ethics and technology sarah kinsworthy, m.a.. innovation over the past several decades, technology...

Ethics and TechnologyEthics and TechnologySarah Kinsworthy, M.A.Sarah Kinsworthy, M.A.

InnovationInnovation

Over the past several decades, technology has Over the past several decades, technology has advanced at an amazing rate.advanced at an amazing rate.

As new technology develops, professionals are As new technology develops, professionals are challenged to create new and innovative ethical challenged to create new and innovative ethical boundaries to accommodate the advancement.boundaries to accommodate the advancement.

New TechnologyNew Technology

There are numerous examples of ethical considerations There are numerous examples of ethical considerations for technologyfor technology

TelephonesTelephones

Cell PhonesCell Phones

InternetInternet Chat RoomsChat Rooms Private vs. semiprivate email accountsPrivate vs. semiprivate email accounts

Personal ComputersPersonal Computers

Ethical ManagementEthical Management

ACA states counselors must protect every client ACA states counselors must protect every client and their rights to confidentiality.and their rights to confidentiality.Food for thought:Food for thought: Standards of confidentiality for printed information Standards of confidentiality for printed information

apply to those for electronic media.apply to those for electronic media. Fax machines often transmit confidentially.Fax machines often transmit confidentially. Electronic information is not always as private as Electronic information is not always as private as

necessary.necessary.Ex: emailEx: email

Confidential information should not be discussed on Confidential information should not be discussed on cell phones.cell phones.

TelephonesTelephones

ConsiderationsConsiderations State that the phone has a confidential line and/or State that the phone has a confidential line and/or

voicemail.voicemail. Always state on voicemail at the end of your greeting:Always state on voicemail at the end of your greeting:

““If this is an emergency, please hang up and dial If this is an emergency, please hang up and dial 911, or go to the nearest emergency room.”911, or go to the nearest emergency room.”

Cell PhonesCell Phones

Cell phones have been found to lack security Cell phones have been found to lack security regarding the transmittal of confidential regarding the transmittal of confidential informationinformation Avoid the use of cell phones when discussing Avoid the use of cell phones when discussing

confidential informationconfidential information Occasionally, conversations on cell phones can be Occasionally, conversations on cell phones can be

picked up on other electronicspicked up on other electronicsEx: BVRCCEx: BVRCC

Electronic MediaElectronic Media

Personal ComputersPersonal Computers Hardware: hard disk, disks, CD-ROM’s, etc…Hardware: hard disk, disks, CD-ROM’s, etc…

Hardware can be protected with a mechanical Hardware can be protected with a mechanical lock/key.lock/key.The hardware should be locked when unattended or The hardware should be locked when unattended or not in use.not in use.

Software: Microsoft Word, Excel, Medisoft, etc…Software: Microsoft Word, Excel, Medisoft, etc…The documents created with software can be The documents created with software can be protected with passwords for authorized personnel.protected with passwords for authorized personnel.Authorized personnel should “log off” when the Authorized personnel should “log off” when the computer is unattended. computer is unattended.

Email and Fax MachinesEmail and Fax Machines

EmailEmail Confidential information transferred by email should Confidential information transferred by email should

only be transmitted to secure locationsonly be transmitted to secure locationsPassword controlled systemsPassword controlled systemsMechanically locked systemsMechanically locked systemsPsychologists' Use of E-mail with Clients: Some Ethical ConsiPsychologists' Use of E-mail with Clients: Some Ethical Considerationsderations

Fax MachinesFax Machines Counselors must attempt to send facsimiles to secure Counselors must attempt to send facsimiles to secure

locationslocationsDo not send to centrally located machinesDo not send to centrally located machinesProvide a cover letter with a Confidentiality StatementProvide a cover letter with a Confidentiality Statement

Computer-Assisted CounselingComputer-Assisted Counseling

Career CounselingCareer Counseling Programs such as System for Guidance and Programs such as System for Guidance and

Information-Plus (SIGI-PLUS) have been found to be Information-Plus (SIGI-PLUS) have been found to be useful with highly motivated clients.useful with highly motivated clients.

Clients with lower levels of motivation were found to benefit Clients with lower levels of motivation were found to benefit less.less.

Clinicians need to assess the appropriateness of such Clinicians need to assess the appropriateness of such programs according to each clients level of motivation.programs according to each clients level of motivation.


RehabilitationRehabilitation Clients with traumatic brain injury began receiving Clients with traumatic brain injury began receiving

cognitive retraining with computers in the 1970’s.cognitive retraining with computers in the 1970’s. Cognitive Retraining System (CACR)Cognitive Retraining System (CACR)

The NeuroScience CenterThe NeuroScience Center Computers made it easy to record and track a patients Computers made it easy to record and track a patients

improvementimprovement


Other UsesOther Uses Various software has been developed for Various software has been developed for

psychoeducation in a number of wayspsychoeducation in a number of waysAIDS educationAIDS education

Drug and Alcohol abuse educationDrug and Alcohol abuse education

Sexual DysfunctionSexual Dysfunction

DistressDistress

SmokingSmoking

Computer-Assisted Counseling:Computer-Assisted Counseling:Is it Effective?Is it Effective?

Does computer-assisted counseling devaluate Does computer-assisted counseling devaluate the client/counselor relationship?the client/counselor relationship? Psychodynamic and humanistic counselors believe Psychodynamic and humanistic counselors believe

face-to-face interaction is imperative to the counseling face-to-face interaction is imperative to the counseling relationship.relationship.

Computer-assisted counseling allows clients to: Computer-assisted counseling allows clients to: Learn new behaviorsLearn new behaviors Express emotionsExpress emotions Hone insightful capacitiesHone insightful capacities Gain feedbackGain feedback Practice interaction with individualsPractice interaction with individuals

Appropriateness for ClientsAppropriateness for Clients

It is important to identify It is important to identify which interventions are which interventions are most appropriate for each most appropriate for each clientclient Determine if a particular Determine if a particular

computer program is right computer program is right for the clientfor the client

Assess the client’s level of Assess the client’s level of function and cognitive function and cognitive capabilitiescapabilities

Validation of ProgramsValidation of Programs

APA and ACA require that assessment software APA and ACA require that assessment software be validated prior to use with clientsbe validated prior to use with clients

Also required that clinicians are competent and Also required that clinicians are competent and trained to administer the assessmenttrained to administer the assessment

This guideline is not in place for computer-This guideline is not in place for computer-assisted programsassisted programs Not tested for reliability or validityNot tested for reliability or validity No training required for administrationNo training required for administration At present, anyone can administer it!At present, anyone can administer it!

Ethical DilemmasEthical Dilemmas

ACA has some standards for computer-assisted ACA has some standards for computer-assisted counseling. counseling. EthicsEthics -Section A.12.g -Section A.12.g

The counselor must ensure that each client:The counselor must ensure that each client: Is capable of using the programIs capable of using the program

Emotionally, cognitively, and physicallyEmotionally, cognitively, and physically The program must be appropriate for the clientThe program must be appropriate for the client Comprehends the purpose of the programComprehends the purpose of the program Receives a follow-up session(s) to preserve the intent Receives a follow-up session(s) to preserve the intent

of the programof the programCorrect any misconceptionsCorrect any misconceptionsDetermine if misuse has taken placeDetermine if misuse has taken placeAssess for alternate interventionsAssess for alternate interventions

Online CounselingOnline Counseling

ForumsForums Very recent advancement in counselingVery recent advancement in counseling Ethical boundaries are still fuzzyEthical boundaries are still fuzzy

InternetInternet EmailEmail

Counselors should be careful of transmitting confidential Counselors should be careful of transmitting confidential informationinformation

Often, this information can be interceptedOften, this information can be intercepted

Clients typically use email to ask mental health professionals Clients typically use email to ask mental health professionals specific questions specific questions

Online CounselingOnline Counseling

Future applicationsFuture applications Advertising for services in the mental health Advertising for services in the mental health

fieldfield Real-time video conferencingReal-time video conferencing

Ethical ImplicationsEthical Implications Need technological applications to protect Need technological applications to protect

clientsclientsVideo signal scramblingVideo signal scrambling

Data encryptionData encryption

Development of Ethical PoliciesDevelopment of Ethical Policies

TelehealthTelehealth Allows professionals to communicate with consumers Allows professionals to communicate with consumers

from remote locationsfrom remote locationsEx: VideoconferenceEx: Videoconference

Office for the Advancement of Telehealth - WelcomeOffice for the Advancement of Telehealth - Welcome

Perks for ProvidersPerks for Providers Many professionals are eligible for reimbursement Many professionals are eligible for reimbursement

from Medicarefrom Medicare Federal Communications Commission (FCC) offers Federal Communications Commission (FCC) offers

grants grants

NBCC EffortsNBCC Efforts

WebCounselingWebCounseling The NBCC created WebCounseling in an The NBCC created WebCounseling in an

effort to better serve clientseffort to better serve clients It is a way for mental health professionals to It is a way for mental health professionals to

communicate with clients with remote access.communicate with clients with remote access.

NBCC News (1997)NBCC News (1997) Standards-pg. 3Standards-pg. 3 http://www.nbcc.org/extras/pdfs/recert/newslethttp://www.nbcc.org/extras/pdfs/recert/newslet

ters/newsnotes_14-2.pdfters/newsnotes_14-2.pdf

ACA’s EffortsACA’s Efforts

Created standards for practice in online Created standards for practice in online counseling in 1999counseling in 1999ACA Code of EthicsACA Code of Ethics A.12.hA.12.h EthicsEthics Cybercounseling and Cyberlearning: Strategies & Cybercounseling and Cyberlearning: Strategies &

Resources for the MillenniumResources for the Millennium Bloom & Walz, 2000Bloom & Walz, 2000

A handbook discussing various web references and A handbook discussing various web references and professional experiences with cybercounselingprofessional experiences with cybercounselinghttp://images-eu.amazon.com/images/P/155620180X.01.LZZhttp://images-eu.amazon.com/images/P/155620180X.01.LZZZZZZZ.jpgZZZZZ.jpg

Telepsychology RegulationTelepsychology Regulation

In 1997, a study looked at pertinent In 1997, a study looked at pertinent information regarding regulation according information regarding regulation according to each state’s Attorney Generalto each state’s Attorney General

The Survey Says!:The Survey Says!: Only 7% of all 50 states had regulations Only 7% of all 50 states had regulations

regarding telehealth in 1999.regarding telehealth in 1999. Only 7% of all licensing agencies had defined Only 7% of all licensing agencies had defined

regulations for telehealth.regulations for telehealth.


Future development of policies was only Future development of policies was only addressed 17% of the time in the agencies with addressed 17% of the time in the agencies with regulations.regulations.

Much of the regulations created are developed Much of the regulations created are developed out of necessityout of necessity LitigationLitigation


How should we address professionals who How should we address professionals who practice across state lines?practice across state lines? There are 51 jurisdictionsThere are 51 jurisdictions

Is it possible to be aware of and comply Is it possible to be aware of and comply with all regulations?with all regulations? 45% said professionals should be held 45% said professionals should be held

accountable to the laws of the states in which accountable to the laws of the states in which their practices are offered.their practices are offered.

Examples of CybercounselingExamples of Cybercounseling

What is wrong with each of these websites?What is wrong with each of these websites?

http://sgoldsmith1.tripod.com/id13.htmlhttp://sgoldsmith1.tripod.com/id13.html

ONLINE COUNSELING & Psychotherapy by seaONLINE COUNSELING & Psychotherapy by seasoned professionalssoned professionals

What is right about these?What is right about these?

http://www.williamscounselingservices.com/http://www.williamscounselingservices.com/

Online therapy and online counseling at HelpHorOnline therapy and online counseling at HelpHorizonsizons

Computer-Assisted AssessmentsComputer-Assisted Assessments

PurposePurpose

Administer, score, and interpret informationAdminister, score, and interpret information

Examples of computerized assessments:Examples of computerized assessments: Wechsler Adult Intelligence Scale-III (WAIS-III Wechsler Adult Intelligence Scale-III (WAIS-III

(subtests))(subtests)) Wonderlic Personnel TestWonderlic Personnel Test MMPI-2MMPI-2


BenefitsBenefits QuickQuick ReliableReliable Non-repetitiveNon-repetitive Minimizes human errorMinimizes human error

ConcernsConcerns Unqualified individuals may try to administer these Unqualified individuals may try to administer these

assessmentsassessments Providers must be competent in the administration of Providers must be competent in the administration of

these assessmentsthese assessmentsAdequate trainingAdequate training


LimitationsLimitations Examinees should be observed during testingExaminees should be observed during testing

Stimulus control, unfavorable conditionsStimulus control, unfavorable conditions SESSES

Lack of available technology for clients with little or Lack of available technology for clients with little or no financial meansno financial means

Cannot be used as a replacement for Cannot be used as a replacement for professionalsprofessionals


ReportsReportsToo much reliability on the technology to Too much reliability on the technology to interpret the findings of the assessmentinterpret the findings of the assessment Ex: Qualitative dataEx: Qualitative data

Data should be reviewed by the counselorData should be reviewed by the counselorAgencies may be pressured to use under-Agencies may be pressured to use under-qualified individuals for testingqualified individuals for testing Lack of fundingLack of funding Lack of timeLack of time

Computer-Assisted Counselor Computer-Assisted Counselor EducationEducation

Supervision and PracticaSupervision and Practica

BenefitsBenefits Email as a form of communication between Email as a form of communication between

professionalsprofessionalsShare ideasShare ideas

ConcernsConcerns Neglects the nonverbal communication Neglects the nonverbal communication

between supervisor and superviseebetween supervisor and superviseeEx: Crossed arms, smiling, furrowed eyebrowsEx: Crossed arms, smiling, furrowed eyebrows


Distance LearningDistance Learning ConvenientConvenient Consistent quality to all usersConsistent quality to all users Those in remote areas have access to education Those in remote areas have access to education Time limitations are minimizedTime limitations are minimized Limited mobility individuals have equal opportunityLimited mobility individuals have equal opportunity


Modalities for online educationModalities for online education AsynchronousAsynchronous

Curricula are available continuouslyCurricula are available continuously

Ex: Web CT, BlackboardEx: Web CT, Blackboard

Blackboard 6 | Sam Houston State UniversityBlackboard 6 | Sam Houston State University SynchronousSynchronous

Curricula are available for a discrete period of timeCurricula are available for a discrete period of time

Ex: Timed online exams, assignmentsEx: Timed online exams, assignments

Distance LearningDistance Learning

Ethical ConcernsEthical Concerns Lack of personal contact Lack of personal contact Prerecorded lectures lack an opportunity Q & Prerecorded lectures lack an opportunity Q &

A timeA time Discourages active participation in classDiscourages active participation in class Limited collegial interactionLimited collegial interaction Cost may hinder some studentsCost may hinder some students Clarification of information is limitedClarification of information is limited

Development of Distance Learning Development of Distance Learning CurriculaCurricula

MissionMission Review the goals of the distance learning programReview the goals of the distance learning program

Populations, structure, proceduresPopulations, structure, procedures

Delivery of distance learningDelivery of distance learning Video conferencesVideo conferences Prerecorded tapesPrerecorded tapes Discussion forumsDiscussion forums


InstructorsInstructors Need competencies related to technologyNeed competencies related to technology Understand troubleshooting proceduresUnderstand troubleshooting procedures Property rights of curriculaProperty rights of curricula

ResourcesResources Texts should be complimentary to online Texts should be complimentary to online

applicationsapplications Interactive workbooks to encourage students Interactive workbooks to encourage students

to process the learned materialto process the learned material


Support for StudentsSupport for Students Students should be screened for capacity to succeedStudents should be screened for capacity to succeed Career counselingCareer counseling RegistrationRegistration Financial aidFinancial aid Selection of coursework and loadSelection of coursework and load Need low student/teacher ratio Need low student/teacher ratio

10:1 (CACREP)10:1 (CACREP)


Evaluation of ProgramsEvaluation of Programs Course evaluations from studentsCourse evaluations from students QualityQuality Assignment completion and punctuality ratesAssignment completion and punctuality rates

Computer-Assisted Instruction (CAI)Computer-Assisted Instruction (CAI) Used to present specific concepts/informationUsed to present specific concepts/information Can help illustrate specific constructsCan help illustrate specific constructs

Technoanxious vs. TechnocenteredTechnoanxious vs. Technocentered

TechnoanxiousTechnoanxious Uncomfortable with technologyUncomfortable with technology Often perceives technology as a negative influence Often perceives technology as a negative influence

Computers, cell phones, CAI, etc…Computers, cell phones, CAI, etc…

TechnocenteredTechnocentered Comfortable with technologyComfortable with technology Willing to utilize technology for the advancement of the Willing to utilize technology for the advancement of the

professionprofession

Software: Ethical ConcernsSoftware: Ethical Concerns

PiratingPirating Use of software without consent/compensation from Use of software without consent/compensation from

the ownerthe owner Law suits have heightened society’s awareness Law suits have heightened society’s awareness Created legislation as a result of law suitsCreated legislation as a result of law suits

Ex: Napster,MetallicaEx: Napster,Metallica

Case Scenario #1Case Scenario #1Suzie is a counselor at the Happy Hearts Counseling Center. She Suzie is a counselor at the Happy Hearts Counseling Center. She has just finished an intake session with a new client and received has just finished an intake session with a new client and received consent from the client to share information with her psychiatrist. The consent from the client to share information with her psychiatrist. The patient gave Suzie all of her psychiatrist’s contact information; patient gave Suzie all of her psychiatrist’s contact information; however, Suzie failed to confirm the information prior to faxing off the however, Suzie failed to confirm the information prior to faxing off the consent form and confidential client information. She also neglected consent form and confidential client information. She also neglected to include a cover sheet with a confidentiality statement. The to include a cover sheet with a confidentiality statement. The confidential information made its way to the incorrect location, a confidential information made its way to the incorrect location, a centrally located fax machine in a very busy office. Everyone near the centrally located fax machine in a very busy office. Everyone near the fax machine saw the client’s identifying information and where she fax machine saw the client’s identifying information and where she was seeking services.was seeking services.

How can this situation be rectified? How can it be prevented in the How can this situation be rectified? How can it be prevented in the future?future?

Case Scenario #2Case Scenario #2

The Happy Hearts Counseling Center recently hired a new The Happy Hearts Counseling Center recently hired a new administrative assistant. Unfortunately, due to time constraints, the administrative assistant. Unfortunately, due to time constraints, the individual who was assigned to train the new employee failed to individual who was assigned to train the new employee failed to cover all necessary information about confidentiality requirements. cover all necessary information about confidentiality requirements. Due to this lack of training, the employee did not learn the specific Due to this lack of training, the employee did not learn the specific guidelines for sharing confidential information via the internet. The guidelines for sharing confidential information via the internet. The employee emailed another counselor confidential information about employee emailed another counselor confidential information about a specific client (including the clients full name and presenting a specific client (including the clients full name and presenting problem) to the counselor’s personal email address. Much to the problem) to the counselor’s personal email address. Much to the counselor’s surprise, when he checked his email that evening in his counselor’s surprise, when he checked his email that evening in his living room he found the document containing sensitive information. living room he found the document containing sensitive information. Some members happened to be nearby when he checked his email.Some members happened to be nearby when he checked his email.

What are some ways this problem could have been prevented? What are some ways this problem could have been prevented? What steps should the counseling center take to correct the What steps should the counseling center take to correct the problem?problem?

ReferencesReferences

ACA Code of Ethics (2005). Retrieved June 6, ACA Code of Ethics (2005). Retrieved June 6, 2006, 2006, from http://www.counseling.org.from http://www.counseling.org.Bloom, J., & Walz, G. (2000). Bloom, J., & Walz, G. (2000). Cybercounseling and Cybercounseling and cyberlearning: Strategies and resources cyberlearning: Strategies and resources for the new for the new millennium.millennium. Alexandria, Virginia: American Alexandria, Virginia: American Counseling Association.Counseling Association.Bracy, O. The NeuroScience Center. (2006). Retrieved Bracy, O. The NeuroScience Center. (2006). Retrieved

June 5, 2006, from June 5, 2006, from http://www.neuroscience.cnter.com/.http://www.neuroscience.cnter.com/.Goldsmith, S. (2005). Retrieved June 6, 2006, from Goldsmith, S. (2005). Retrieved June 6, 2006, from http://sgoldsmith1.tripod.com/id13.html.http://sgoldsmith1.tripod.com/id13.html.HelpHorizons.com. (2006). Retrieved June 6, 2006, from HelpHorizons.com. (2006). Retrieved June 6, 2006, from

http://www.helphorizons.com/.http://www.helphorizons.com/.

ReferencesReferences

National Board for Certified counselors. (1997). National Board for Certified counselors. (1997). Guidelines for the new world of webcounseling. Guidelines for the new world of webcounseling. NBCC NewsNotes,NBCC NewsNotes, 14(2), 1-2. Retrieved June 6, 14(2), 1-2. Retrieved June 6, 2006, from 2006, from http://www.nbcc.org/extras/pdfs/recert/newsletters/nhttp://www.nbcc.org/extras/pdfs/recert/newsletters/newsnotes_14-2.pdf.ewsnotes_14-2.pdf.Office for the Advancement of Telehealth. (2006). Office for the Advancement of Telehealth. (2006). Retrieved June 5, 2006, from Retrieved June 5, 2006, from http://telehealth.hrsa.gov/welcome.htm.http://telehealth.hrsa.gov/welcome.htm.The WebCounseling Site. (2006). Retrieved June 6, The WebCounseling Site. (2006). Retrieved June 6, 2006, from http://webcounseling.tripod.com/cgi-2006, from http://webcounseling.tripod.com/cgi-bin/in.pl.bin/in.pl.Williams Counseling Services. (2006). Retrieved June 6, Williams Counseling Services. (2006). Retrieved June 6,

2006, from 2006, from http://www.williamscounselingservices.com/.http://www.williamscounselingservices.com/.

ethics and technology sarah kinsworthy, m.a.. innovation over the past several decades, technology...

Documents

cell phones cell phones

electronic information

use of cell phones

printed information

bvrcc slide

new technology

secure locations counselors

rooms private