client online could potentially have problems with boundaries, as speaking online can be seem as more of a “friend” relationship rather than a counselor/client relationship. Using the internet takes away the personal face-to-face communication that assists the counselor with maintaining professional boundaries. Due to the extensive list of pros and cons in regards to ethical issues, scholarly journals have been compiled to reveal the ethical issues that plague online therapy. Three articles on ethical issues were selected based on their relevance to the selected topic.
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These articles are important to the field of Mental Health Counseling and ethics because these journals help counselors and students gain insight into the ethical issues that arise due to online therapy. In the first article, “Ethical Issues in Providing Online Psychotherapeutic Interventions”, focuses on the importance of the potential intrusion of confidential matters and the differences in in-person therapy sessions and online therapy sessions. The article gives many examples as to why each option is different from the other as well as the risks and benefits of each option. The second article, “Ethical Challenges of Medicine and Health on the Internet: A Review”, focuses on the ethical concerns of receiving healthcare over the internet, and the codes of ethics that can keep the professionalism of counselors and doctors, even when services are digital. This is a beneficial article because it explains the use of the codes of ethics to maintain the ethical boundaries without the counselor and client falling into a comfortable and inappropriate relationship.
The third article, “The Ethical and Clinical Implications of Utilizing Cybercommunication in Face-to-Face Therapy” focuses on the challenges of online therapy versus face-to-face therapy, such as “confidentiality, professional boundaries, effective and competent practice, and unanticipated contact” (Fantus, Mishna). This article is important to the field of Psychology and ethics because it gives many potential risks and benefits to online usage for therapy sessions. It combines online therapy with face-to-face therapy to give a balance for those who are unable to fully be engaged in a face-to-face therapy session.
These articles were hoping to find out if the benefits outweighed the risks in terms of online therapy and face-to-face therapy. The first article states that, in terms of risks, “in-person clients can become sexually attracted to the therapist and vice versa; therapists can be incompetent in the delivery of services; the therapist’s confidential records are vulnerable to being stolen or viewed by unauthorized persons even if stored in a locked office and a locked file cabinet; miscommunication can occur during in-person therapy; and clients receiving in-person therapy can deceive and mislead the therapist” (Childress). However, online therapy has similar issues. Confidentiality and privacy can be invaded by third parties looking to gather information on session topics, payment information, etc.
The second article states that the codes of ethics are needed to help counselors maintain the professional boundaries when unable to engage in face-to-face therapy. With counselors ensuring that the ethical codes are followed, the professional boundaries between counselor and client remain solid and unbreakable. Unfortunately, some counselors believe that the codes of ethics have an air of pseudoaccountability, where “weak regulations give the appearance of setting and enforcing high standards” (Dyer). With this, an ethical dilemma is created in regards to online therapy. The counselor could potentially be more relaxed with online therapy and let these codes of ethics lapse, while it is more difficult to let the codes of ethics lapse when they engage in face-to-face therapy.
The third article discusses how many websites use privacy policies to disclose to customers that their privacy may be compromised, in the case of businesses such as Apple, Skype, Amazon, etc. The information that people transmit over these websites and counseling websites cannot be guaranteed to be stored safely without risk of breach. Another ethical problem is that boundaries can become blurred with online therapy. When it comes to online therapy, clients can feel as if “their relationship [with the counselor] is fluid and not bound by the parameters that historically have defined professional-client relationships” (Fantus, Mishna). This can lead to ethical concerns if both the counselor and client become too friendly while engaging in online therapy.
The articles all showed results that there are both risks and benefits to both online therapy and face-to-face therapy. While online therapy is good for those who are too busy with life to sit in a therapy sessions, such as stockbrokers or doctors, or those who have severe anxiety and are unable to leave their homes, it can also leave holes where hackers and third parties can access the private and confidential information of the clients, such as the topics of the sessions as well as the payment information if the clients choose to pay online. In addition, it can be difficult for counselors to keep the professional boundaries solid when they communicate solely by either FaceTime or text. Finally, it can leave traces of the communication discussion so anyone would be able to access the transcripts if they have the capability to hack into the webpage.
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With face-to-face therapy, there is the problem that the client can become too comfortable with the counselor and this can cause an ethical dilemma if both the client and the counselor become attracted to the other and end up engaging in inappropriate relationships. In addition, the clients could be able to deceive the therapist during face-to-face therapy and seem as if they are being more cooperative than they actually are. This deception can cause ethical problems if they are engaging in mandatory therapy due to court requirements, as the counselor could be led to believe that the client is making progress, only for the client to graduate from the therapy and return to what he was doing previous. However, face-to-face therapy is a better alternative for the security of the session topics, as there is no concern for payment information and transcripts of the discussion to be transmitted online. While this is a better alternative, there is the chance that a client would be able to steal any of the physical files in the counselor’s office.
The articles’ conclusions were all supported by their evidence because there are both a large amount of risks and a large amount of benefits when it comes to both online therapy and face-to-face therapy. In addition, the articles discuss the codes of ethics and how they are affected by the addition of online therapy. For example, in the article “Ethical Challenges of Medicine and Health on the Internet: A Review”, it states that “codes of ethical conduct rely on self-regulation for enforcement” (Dyer). With this, the counselors who engage in either, or both, online therapy and face-to-face therapy are responsible for following the ethical codes by themselves. Also, it states that when it comes to online therapy websites, “ethical boundaries were stretched, even broken, in disregard for [their] web site visitors, often in the name of profit” (Dyer).
The implications of these findings in the field of psychology indicate that it is on a case by case basis to determine which mode of therapy would better benefit each client. In some cases, the client would choose to utilize the online therapy sessions due to their busy schedules, even if they were informed of the risks of online counseling. In other cases, the clients would prefer to utilize face-to-face so that they can keep as much privacy and confidentiality as possible. As long as informed consent is in place for those who choose to utilize the online therapy sessions, and they understand the risks of accepting the sessions, it should be acceptable for the clients to choose their own sessions. However, the implications brought on by these studies opens up more information for the counselors and clients so that they can be better prepared to make informed decisions on what type of therapy they choose to engage in.
The overall strengths and weaknesses of the articles showed that there is much information to be shown to the counselors and other researchers to make them better prepared for those who have questions on the subjects. In terms of strengths, the articles give enough information so that the researchers and counselors can fully understand the implications of choosing one type of therapy over another. In addition, the articles tie in the codes of ethics with the controversy of online vs face-to-face so that the counselors have a cushion to the information, so that they can understand how to engage in online therapy or face-to-face and still maintain the professional boundaries.
In the end, there are many good benefits to utilizing either online therapy services or face-to-face therapy services, and there are many risks to utilizing either online therapy services or face-to-face therapy services. If the client is given informed consent on the risks and benefits of both online and face-to-face therapy, the client would be able to make their own informed decision on the type of therapy that they want. These articles give an extensive look at the pros and cons of online therapy versus face-to-face therapy, and it can help counselors and researchers the information that they need so that they can ensure their clients are fully informed.
- Childress, C.A. (0AD). Ethical Issues in Providing Online Psychotherapeutic Interventions. Journal of Medical Internet Research. Retrieved on September 24, 2019.
- Cottone, R., & Tarvydas, V. (2016). Ethics and decision making in counseling and psychotherapy. NY, NY: Springer Publishing Company.
- Dyer, K.A. (0AD). Ethical Challenges of Medicine and Health on the Internet: A Review. Journal of Medical Internet Research. Retrieved on September 25, 2019.
- Fantus, S. & Mishna, F. (0AD). The Ethical and Clinical Implications of Utilizing Cybercommunication in Face-to-Face Therapy. Smith College Studies of Social Work. Retrieved on September 26, 2019.
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