This consent is to be used in conjunction with, but does not replace, the Informed Consent document you have already signed that is required of all clients prior to starting therapy services.
What is Telemental Health?
Telemental healthcare includes the practice of diagnosis, treatment, education, goal setting, accountability, referral to resources, problem solving, skills training, and help with decision making through the use of internet-based videoconferencing. Telehealth psychotherapy will occur primarily through interactive audio, video, and telephone communications.
Risks of Telemental Health
- Technological failure, such as unclear video, loss of sound, poor connection, "lag-time,"or loss of connection.
- Nonverbal cues are less readily available to both the therapist and the client.
- Interruptions by the client’s family (if the client is at home).
Benefits of Telemental Health
- Availability for those confined by a significant health condition.
- Less limitations by geographical location.
- Reduction of travel to a physical office, which includes decrease in travel time.
- Participation in therapy from your own home or the environment of your choosing.
Disclosure
Telemental health from clinicians employed by Coastal Counseling Center may occur only with current residents of Georgia. The law states that the client must be in the state of Georgia at the time of the session. The federal laws that protect privacy and confidentiality also apply to Telemental Health. Any exceptions to confidentiality are described in the Informed Consent document.
All existing laws regarding client access to mental health information and copies of mental health records apply. No permanent video or voice recordings are kept from Telemental health sessions. Clients may not record or store videoconference sessions or face-to-face sessions.
Platform
At this time, Coastal Counseling Center clinicians use Doxy.me, a HIPAA-compliant platform for audio and video sessions. There are no programs to download. Doxy.me does not store sessions; once the session has ended, there is no transcript or recording.
Expectations of client during each session
The client’s bandwidth connection, resolution and web camera should be of good or exceptional quality. Poorer qualities may result in potential disruption of the session.
- Proper lighting and seating to ensure a clear image of each person’s face.
- The client’s attire should be appropriate to an in-office visit.
- Only agreed upon participants will be present. The presence of any individuals unapproved by both parties and not part of the treatment plan will be cause for termination of the session.
- Unless there is a significant medical condition or situation that would prohibit a face-to-face session, it is preferred that the initial session be in-office with the therapist in the office for the initial session.
- The client must disclose the physical address of their location at the start of the session. Unknown locations will be cause for termination of the session.
- The client shall also provide a phone number where they can be reached in the event of service disruption.
Important
Telemental health services are not for everyone and may not be the most effective form of treatment for certain individuals or presenting problems. If it is believed the client would benefit from another form of service (e.g. face-to-face sessions) or another provider, an appropriate referral may be made. If it would be beneficial for occasional face-to-face sessions with a clinician from Coastal Counseling Center, this will be discussed as part of the treatment plan and the client has the right to refuse such a recommendation. This may result in a referral to another provider as well. Coastal Counseling Center clinicians adhere to the codes of ethics by their respective disciplines (i.e., professional counseling, marriage and family therapy, and social work). The clinicians also adhere to the Telemental Health ethics with the Georgia Composite Board for PC, MFT and SW.
Response to technical difficulties
Should technical difficulties cause session disruption, the clinician will contact the client via preferred telephone contact. If the technical difficulties can be resolved quickly, the session will resume and the client will not experience a shortened session length. If the technical issues cannot be resolved in a timely manner, the session will be rescheduled for a time when functionality is restored. The client will be contacted by telephone to develop a plan for continuation of the session.
Payment
Session costs are outlined in the Informed Consent and the Center’s website. Payment for services is to be made at, or prior to, the time of service.
Contact between sessions
Telephone contact can be made in between sessions for the purposes of scheduling or other needs. Videoconference technology is reserved for therapy sessions only.
Consent to Treatment
I voluntarily, agree to receive Telemental Healthcare assessment, care, treatment, or services and authorize the designated Coastal Counseling Center clinician to provide such care, treatment, or services as are considered necessary and advisable.
I understand and agree that I will participate in the planning of my care, treatment, or services and that I may withdraw consent for such care, treatment, or services that I receive through Coastal Counseling Center at any time.
By typing your name on this Informed Consent, I, the undersigned client, acknowledge that I have both read and understood all the terms and information contained herein. Ample opportunity has been offered to me to ask questions and seek clarification of anything unclear to me.