I have to admit, I am all about technology. I am wired up, hooked up and linked up with more devices and sites than I can keep up with. If texting had been around when I was younger, I would have been that kid sitting across from the counselor because he/she has a 10,000 a month text habit and the parents are freaked out. I’ve so enjoyed the blogs from my fellow bloggers about the pros and cons of using electronic communications and social media with our clients. As great as technology is, it continues to present new ethical and practical challenges as we incorporate new ways to communicate into our professional practice. So, when a client recently asked me about Skype, I found myself face-to-face with my own challenge.
My client was planning on taking an extended summer trip. She is very tech savvy and asked if we could conduct counseling sessions via Skype. Her exact words to me were, “Miss Dawn, it’ll be like watching each other on TV only we can talk to each other.” Hmm….Counselor TV…I had to think about that. Initially, I was excited. How cool will it be to be able to “see” my client and test-drive some cool technology? Then, as the excitement waned, reality showed up. What did I really know about cyber-counseling? I’d dabbled with Skype but hadn’t really considered the implications of using it with clients. So, I set off on a fact-finding mission.
What I found was not much. A few of my professional peers had used Skype on a limited basis. Others likened using Skype with clients to the way physicians are using tele-medicine with their patients. Some are doing it but not many. My next stop was the ethical code and standards of practice. Cyber-counseling still requires us to be vigilant about many of the same issues such as confidentiality, informed consent and accessibility. It also presents a jurisdictional issue and requires compliance with regulations for counselors in the jurisdiction in which services are rendered. Does that mean where I am? Where my client is? Both? The answer was different depending on who I asked. Probably the biggest concern for me was the issue of assessing risk. Could Skyping give me the quality of interaction needed to accurately assess risk? I just couldn’t decide.
In the end, I said no to Skype for now. Using a technology that I am not completely competent or comfortable with would place me in the position of working outside my scope of practice. The more I read, the more questions I had. I realized I am indeed not ready for prime time. I’m sure that some of you have already embraced Skype or other on-line counseling formats. What works best for you? What has been your biggest challenge? If you’re not using on-line options, why not? I’d be so interested to hear your thoughts about it. I know the issue is going to come up again, and next time, I want to be able to say “I’m ready for my close up!”
Dawn Ferrara is a counselor in private practice and clinical manager for a community-based children’s mental health program. Her areas of interest include disaster mental health counseling, lifestyle management, and counselor wellness.