Telehealth

Question 1

Pro

Answer 1

• Access:
  o Remote
  o Without ready childcare
  o Reduce barriers to coming into MH services e.g., stigma, social anxiety,
  o Continuity of care in an uncertain world

Question 2

Risk

Answer 2

• Challenges to assessment
  o Non-verbal cues (harder to diagnose differentials)
  o Miscommunication (hard to have spontaneous clarification over email text etc)
  o Boundary setting (after hours, text and email responses can elicit less formal and shortened expressions)
  o Time (unexpected or unforeseen time delays may lead to client speculate and increase anxiety)
  o Technological issues (messages not received, files deleted, hackers brief confidentiality, sending to the wrong person)
  o Ability to manage crises
  o Not having a neutral space for therapy (lack of emotional containment) - workaround would be finding a way to “open/close” the space

Question 3

Ethics

Answer 3

• 1.6 Confidentiality
  o Private space, private computer/hack, storage notes (personal computer/physical notes at home)
  o Breaches of confidentiality – psychologist have ethical responsibility to act on risk
• 1.6 informed consent
  o We need to be aware of the risks of telehealth
• Principle 3 storing records no identifying info
• 3.3 maintain appropriate boundaries
• 2.2 Competence
  o psychologists must attain competence in the areas in which they practise (Psychologists may not be trained in telehealth)
• Principle 4: Social Responsibility- if you have means of benefitting society should do it
  o some ppl may not have access to the technology/internet
• Principle 4: psychologists must be aware of inequities and take steps to reduce these
  o if only some clients can access telehealth, this is an inequity (NOT to take away computers but to increase?)
• Principle 2.2 + 3.2 Aware of how individual factors (stresses, values, beliefs) influence work
  o When during pandemic etc when we use telehealth not good for us to be practising
• Principle 4.1 - Competence informed through relevant reading, peer consultation, and continuing education
  o Research to see if appropriate for that disorder etc

Question 4

Legislation

Answer 4

• Code of Health and Disability Service Consumer Rights - says that clients have a right to confidentiality
• Privacy Act - storage of notes
• Health Practitioners Competency Assurance Act: duty to only work within our scope of practice (possibly not trained in telehealth)
• Legal issue as psychologists should report suspicions of abuse/neglect children under 17 (protected as report under Child, Young persons and their Family Act 1989)
• Discretion to warn harm others - Amendment to Privacy Act - if aware of threat to other, likelihood, and timing threat will be realised should report, if not you might be negligent