MFT Regulation and Technology: A Brief Overview 2012 Annual AMFTRB Meeting San Francisco, California Charles West, PhD, AMFTRB Past President
Disclaimer: The data presented may include an occasional inaccuracy despite all my best efforts. Consider what you may find useful, leave what is not.
E Informed consent for MFT clients 6 states have extensive e therapy policy guidelines for MFTs A total of 13 states have specific informed consent policies
AAMFT Code of Ethics 2012 1.14 Electronic Therapy. Prior to commencing therapy services through electronic means (including but not limited to phone and Internet), marriage and family therapist ensure that they are compliant with all relevant laws for the delivery of such services. Additionally, marriage and family therapists must: (a) determine that electronic therapy is appropriate for clients, taking into account the clients intellectual, emotional, and physical needs; (b) inform clients of the potential risks and benefits associated with electronic therapy; (c) ensure the security of their communication medium; and (d) only commence therapy after appropriate education, training, or supervised experience using relevant technology.
AAMFT Code of Ethics 2012 2.7 Protection of Electronic Information. When using electronic methods for communication, billing, recordkeeping, or other elements of client care, marriage and family therapists ensure that their electronic data storage and communications are privacy protected consistent with all applicable laws.
But before we go further: A brief Overview of MFT State Licensure Requirements Minimum credit hour requirements of the qualifying degree: Minimum number of hours is not specified: 17 states 39*: 3 (Indiana, 27?) 45: 9 48: 8 60: 14 (movement is toward 60)
Graduate Program Practicum Client Contact Hour Minimums States that do not specify a minimum number of practicum CCHs specified: 11 100 199: 2 280: 1 300: 23 500: 13 600: 1 2006: 33 states required 300+, 37 states today States that specify a minimum of practicum supervision hours: 14
Minimum number of post graduate client contact hours required by states 500: 1 1000: 18 1200: 1 1250: 1 1500: 19 1600: 1 2000: 6 2500: 1 3000: 2 4500: 1
2006: Number of states that were below 2 years and 1000 CCHs : 12 2012: 2
Minimum number of required Post Graduate Supervision Hours by states 100: 16 150: 6 175: 1 200: 24 225: 1 300: 2 400: 1 2006: 16 states 200+; 2012: 28
Minimum Post graduate Supervisor Qualifications AAMFT Approved Supervisor/Equivalent: 7 (2006: 9) LMFT + Training: 15 LMFT: 8 Other licenses with stipulations: 21 2006: 14 states required supervision training for LMFTs; 2012: 22 states.
E therapy Policies Across the States Who do we regulate? Where does e therapy occur?
Buyer Beware: We only regulate our own licensees Alaska: Anyone considering utilizing e therapy, or online therapy needs to know that if you are living in Alaska and receiving e therapy, or on line therapy, from a therapist outside of Alaska, there is no process available for regulations of that therapist. Please inquire with the therapist as to their credentials and license.
Others that only regulate their licensees: Colorado: Extensive teletherapy policy with the following disclaimer: This policy applies only to Mental Health professionals listed, certified, registered, or licensed, and treating clients within the State of Colorado. Oregon s and Virginia s policies only apply to licensees of their individual states
A bit higher standard: You have to have a license to provide e therapy in our state Arkansas Rules, Section 1.4: Persons engaged in practices/activities of Counseling or Marriage and Family Therapy to individuals or groups in Arkansas must hold an Arkansas license for whatever method the services are offered, rendered or delivered.
Other states New York: Practice as a licensed professional in New York State, even through telepractice, requires the practitioner to be licensed or otherwise authorized to practice in New York.
Yet a bit higher: you have to have a license in those other states Ohio: All practitioners providing counseling, social work or marriage and family therapy via electronic service delivery to Ohio citizens shall be licensed in Ohio. All licensees of this board providing services to clients outside the state of Ohio shall comply with the laws and rules of that jurisdiction. South Carolina: Professional Counselors shall obtain legal authorization to practice in any jurisdiction in which they maintain an electronic presence via the internet or other electronic means. Massachusetts May not be the only states to require this.
E therapy: Occurs Where the client is located. Arkansas Section 3.5 9(F): Any Technology Assisted Distance Counseling or Marriage and Family Therapy that occurs within the State of Arkansas, whether by an Arkansas counselor or by an out of state Counselor or Marriage and Family Therapist, is deemed to have occurred in Arkansas. All providers of services whether traditional or Technology Assisted who may offer or provide Counseling or Marriage and Family Therapy services to individuals or groups must hold a valid Arkansas license to provide such services.
Others that say it is where the client is California: Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates. Arizona Iowa Louisiana Mississippi (can be inferred) New Mexico (Website: You must have an active license to practice in the State of New Mexico) West Virginia
Massachusetts Distance delivery of counseling and therapy is considered to occur in two locations: where the client is located and where the clinician is located. Therefore, the provision of counseling and/or therapy to individuals located within Massachusetts at the time services are occurring, are considered to fall under the jurisdiction of the Board, regardless of the location of the provider. Mental health professionals licensed by any jurisdiction other than Massachusetts, and not licensed by any Massachusetts Board or not eligible for an exception to Massachusetts licensure, are considered unlicensed by this Board for practice in Massachusetts.
Training: E supervision 15 states specifically allow some level of e supervision Kansas and Missouri: Emergencies or hardship Colorado: allows it between two professionals Oregon: up to 75% of supervision can be electronic Minnesota is considering allowing e supervision up to 25% of supervision hours
Training: E therapy services North Dakota, Texas, Oregon and California specifically allow pre fully licensed individuals to provide e therapy services
Electronic = Face to face Idaho MARRIAGE AND FAMILY THERAPIST SUPERVISOR REQUIREMENTS (RULE 239).03.c. Faceto face may include a face to face setting provided by a secure live electronic connection between the supervisor and supervisee.
Maryland 10.58.12.02 Definitions. (B[2](a))..02 Definitions. A. (3) Face to Face. (a) Face to face means in the physical presence of the individuals involved in the supervisory relationship during either individual or group supervision, or using video conferencing which allows individuals to hear and see each other in actual points of time.
Other states North Dakota: Up to fifty hours of the two hundred hours of face to face supervision may occur via telephonic or other electronic media, as approved by the supervisor (Larry: Considering 50%) Ohio: Electronic service delivery shall require an initial face toface meeting, which may be via video/audio electronically, to verify the identity of the electronic service delivery client. You also have to have a website. Oregon: Supervision requires face to face, including through electronic communication. Texas: Up to 50 hours of face to face supervision may occur via telephonic or other electronic media, as approved by the supervisor.
E continuing education 32 states specifically allow it, of these 20 cap the number hours. Indiana says specifically it can be 100% online.
States that specifically accept online degrees in rules or statutes: Arkansas and Oregon, both changed CACREP standard within the last year
States that deny or somewhat deny online degrees in rules or statutes (what we know): District of Columbia Illinois Kansas (50% rule) Missouri unless the student can simultaneously interact with the course instructor visually and verbally during the transmission of course information. New Hampshire
The End