2 Legal-Ethical CE credit hour on demand self study interactive webinar presentation on accessibility in teletherapy
Can You Hear Me? The Legal and Ethical Role of Accessibility in Anti-Oppressive and Neurodivergent-Affirming Teletherapy
Even though multiple legal and ethical statutes apply to therapists and outline a duty to provide accessible services for disabled clients, few therapists endorse awareness around these issues and fewer still comply with both the letter and spirit of laws and guidance around accessibility.
On Demand Self Study
By bringing light to these requirements while providing practical steps and resources to address inaccessibility in teletherapy practice, this 2-hour law and ethics training aims to create familiarity and comfort for therapists providing teletherapy and combat stigma and inaccessibility in teletherapy.
Almost every therapist switched to providing some form of teletherapy modality at the start of the COVID-19 pandemic, and many therapists maintain the use of teletherapy within their practices to this day. Research indicates that a primary reason for poor accessibility and poor disability competence within the counseling field is a lack of awareness around applicable laws and ethical codes combined with a fear of doing the “wrong thing,” which in turn reinforces stigma and inhibits accessibility in therapy for clients of all disability statuses.
Emily Decker, MS, LPC, NC situates this conversation within an anti-oppressive and neurodivergent-affirming framework, connecting concepts of accessibility and disability justice with mental health care, providing an overview of legal and ethical issues pertaining to accessibility within teletherapy, identifying and dispelling common myths about accessibility and disability, and highlighting specific, concrete resources for therapists to use to enhance the accessibility of their services.
Real feedback from this event:
“I could not be happier that this is a topic that is being brought to attention more and the presenter did an incredible job”
“The training was so supportive, affirming, and accessible that I even felt comfortable enough to ask a question, which isn’t something I very rarely do. Having the captions automatic like that was fabulous.”
“Very thorough presentation, appreciated all the information on the slides. Also appreciated the many examples which were quite helpful.”
Legal Considerations
Define disability, accessibility, and teletherapy and identify main legal and ethical guidelines that apply to the provision of
teletherapy
Connect the Dots
Explain connections between access, oppression, and harm to marginalized
communities
Accessibility Focus
Identify common accessibility needs around several common client and clinician disability identities – including: neurodivergence, trauma, chronic pain, and sensory disabilities
Emerging Technology
Explain the ways in which emerging technologies such as AI may both contribute to and inhibit accessibility and oppression within the practice of therapy
Compliance Assessment
Assess current teletherapy practices for compliance with reviewed laws and
ethical statutes around accessibility within mental health, specifically
teletherapy
Real World Application
Apply gained knowledge to evaluate changes each practitioner can make to
enhance accessibility within their teletherapy practice
Who is this event for?
This course is designed for solo practitioners, group practice leaders, and group practice clinical staff members. It is also suitable for practices that consist of 100% telehealth, or a mixture of in-person and telehealth treatment.
Hybrid Practices
Teletherapy Only Practices
Thank you for the information and for making it so accessible. Somehow you take the driest material and make it fun and immediately relevant. You folks knock it out of the park!
Course Details
2 CE Credit Hour. Self-Study, On-Demand, Recorded Video Seminar CE training.
Title: Can You Hear Me? The Legal and Ethical Role of Accessibility in Anti-Oppressive and
Neurodivergent-Affirming Teletherapy
Authors/Presenters: Emily Decker, MS, LPC, NCC
CE Length: 2 CE credit hours, legal-ethical
Legal-Ethical CE Hours: 2 legal-ethical CE credit hours
Educational objectives:
- Identify main legal and ethical guidelines that apply to the provision of
teletherapy - Explain connections between access, oppression, and harm to marginalized
communities - Identify common accessibility needs around several common client and
clinician disability identities
Syllabus:
2. Defining Key Terms
a. Disability
i. legal vs. social definitions of disability
ii. Definitions by disabled people
b. Accessibility
c. Teletherapy
3. Overview of Related Ethical Duties
a. ACA Code of Ethics
i. Accessibility in digital communication and websites
ii. Modification of assessment administration for accessibility
iii. Provision of interpretation services
b. Disability-Related Counseling Competencies
i. Section A: Understanding and Accommodating the Disability
Experience, which encourages inclusion, as well as viewing
disability as diversity, demonstrating respect, and understanding
experiences of oppression and stigma;
ii. Section B: Advocacy for [People with Disabilities] and Support of
their Self-Advocacy, which encourages exactly what is described
in the section title;
iii. Section C: The Counseling Process and Relationship, which
outline the need for accommodations and accessibility, caution
against overgeneralization and stereotyping, and ensure
treatment matches the client’s needs and capacities,
iv. Section D: Testing and Assessment, which calls on counselors to
understand the ways in which assessment and testing is rooted
in ableism, ensure tools are appropriately normed for the client’s
population (i.e. disability), account for the impact of context and
environment on results, and provide reasonable accommodation
during the assessment process.
encourages identifying inappropriate or stigmatizing language
and practices, understanding systemic oppression, recognizing
the rights of disabled people, understand major legal concepts
and civil rights laws regarding disabled people, strive to
implement universal design standards, engage in mentorship,
and seek consultation to avoid abuse of privilege and power.
4. Overview of Related Legal Duties
a. ADA
i. Title I: Employment (15+ employees)
1. Discrimination:
2. Hiring, advancement, compensation, training, benefits,
privileges, terms & conditions
a. Including due to need for accommodations
3. Segregating/classifying employee resulting in opportunity
loss
4. Using standards that perpetuate discrimination
a. Including selecting/administering qualifications
tests in ways that don’t accurately reflect disabled
employee’s skills
5. Not making reasonable accommodations
6. Working with an organization that does any of the above
to an employee
7. Requiring abilities unrelated to job functions
a. Ex: requiring therapists to be able to walk 10 feet
unassisted
8. Requiring medical examinations unrelated to job duties
ii. Title II (State and Local Gov’t) & III (Businesses Open to Public)
1. Equal opportunity to benefit from all programs, services,
and activities
2. Meet physical ADA accessibility requirements
3. Modify business policies & procedures for reasonable
accommodation
4. Allow access to service animals and mobility devices
5. Take steps to communicate effectively with people w/
vision, speech, and hearing limitations
iii. Section 508 :
1. Requires all websites and electronic materials to be
accessible to people with disabilities
b. HIPAA
i. Security in communication
1. Applies to accessibility features like captions, too
5. Compliance vs. Accessibility
a. Identifying and challenging norms vs rules for teletherapy
b. Applying social justice and anti-oppressive principles to disability and
accessibility
a. Neurodivergence
b. Trauma
c. Chronic pain and chronic illness
d. Sensory disabilities
7. AI: Helping or Hurting Accessibility?
a. Overview of potential benefits for AI use
b. Overview of potential costs for AI use
c. Applying ethical principles to weigh these considerations
8. Practical Steps to Increase Accessibility
a. Script for broaching accessibility with clients
b. Resources for auditing accessibility
c. Overview of disability-affirming practices (handout)
d. Additional resources around integrating disability justice principles into
therapy spaces and exploring disability as a multicultural identity
Meet Our Presenter
Presented by
Emily Decker, MS, LPC, NC
Emily Decker, MS, LPC, NCC (she/they) is a doctoral candidate in counseling education at George Washington University in Washington, D.C., as well as a 2023 NBCC Minority Doctoral Fellow. She has a Master’s degree in Clinical Rehabilitation Counseling from Portland State University. She specializes in disability cultural competence and disability identity. Her passion for “going directly to the need” has led her to work in schools, emergency rooms, crisis centers, housing transition programs, skill rehabilitation programs, community mental health agencies, and everywhere in between. In her Oregon-based private practice, Emily is a pioneer of accessibility, and has been providing disability-affirming therapy since 2016, and teletherapy since 2018. Emily also provides disability-affirming clinical supervision to pre-licensed counselors and consultation services to mental health practices and education settings seeking to enhance the accessibility of their services and increase cultural competence around disability. Emily identifies as a white, queer, fat, neurodivergent, immunocompromised, disabled human.
esources & Citations: (Estimated, Abridged)
https://www.counseling.org/docs/default-source/default-document-library/2014-
code-of-ethics-finaladdress.pdf
Americans With Disabilities Act [ADA] of 1990, Pub. L. No. 101-336, 104 Stat. 328.
(1990). https://www.ada.gov/law-and-regs/ada/
Andrews, E. E. (2020). Disability as diversity: Developing cultural competence.
Oxford University Press.
Andrews, E. E., Ayers, K. B., Brown, K. S., Dunn, D. S., & Pilarski, C. R. (2021). No
body is expendable: Medical rationing and disability justice during the COVID-19
pandemic. American Psychologist, 76(3), 451–461.
https://doi.org/10.1037/amp0000709
Centers for Disease Control (CDC). (2023, May 15). Disability Impacts All of Us
Infographic | CDC. Centers for Disease Control and Prevention.
https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-
all.html
Chapin, M., McCarthy, H., Shaw, L., Bradham-Cousar, M., Chapman, R., Nosek, M.,
Peterson, S., Yilmaz, Z., & Ysasi, N. (2018). Disability-related counseling
competencies. American Rehabilitation Counseling Association, a division of ACA.
https://www.counseling.org/docs/default-source/competencies/arca-disability-
related-counseling-competencies-final-version-5-15-19.pdf
Cornell University. (2022). Definition of disability. Disability Statistics. Accessed
2/1/2013. https://disabilitystatistics.org/faq.cfm#content
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The Impact of Mental Illness
Stigma on Seeking and Participating in Mental Health Care. Psycholo
United States 2018. MMWR Morbidity and Mortality Weekly Report 2020, 69, 1238-
1243. http://dx.doi.org/10.15585/mmwr.mm6936a2
Czeisler, M. É., Board, A., Thierry, J. M., Czeislet, C. A., Rajarnatham, S. M. W.,
Howard, M. E., & Clarke, K. E. N. (2021). Mental health and substance use among
adults with disabilities during the COVID-19 pandemic — United States, February–
March 2021. MMWR Morb Mortal Wkly Rep 2021, 70, 1142–1149.
http://dx.doi.org/10.15585/mmwr.mm7034a3
Deroche, M.D., Herlihy, B., & Lyons, M.L. (2020). Counselor trainee self-perceived
disability competence: Implications for training. Counselor Education & Supervision,
59. https://doi.org/10.1002/ceas.12183
Johns Hopkins Medicine. (2021). New Analysis: More U.S. Adults Identify as Disabled;
Ethnic and Socioeconomic Disparities Persist.
https://www.hopkinsmedicine.org/news/newsroom/news-releases/2021/11/new-
analysis-more-us-adults-identify-as-disabled-ethnic-and-socioeconomic-disparities-
persist
Ladau, E. (2022). Demystifying disability. Ten Speed Press.
Lewis, T. A. (2022). Working Defitition of Ableism—January 2022 Update. TALILA A.
LEWIS. https://www.talilalewis.com/blog.html
Lund, E.M., Wilbur, R.C., & Kuemmel, A.M. (2020). Beyond legal obligation: The role
and necessity of the supervisor-advocate in creating a socially just, disability-
affirmative training environment. Training and Education in Professional Psychology,
14(2), 92-99. http://dx.doi.org/10.1037/tep0000277
Lund, E. M., Forber-Pratt, A. J., Wilson, C., & Mona, L. R. (2020). The COVID-19
pandemic, stress, and trauma in the disability community: A call to action.
Rehabilitation Psychology, 65(4), 313–322. https://doi.org/10.1037/rep0000368
Mackelprang, R. W., Salsgiver, R. O., & Parrey, R. C. (2021). Disability: A Diversity
Model Approach in Human Service Practice (4th ed.). Oxford University Press.
Olkin, R. (2019). The Experiences of Microaggressions against Women with Visible
and Invisible Disabilities. Journal of Social Issues, 75(3), 757–785.
https://doi.org/10.1111/josi.12342
Ratts, M. J., & Greenleaf, A. T. (2017). Multicultural and Social Justice Counseling
Competencies: A Leadership Framework for Professional School Counselors.
Professional School Counseling, 21(1b), 2156759X1877358.
https://doi.org/10.1177/2156759X18773582
Rivas, M. & Hill, N.R. (2018). Counselor trainees’ experience with counseling
disability: A phenomenological study. Counselor Education, 57(2), 116-131.
https://doi.org/10.1002/ceas.12097
https://doi.org/10.1007/s10447-020-09404-y
Smart, J. F., & Smart, D. W. (2006). Models of disability: Implications for the
counseling profession. Journal of Counseling & Development, 84(1), 29–40.
https://doi.org/10.1002/j.1556-6678.2006.tb00377.x
Strike, D. L., Skovholt, T. M., & Hummel, T. J. (2004). Mental health professionals’
disability competence: Measuring self-awareness, perceived knowledge, and
perceived skills. Rehabilitation Psychology, 49(4), 321–327.
https://doi.org/10.1037/0090-5550.49.4.321
Wilbur, R.C., Kuemmel, A., & Lackner, R.J. (2019). Who’s on first? Supervising
psychology trainees with disabilities and establishing accommodations. Training and
Education in Professional Psychology, 13(2), 111-118. Doi:
http://dx.doi.org/10.1037/tep0000231
Woo, H., Goo, M. and Lee, M. (2016), A content analysis of research on disability:
American Counseling Association journals between 2003 and 2013. Journal of
Multicultural Counseling and Development, 44, 228-244.
https://doi.org/10.1002/jmcd.12051
This training discusses strategies for compliance with some federal laws, including
the ADA and HIPAA. While the presenter has worked to assemble information from a
variety of vetted and valid resources, the presenter is not an attorney. Further,
clarifications and modifications around these laws, and many other laws and
statutes pertaining to disability, continue to emerge. Additionally, this presentation does not address state- or profession-specific laws and statutes that may apply.
result in noncompliance with applicable laws and ethics.
Conflicts of Interest: None stated or known.
Commercial Support: None