Telecounseling Professional Development Series June 18 Introduction to

Telecounseling Professional Development Series June 18 Introduction to Professional Telecounseling: Ethical and Legal Considerations | July 2 General Telecounseling Practice Considerations July 16 Professional Tele. SCHOOL Counseling | July 30 Professional Clinical Telemental Health Counseling The Webinar Will Begin Shortly UNCP Department of Counseling

Dr. Jeffrey M. Warren, Ph. D, LCMHCS, LSC, NCSC Chair, Department of Counseling, Associate Professor of School Counseling UNCP Department of Counseling

Dr. Nicole Stargell, Ph. D, LCMHCA, LSC, NCC, BC-TMH Associate Professor, Department of Counseling UNCP Department of Counseling

General Telecounseling Practice Considerations Department of Counseling The University of North Carolina at Pembroke College of Health Sciences UNCP Department of Counseling 4

CSI Phi Sigma Telecounseling Professional Development Series Obtaining CE Clock Hours with Certificate UNCP Department of Counseling 5

Obtain Clock Hours for the Live Webinar 1. Attend the whole webinar. 2. After completion of the live webinar, a program evaluation will pop up in your browser. 3. Complete the program evaluation survey. 4. Your certificate will be emailed after all four presentations in this series. 5. The recorded webinar, PPT slides, & handouts will be posted online. UNCP Department of Counseling 6

Obtain Clock Hours for the Recorded Webinar 1. Watch the whole webinar. 2. Complete the posttest online. 3. After completion of the posttest, you will receive an email with a link to the CE evaluation. 4. Complete the CE evaluation survey. 5. Your certificate will be emailed within 10 business days. UNCP Department of Counseling 7

Agenda • Brief Review of Legal and Ethical Considerations • Discuss General Practice Considerations for Professional Counselors UNCP Department of Counseling 8

Telecounseling Healthcare Provider in One Place Patient or Client in Another Place Healthcare Administered via Technology (HRSA, 2019) • Professional Teleschool Counseling ◦ Individual Student Planning ◦ Responsive Services • Clinical Telemental Health Counseling UNCP Department of Counseling 9

Poll Question On a scale of 1 -7, how confident are you with your telecounseling skills? Very Little Very Much __________________ 1 4 7 UNCP Department of Counseling 10

Ethics ◦ School Counselors adhere to the same ethical guidelines in a virtual/distance setting (ASCA, 2016, A. 15. ) ◦ Counselors understand that the profession of counseling may no longer be limited to inperson, face-to-face interactions. (ACA, 2014, Section H) UNCP Department of Counseling 11

Legal • “…the North Carolina Board of Licensed Clinical Mental Health Counselors has confirmed that it has no separate view per se with regard to the provision of services via electronic means as long as a licensee is practicing in a manner consistent with his/her training and experience…” www. ncblcmhc. org UNCP Department of Counseling 12

Legal • NC DPI (2020) Remote Instruction Plan • “Guidance counselors may use the virtual environment to convene groups of students as they would in a face-toface setting. ” ◦ Develop opportunities for Instructional Support Personnel to sustain the school’s instructional program as articulated by leadership. ◦ Consider how these employees will support the social -emotional needs of students and families in a virtual environment. ◦ Consider how these employees will adapt their inperson programming to the offsite programming. UNCP Department of Counseling 13

Students Using Telecounseling • Some states have specific rules • In general, students can do what their supervisors do “The practice of counseling may be provided in North Carolina by…qualified counselor interns, who are providing services that constitute a part of the supervised course of study…through electronic means such as telehealth. ” (NCBLPC, 2014) UNCP Department of Counseling 14

Supervision • Telecounseling supervision ◦ Some states allow, some don’t ◦ Same that applies to practice, applies to supervision • “Video supervision is permitted as long as the session is synchronous and involves verbal and visual interaction during the supervision. ” (NCBLPC, 2014) UNCP Department of Counseling 15

Supervision • UNCP Students require ◦ Co-Telecounseling/Live Supervision ◦ Direct supervision at all times • Professional counselors follow supervision guidelines for their licensure UNCP Department of Counseling 16

Determine Scope of Practice • Determine your scope of practice ◦ CMHC • Typical clinical hour • Age range and specialty • Types of interventions ─Talk therapy ─Creative interventions UNCP Department of Counseling 17

Determine Scope of Practice • PSC ◦ Individual Student Planning ◦ Responsive Services • • • Receiving referrals/Crisis Response Short-term counseling Group counseling Long-term counseling Family counseling ◦ Consult with administration • How much time should be spent in direct service? UNCP Department of Counseling 18

Determine the Technology • What is available to you? ◦ Consult Administrators ◦ Peers • • Computer or Tablet Encrypted Email Telephone File Storage—hardware/software ◦ BAA UNCP Department of Counseling 19

Determine the Technology • Video Platform ◦ ◦ Doxy. me Simple Practice Consult Administrators/Technical Team BAA • How will the client sign informed consent? ◦ EHR ◦ Postal Mail-SASE to workplace to be scanned ◦ Email UNCP Department of Counseling 20

Scheduling • When are you available? • Who will schedule the sessions? • How will you remind clients? UNCP Department of Counseling 21

Counseling Considerations • Screening ◦ Past or present NSSI, HI ◦ Level of comfort with technology ◦ Access to technology and privacy • Issues of privilege • Ongoing assessment of client suitability ◦ Nature and severity of symptoms ◦ Mental Status Exam ◦ Crisis (frequency) UNCP Department of Counseling 22

Best Practices • • Ongoing training in telecounseling Abide by relevant codes of ethics Verify jurisdiction Verify client location (guardian location) Verify client identity Display credentials with links Assess client suitability and access UNCP Department of Counseling 23

Best Practices cont’d • Telecounseling informed consent ◦ Consent for Minors (parent/legal guardian) ◦ Ongoing • Alternative communication for technical issues • Emergency contact • Privacy and safety of client • Confidentiality and data security UNCP Department of Counseling 24

Best Practices cont’d • Viable referral • Communication policies for between sessions (Center for Credentialing and Education, 2016) UNCP Department of Counseling 25

Counseling Considerations • Professional liability insurance • Practicing across multiple counties or states ◦ ◦ Local Management Entity (LME) Managed Care Organization (MCO) Emergency Resources Referral Sources UNCP Department of Counseling 26

Counseling Considerations • Private Location for Counselor and Client ◦ ◦ Closed door Sound machine, headphones Do not disturb sign Flat wall color (blue or green), limited distractions, no open doors or open air ◦ Lighting • Flexibility with interruptions on client’s end • Reading Client Nonverbals UNCP Department of Counseling 27

Counseling Considerations • What if the client prefers texting? • What if clients want to use videoconferencing software without a BAA? • What if clients want to do a session in a public setting? UNCP Department of Counseling 28

Counseling Considerations • Master the Technology ◦ Practice ◦ Troubleshoot with a colleague • Secure Internet Connection ◦ Test internet speed • Restart device regularly UNCP Department of Counseling 29

Counseling Considerations • Maintain strong boundaries ◦ You are in the client’s home ◦ They are in yours ◦ Might have sessions outside standard business hours • Maintain telecounseling records for 7 years (NBCC says 5, but other entities might require 7) UNCP Department of Counseling 30

Prepare for Session • Does the client need any materials? ◦ Worksheets/books ◦ Paper and pencil ◦ Toys • Do I need any materials? • Adapt Treatment Plans • Refer if you don’t feel competent addressing the issue in an online setting UNCP Department of Counseling 31

Building the Therapeutic Relationship • • • Remember your basic helping skills Adjust for communication challenges Use immediacy Focus and relax Start off slow and get a feel for the process UNCP Department of Counseling 32

Supervision • Seek Supervision ◦ Formal ◦ Peer • Consultation • Lifelong Learning UNCP Department of Counseling 33

Counseling Considerations • Telecounseling with minors ◦ Adapt Informed Consent Accordingly ◦ Have an adult present at all times ◦ Determine if/when guardians will participate in session ◦ Confirm location and identity ◦ Confidentiality and collaboration UNCP Department of Counseling 34

Counseling Considerations • Group telecounseling ◦ Increased risk to confidentiality ◦ Cannot control what other group members do outside of group ◦ Online members taking recordings/screenshots prohibited ◦ Member location/privacy and technology ◦ Use nicknames or initials on screen ◦ Mute microphone while not speaking UNCP Department of Counseling 35

Counseling Considerations • Self-Care ◦ Leave work in your office ◦ Manage your own life outside of session ◦ Bring everything you need to be comfortable before session ◦ Minimize disruptions UNCP Department of Counseling 36

Poll Question • Have you been getting enough self-care? ◦ Yes ◦ No UNCP Department of Counseling 37

Up Next • Discussion Hour 07/16/20 3 pm Professional Tele. SCHOOL Counseling 07/30/20 3 pm Professional Clinical Telemental Health Counseling UNCP Department of Counseling 38

Advanced School Counseling for Postsecondary Success Graduate Certificate 12 Credit Hours • • CNS 5650: School Counselor as Leader, Advocate, and Consultant (3) • CNS 5750: College and Career Readiness (3) • CNS 5770: Evidence-Based School Counseling (3) • CNS 5780: Addressing the Achievement Gap and Issues of Social Justice (3) All courses available online. UNCP Department of Counseling Contact Dr. Shenika Jones shenika. jones@uncp. edu

Play Therapy Graduate Certificate • 12 Credit Hours • CNS 5810: Introduction to Play Therapy • CNS 5820: Play Therapy Theories and Techniques • CNS 5830: Play Therapy for Specific Challenges • CNS 5840: Filial and Family Play Therapy Meets education requirements for Registered Play Therapist (RPT) and School-Based Registered Play Therapist (SB-RPT) credentials. UNCP Department of Counseling Contact Dr. Jonathan Ricks jonathan. ricks@uncp. edu

Graduate Certificate in Addictions Counseling • 12 Credit Hours • CNS 5900: Issues in Addictions (Prerequisite for other three courses) • CNS 5860: Contemporary Issues and Special Population in Addiction • CNS 5870: The Family and Addiction • CNS 5890: Diagnosis, Treatment, and Psychopharmacology in Contact Dr. Stephanie Robinson Addiction Stephanie. robinson@uncp. edu • Apply for Fall or Spring semesters. All courses available online. UNCP Department of Counseling

Dr. Jonathan Ricks, Ph. D, LCMHC, LSC, NCC, RPT Assistant Professor & Field Placement Coordinator for Professional School Counseling UNCP Department of Counseling

UNCP Department of Counseling

Discussion • What questions do you still have around ethical and effective offering of telecounseling services? UNCP Department of Counseling 44

Discussion • What are your hopes and fears around conducting telecounseling services? UNCP Department of Counseling 45

Discussion • What are some ethical considerations that may be specific to your site in the Fall? UNCP Department of Counseling 46

References • American Counseling Association. (2014). ACA code of ethics. Retrieved from https: //www. counseling. org/resources/acacode-of-ethics. pdf • American School Counselor Association. (2016). Ethical standards for school counselors. Retrieved from https: //www. schoolcounselor. org/asca/media/as ca/Ethics/Ethical. Standards 2016. pdf UNCP Department of Counseling 47

References Health Resources & Services Administration. (2019). Telehealth programs. Retrieved from https: //www. hrsa. gov/rural-health/telehealth North Carolina Board of Licensed Clinical Mental Health Counselors. (2014). Chapter 53 - Board of licensed professional counselors, Administrative Rule 21 NCAC 53. 0212. Retrieved from https: //www. ncblpc. org/Assets/Laws. And. Codes/NCBL CMHC_Administrative_Rules(NCACTitle 21 Chapter 5 3). pdf https: //www. ncblpc. org/Home/Information#: ~: text=The%20 practice%20 of%20 counseling%20 may, that%20 consti tute%20 a%20 part%20 of UNCP Department of Counseling 48

References North Carolina Department of Public Instruction. (2020). Remote instruction plans. Retrieved from https: //docs. google. com/document/d/e/2 PACX 1 v. SJtc. Sk. Wir. Sr 19 EJXe_Cy 4 Vhy. Mdjx_Ught. MG_u 65 HGc. Ku 7 q. FA _Do_P 1 m. M 9 FI 0 ob. Qx 0 FBI 69 Z 9 e. UUGq/pub Key Resource within this reference: https: //drive. google. com/file/d/1 IFCJl. Fok. Ff. Te. UGi. IFY Mn 8 nq. UU 4 iieuh 2/view UNCP Department of Counseling 49