An Online Therapy Primer: Legal, Ethical, and Technical Issues in Starting Telemental Health Practice

2 CE Credit Hours. Legal-Ethical. Guided Reading Course.

Presented By: Roy Huggins, LPC NCC

Course Description

Laptop on a Pile of Books

Telemental health is the latest frontier in mental health practice, and it’s hotter than a laptop computer in July!

Most professionals know that training on telemental health practice is available, but it is often long, expensive and time-consuming. This course will bridge the gap between the initiate still getting started and the more thorough training and credentialing programs available for telemental health practice.

This is a guided reading, which means it is a collection of articles that we’ve published here at Person-Centered Tech and elsewhere on the web. You may have read some of these articles, and here is your chance to get CE credit for the time invested! The course will also tie the content together and more closely engage your mind in the learning process.

This is an introductory-level course for counselors, marriage and family therapists, clinical social workers, and counseling and clinical psychologists.

Educational Objectives

  • Specify the learner’s goals for telemental health practice and determine if and how those goals are legally and ethically feasible.
  • Identify the specific relevant ethical and legal standards that the learner must follow in order to begin performing professional telemental health services.
  • Identify the competencies the learner needs to develop for beginning telemental health practice, and develop strategies for attaining those competencies.
  • Select technological tools that are appropropriate for the learner and the learner’s telemental health treatment population.


This course is a guided reading, which means it is made up of a series of related articles. Below are the articles included in this course:

  • How to Get Started With a “Skype Therapy” Practice: A survey article that covers the basics of what issues to cover and authorities to inquire with when starting up telemental health practice.
  • To Practice Telemental Health, Am I Required to Receive Training?: A survey of how our professional organizations view telemental health competence gained through training. We give some examples of ethical and legal requirements regarding telemental health competence, specifically as gained through training.
  • Can I Practice “Skype Therapy” Across State Lines?: A survey of the issues involved in practicing across state lines. Covers multiple licensure and “calling it coaching.”
  • International Online Therapy: What to Know Before You Go (and Start Doing It): A survey of the issues to investigate when practicing across national borders. We cover not just licensure but also cultural/logistical/communications issues and things that are unique about how we view mental health practice in the US.
  • How Skype Became Software Non-Grata, and Other Tech Will, Too: A combination of a legal-technical survey of exactly why Skype is no longer accepted with a discussion of the process of cost-benefit analysis in security risk management vis-a-vis choosing the right software for your practice. This article is meant to prepare professionals to think forward regarding what tools they use now that may become seen as unacceptable or strange to use in the future.
  • What You Need to Know About Telemental Health Technology: A survey of legal-technical issues to address in software service selection. Covers HIPAA, ethics codes and state laws, and American Telemedicine Association guidelines for video software.
  • Do I Need a Whole Telemental Health “Platform?”: A survey of basic technical-logistical needs that a telemental health practice has. Explores how each need could be met by an integrated platform vs. being accomplished via a “piecemeal” strategy.
  • When Online Therapy Video Sessions Go Glitchy: Some Tips: A technical explanation of why video-based telemental health sessions can get interrupted by lag in the Internet connection caused by the therapist’s or client’s own setup problems. Gives strategies for solving these problems proactively.


  • American Association of Marriage and Family Therapists. (2015). Code of Ethics . Alexandria, VA: Author.
  • American Counseling Association. (2014). Code of Ethics . Alexandria, VA: Author.
  • American Psychological Association. (2010). American Psychological Association Ethical Principles of Psychologists and Code of Conduct . Washington, DC: Author.
  • American Psychological Association. (2013). Guidelines for the Practice of Telepsychology. Author.
  • American Telemedicine Association. (2009). Practice Guidelines for Videoconferencing-Based Telemental Health. Author.
  • Kashing, S. (2015). COACHING vs. THERAPY: Frequently Asked Questions. Retrieved July 23rd, 2016 from California Association of Marriage and Family Therapists:
  • Mintz Levin. (2016). State Data Security Breach Notification Laws. Boston: Author.
  • NASW and ASWB. (2005). Standards for Technology and Social Work Practice. Author.
  • National Association of Social Workers. (2008). Code of Ethics . Washington, DC: Author.
  • National Board for Certified Counselors. (2012). Code of Ethics . Greensboro, NC: Author.
  • National Board for Certified Counselors. (2012). Policy Regarding the Provision of Distance Professional Services. Author.
  • Oregon Board of Licensed Professional Counselors and Therapists. (2011). Distance Counseling. Oregon State Archives . Salem, OR: Author.
  • Reinhardt, R. (2013, February). HIPAA FInal Rule and the Conduit Exception. Retrieved October 17, 2013, from Tame Your Practice:
  • Strom, E. L. (2014, March). Distance mental health counseling: The regulation of practice across jurisdictions. Presented at the American Counseling Association annual conference in Honolulu, HI.
  • US Dept. of Health and Human Services. (2006). HIPAA Administrative Simplification . Washington, DC: Author.
  • US Dept. of Health and Human Services. (2013). HIPAA Omnibus Final Rule . Washington, DC: Author.
2 CE Credit Hours.

Presented/Developed By

Roy Huggins, LPC NCCRoy Huggins, LPC NCC, is a counselor in private practice who also directs Person-Centered Tech. Roy worked as a professional Web developer for 7 years before changing paths, and makes it his mission to grow clinicians’ understanding of the Internet and other electronic communications mediums for the future of our practices and our professions.

Roy is an adjunct instructor at the Portland State University Counseling program where he teaches Ethics, and is a member of the Zur Institute advisory board. He has acted as a subject matter expert on HIPAA, security and clinical use of technology for Counseling licensure boards and both state and national mental health professional organizations. He has co-authored or authored 2 book chapters, and he routinely consults with mental health colleagues on ethical and practical issues surrounding tech in clinical practice. He served for 5 years on the board of the Oregon Mental Health Counselors Association and then the Oregon Counseling Association as the Technology Committee Chair.

He really likes this stuff.

Program Notices

Accuracy, Utility, and Risks Statement: The contents of this program are based primarily on publications from the US Department of Health and Human Services, publications from attorneys, and on guidelines and/or ethics codes of these professional organizations: AAMFT, ACA, APA, ATA, NASW, and NBCC. Some interpretation and analysis presented is made by the presenter, in consultation with knowledgeable colleagues and expert consultants. Statements about applications to technology are according to presenter’s understanding of the technology at the time of the program. The presenter may not know how to apply all principles discussed to every technology type or product. This program discusses strategies for complying with covered ethics codes and HIPAA, and for legally and ethically providing telemental health services. It may not include information on all applicable state laws. Misapplication of the materials, or errors in the materials, could result in security problems, data breaches, or non-compliance with applicable laws or ethics codes.

Conflicts of Interest: None.

Commercial Support: None.

This course is subject to our cancellation/refund policy and complaint policy.

2 CE Credit Hours.
Laptop on a Pile of Books

2 CE Credit Hours. Legal-Ethical. Guided Reading Course.


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