Online Counselling and Related Ethical Issues

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Technology has revolutionized the way things are done including teaching, marketing, buying, selling, treating, counselling etc For instance the advent of internet has made the world a virtual global village by making communication between the people of the world simple and fast. To exploit the enormous resources provided by these technological advances various fields among them counselling have incorporated it in their daily routines. The incorporation of technology in counselling has led to the so-called online counselling, which eliminates the need for face-to-face communication between the client and the professional counsellor. This paper will discuss the major ethical issues confronting online counsellors and potential remedies for these issues.

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Online counselling refers to the practice of professional counselling that takes place when the patient and the counsellor are located in different remote locations using electronic means to exchange information with one another (Oravec, 2000). Counselling over the worldwide web is becoming progressively more popular, though the real number of individuals currently providing counselling over the internet is not known. Online counselling is commonly provided via bulletin boards, web telephone hook-up, e-mail, interactive video and chat rooms. Though many counsellors express cautious concern about taking part in online counselling, majority them seem ready to employ it as optional extra to traditional face-to-face counselling. Some of the benefits online therapies relative to traditional face-to-face counselling include increased services to a wide number of individuals, low costs and the possibility of anonymity. Despite the perceived benefits of this medium of counselling, there are numerous legal and ethical issues that must be addressed before embracing it fully. As cited in Oravec (2000) a 1997 study by Sampson and Kolodinsky recognized a number of ethical issues concerning online counselling including use of computers by semi-qualified or exhausted counsellors, confidentiality ,credibility of information provided through computer networks, insufficient intervention by the counsellors, privacy concerns, inequality of access to computer networks by patients and lack of knowledge, on the part of the online counsellors, on the situation of their patients.

The issue of confidentiality is probably the greatest ethical concern when it comes to ethical issues on online counselling. Confidentiality protection is more difficult on the internet counselling than in the traditional face-to-face counselling. Most of the information transmitted by via websites and e-mail can be accessed by system administrators monitoring how various clients are utilizing their platforms. Another factor that jeopardizes the confidentiality of the clients using online counselling is the fact that most firms as well as government agencies scrutinize internet utilization by their workers. It is also important for the online counsellors to keep in mind that information transmitted over unsecure websites or unencrypted can be accessed by third parties via interception. Even encrypted or secure sites do not provide 100 percent security as hackers have been known to access even the most secure sites. Hence counsellor taking part of online counselling are faced with the challenge of protecting their client’s information. Failure to protect to take appropriate security precautions by counsellors when using online counselling may threaten the confidentiality of their clients. Oravec (2000) suggests that on the ethical issues of confidentiality and privacy, all online professional counsellors need to inform their patients of the possibility or level of extent to which different parties will be indirectly taking part or accessing of their online sessions. Educators as well as mental health care supervisors have the obligation of enlightening their trainees on issues concerning the transfer of patient’s confidential information and other records through electronic means. Oravec (2000) states that the according to the international Association of Marriage and Family Counsellors’ ethical code requires that for confidentiality all patients’ should be kept properly. In simple terms all professionals employing internet for counselling purposes are required to explain difficulties of guaranteeing complete confidentiality online counselling. This information should be clearly visible from all the email locations and websites from which their patients may send information. Individuals taking part in internet counselling should take into consideration of their individual privacy and information. In order to eliminate or reduce probable breaches of confidentiality, various stakeholders like the American counselling Association are promoting the provision of these services only through e-mail communication that employ encryption technology which has the ability to block interception of transmission by third parties as well as ‘secure’ websites. According Oravec (2000) online counsellor are also required to inform their patients of the confidentiality limits with reference to the law of the home state of the client as well as the state where the counsellor is licensed. Another important aspect of online counselling in the context of client confidentiality is based on the storage of the client is sensitive information including images. All counsellors are required seek written consent of their patients before reproducing their sensitive information in any form. They are also encouraged to store client’s sensitive information in computers that have active password protection.

Since in online counselling there is no one-on-one between the patient and the counsellor it is difficult for the patient to gauge the qualification and competence of his or her counsellor hence there is need for a way for the patient to get important information about the counsellor prior to using his or her services. This requirement is also reinforced by the fact that clients not only dependent on their counsellor for their wellbeing but also pay for these services. All professional taking part in online counselling should provide concrete information about them including their names and qualifications to their potential customers. This information will enable clients to have confidence in their counsellors as well as gauge their counsellor’s competence. Credentials are grouped into three categories. The first one shows that the professional or counsellor attained her or his degree from recognized learning institution in addition to any relevant training gained from a qualified instructor. The second one shows the licence certificate or license given to him or her by relevant authorities or state in which they counsellors are working or staying. Lastly, the third credentials provide information on the any professional organization to which the professional belongs to or associated with. According to Oravec (2000) the counsellor should provide the client with information on his or her name, qualifications e.g. certification, licensure and degree) as well as any special degrees or training. In addition to providing this information, the patient should be informed on how to verify this information with relevant authorities like licensing boards of a given state. All online counsellors are also required to offer services only in their area of profession and avoid taking part in those areas they are not competent in. Another significant aspect of accountability of the counsellor to his or her patients is his or her regularity, speed as well as reliability. Counsellors should be readily available in emergency cases, should regularly respond to their patient’s inquiries, should honour appointments as well as provide alternative counsellors and contacts in case of absence due unavoidable circumstances e.g. sickness. It is also important for those aspiring to become online counsellors to keep in mind that it is unethical for counsellor to terminate their relationships with their clients without consulting them.

‘Flaming’, which basically refers to sending messages that are emotional in nature, is also become a central ethical issue in online counselling. Most of these messages are hostile in nature. According to Oravec (2000) despite this phenomenon not being unusual in the mental health related cases or settings, researchers in online counselling have elucidated that increased frequency of such messages on online counselling is directly related to nature of the interactive media. Oravec (2000) points out that most of individuals sending flaming messages during online counselling frequently feel sorry about their actions later. This makes it difficult for online counsellors to differentiate between flames and deep emotional expressions that may be directly related to the client’s immediate condition or issue being discussed. Hence it is important for the online counsellors to discuss the issue of flaming with their clients before embarking on counselling sessions. Since the effects of flaming on online counselling groups are detrimental, online counsellors are required to be very vigilant so as to avert the situation before it grows. Hence online professional counsellors have the obligation of protecting the general public against potentially dangerous in case their clients seem dangerous. Hence online professional counsellors need to have professional skills of identifying patients with the potential of hurting others hence provide protection to those in danger. Hence online counsellors are required by law to inform authorities in such cases. For them to undertake this duty, they must know the address as well as complete names of their patients. Failure to provide critical information to authorities in critical times, online professional may be held responsible for any consequences. Online counsellors are also required to protect clients that they feel have the potential of harming themselves. Since all professional counsellors must possess skills for identifying suicidal tendencies in their patients they should be able to avert situations before things get worse by taking any suicidal tendencies very seriously no matter their magnitude.

In order to guard the general public against potential impostors as online counsellors various organizations have developed online counselling code of ethics. The first of such organization to provide such ethical codes was the NBCC, which published its code of ethics in 1997. According to Oravec (2000) the primary purpose of NBCC establishing such a code was to prevent any potential proliferation of unqualified growth of the procedure. Some of the issues provided for in the NBCC code ethics include the requirement that all online professional counsellors must provide both the hotline telephone numbers and a backup professional counsellor in the patient’s locality, they provide genuine links to the certification as well as licensing authorities for the verification of their professional qualifications, they inform their patients of a possibility of misunderstanding due to the absence of visual signals as well as inform their potential clients that their online counselling does not encompass eating disorders, sexual related violence among others. The NBCC code is frequently updated to deal with new or emerging ethical issues. For instance in 2001 it was updated to provide cater for the possibility of minors taking part in the online counselling by stating that all online professional counsellors have the responsibility of verifying whether their clients are minors or adults.

If all the ethical issues related to online counselling are dealt with in a professional manner, online counselling will be the best alternative to traditional face-to-face counselling since it overcomes most of the limitations of the former like costs, distance and stigma.

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References

Oravec, J. A. (2000). Online counselling and internet: Perspectives for mental health care support. Journal of Mental Health, 9(2), 121-135.

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