TELEHEALTH COUNSELING INFORMED CONSENT
The following is an Informed Consent for engaging in Telehealth Counseling with Atrium Counseling Services. Before starting your counseling session, you will be required to click "Agree to Terms of Service" to indicate you have read, understood, and agreed to these terms.
What is Telehealth Counseling?
Telehealth Counseling is mental health counseling that is delivered via electronic, often Internet-based, technology tools. These tools can include videoconferencing software, email, text messaging, virtual environments, specialized mobile health apps, and others. Your counselor provides Telehealth Counseling via videoconferencing software called Doxy.me.
What do I need to understand about Telehealth Counseling?
- You will need access to a computer or mobile device and an internet connection to connect with your counselor for Telehealth Counseling.
- Telehealth Counseling has both benefits and risks, which you and your counselor will monitor as you proceed with your work.
- It is possible that receiving services by Telehealth Counseling will turn out to be inappropriate for you, requiring you and your counselor to cease working by Telehealth Counseling. In that case, your counselor will work with you to find a suitable alternative.
- You can stop work by Telehealth Counseling at any time without prejudice by simply notifying your counselor that you would like to stop and disconnecting from the session.
- You will need to participate in creating an appropriate space for your Telehealth Counseling sessions. An appropriate space is one where your privacy is protected and you are free from distractions.
- You will need to participate in making a plan for managing technology failures, mental health crises, and medical emergencies. Your counselor will walk you through making this plan in your first Telehealth Counseling session.
- Your counselor follows security best practices and legal standards to protect your private health information. You also need to participate in protecting your own security/privacy.
- You must not drive or be under the influence of drugs or alcohol while engaging in Telehealth Counseling.
- You must wear appropriate attire (e.g. street clothes) to all counseling sessions.
Please address any questions or concerns you have about Telehealth Counseling or Doxy.me to your counselor so you can discuss the risks, benefits, and specific application to your treatment.
Assessing Telehealth Counseling’s Fit for You
Although it is well validated by research, service delivery via Telehealth Counseling is not a good fit for every person. Your counselor will continuously assess if working via Telehealth Counseling is appropriate for your case. If it is not appropriate, your counselor will help you explore your options. Please talk to your counselor if: (a) you find the Telehealth Counseling media so difficult to use that it distracts from the services being provided, (b) the technology causes trouble focusing on your services, or (c) there are any other reasons why Telehealth Counseling seems to be causing problems in receiving services.
What are the Risks and Benefits of Telehealth Counseling?
Receiving services via Telehealth Counseling allows you to: (a) Receive services at times or in places where the service may not otherwise be available. (b) Receive services in a fashion that may be more convenient and less prone to delays than in-person meetings. (c) Receive services when you are unable to travel to the service counselor’s office. (d) Utilize technology tools to make progress toward your health goals that may not have been otherwise achievable without Telehealth Counseling.
Receiving services via Telehealth Counseling has the following risks:
Telehealth Counseling services can be impacted by technical failures, may
introduce risks to your privacy, and may reduce your service counselor’s
ability to directly intervene in crises or emergencies. Issues may include
but are not limited to:
- Internet connections and cloud services could cease working or become too unstable to use.
- Cloud-based service personnel, IT assistants, and malicious actors (“hackers”) may have the ability to access your private information that is transmitted or stored in the process of Telehealth Counseling-based service delivery.
- Computer or smartphone hardware can have sudden failures or run out of power, or local power services can go out. Interruptions may disrupt services at important moments, and your counselor may be unable to reach you quickly or using the most effective tools.
- Your counselor may also be unable to help you in-person.
There may be additional risks and benefits to Telehealth Counseling services that arise from: the lack of in-person contact or presence, the distance between you and your counselor at the time of service, and the technological tools used to deliver services. Your counselor will assess these potential benefits and risks, sometimes in collaboration with you, as your relationship progresses.
Please note: Raising your questions or concerns will not, by itself, result in termination of services. Bringing your concerns to your counselor is a normal part of the process.
Our Safety and Emergency Plan
As a recipient of Telehealth Counseling-based services, you will need to participate in ensuring your safety during mental health crises, medical emergencies, and sessions that you have with your counselor. Your counselor will require you to designate an emergency contact. You will need to provide permission for your counselor to communicate with this person about your care during emergencies. Your counselor will also develop with you a plan for what to do during mental health crises and emergencies, and a plan for how to keep your space safe during sessions. It is important that you engage with your counselor in the creation of these plans and that you follow them when you need to.
Transitioning from Telehealth to In-Person Counseling
You always have the right to stop receiving counseling services at any time without prejudice. Typically, your counselor provides services in-person and you would be able to access those in-person services if you choose to stop using Telehealth Counseling. That option is not currently available due to restrictions enacted by the Governor of Ohio. Once those restrictions are lifted, you may begin/resume in-person sessions if you prefer that over telehealth counseling.
Your Telehealth Counseling Environment
You are responsible for creating a safe and confidential space during sessions. You should use a space that is free of other people. It should also be difficult or impossible for people outside the space to see or hear your interactions with your counselor during the session. If you are unsure of how to do this, please ask your counselor for assistance. The following are a few suggestions to help you create a safe environment:
- Use headphones with a built-in microphone to limit what others can hear.
- Place a “session in progress, do not enter” sign on your door so others know not to interrupt your session. Downloadable "Session in Progress" signs available here: DOWNLOAD PDF DOOR SIGNS
- Clear all icons and websites from your computer desktop.
Our Communication Plan
At our first session, we will develop a plan for backup communications in case of technology failures and a plan for responding to emergencies and mental health crises. In addition to those plans, your counselor has the following policies regarding communications:
- The best way to contact your counselor between sessions is via phone.
- Your counselor will respond to your messages between 10a – 7p. Please note that your counselor may not respond at all on weekends or holidays. Your counselor may also respond sooner than stated in this policy. That does not mean they will always respond that quickly.
Our work is done primarily during our appointed sessions. Contact
between sessions should be limited to:
- Confirming or changing appointment times
- Billing questions or issues
- Emergency mental health needs
- Please note that all written messages you exchange with your counselor (e.g. emails and text messages), will become a part of your health record.
- With your permission, your counselor may coordinate care with one or more of your other health care providers. Your counselor will use reasonable care to ensure that those communications are secure and that they safeguard your privacy.
Your Security and Privacy Except where otherwise noted, your counselor employs software and hardware tools that adhere to security best practices and applicable legal standards for the purposes of protecting your privacy and ensuring that records of your health care services are not lost or damaged. As with all things in Telehealth Counseling, however, you also have a role to play in maintaining your security. Please use reasonable security protocols to protect the privacy of your own health care information. For example: when communicating with your counselor, use devices and service accounts that are protected by unique passwords that only you know.
Also, use the secure tools that your counselor has supplied for communications.
Please do not record video or audio sessions without your counselor’s consent. Making recordings can quickly and easily compromise your privacy and should be done with great care. Your counselor will not record video or audio sessions.
Please let your counselor know if you have any questions about the contents of this Informed Consent. Once you have reviewed, understood, and agreed to the terms, please sign below to indicate your consent to Telehealth Counseling:
Client Signature to be obtained electronically