ethics: from aristotle to generation z steve franklin, msw, lcsw stevefranklinmsw

Ethics: From Aristotle to Generation Z

Steve Franklin, MSW, LCSW

www.SteveFranklinMSW.com

Aristotle: “Ethics”

'Chief Good' is, 'that which all things aim at,...

The knowledge of it must have great weight;

and like archers, with a mark in view, we shall be more likely

to hit upon what is right.

values determine what is

right and what is wrong, and Doing what is right or wrong

is what we mean by ethics …

to behave ethically is to behave in a manner that is

consistent with what is generally considered to be right or moral

 Ethical behavior

is the bedrock of mutual trust 

to behave ethically is to behave in a manner that is

consistent with what is generally considered to be right or moral

 Ethical behavior

is the bedrock of mutual trust 

(National Defense University for U.S. Army )

Valuesare the rules by which we

make decisions about right and wrong, should and shouldn't,

good and bad. They also tell us which are

more or less important, which is useful when we have to trade off

meeting one value over another.

Ethical Dilemmasallfreeessays.com

A Summary Of

Forester-Miller, H., & Davis, T.E. (1995).

A Practitioner’S Guide To Ethical Decision Making.

Alexandria, Va: American Counseling Association

Ethical Dilemmas (1) identify the problem;(2) apply your Code of Ethics; (3) determine the nature and dimensions of

the dilemma; (4) generate potential courses of action; (5) consider the potential consequences of all

options…then determine a course of action; (6) evaluate the selected course of action;

(Three Tests)(7) implement this action.

Ethical Dilemmas(1)identify the problem

gather data; be specific and objective:

ethical? Legal?

Clinical?

Ethical Dilemmas

(2) apply your Code of Ethics

Ethical Dilemmas

(3) determine the nature and dimensions of the dilemma;

conflicting values? Legal, ethical or moral obligations?

What principles apply?What is your bias

(what answer are you hoping for)?

Ethical Dilemmas

(4) generate potential courses of action;

brainstorm consultsurvey

Ethical Dilemmas

(5) consider the potential consequences

of all options and then determine a course of action

Ethical Dilemmas

(6) evaluate the selected course of action;  Stadler (1986): Three tests• Test of Justice: would you treat others the same in this situation

• Test of Publicity: would want your behavior reported in the press.

• Test of Universality: would you recommend same course of action to another counselor in the same situation

Ethical Dilemmas

(Return to step 1 if solutions aren’t satisfactory)

(7) implement this action.

Document!

Media of communication and data storage

 • Competency to practice

• Protection of client privacy

Vocal/person-to-person

• Human brain expanded to accommodate gossip.

• Eavesdropping (non-electronic)• Information can be shared.• Information can misremembered,

misrepresented, lied about, forgotten

Stone Tablets

• Long-lasting• Hard to shred• Hard to redact• But at least it’s “set in stone”

Paper

• Mail: Where is it delivered? Where is it picked up?• Shredding• Are files secure?• Can be copied.• Copies may fade over time• May be illegible

Fax

Invented around 1850• Who else might see a fax you receive• Who else might see a fax you send? • Do you have the right number?• No encryption involved with FAX; • hard wired transmission; some consider it more secure.• Use partial SS#/ID when practical• Efax-type (fax server)

Phone

Land line• Susceptible to being tapped• Call clients from home?• Voice mail• Extension line• *67/callbacks

Cellular Phone

• Password protected?• Would a family member ever pick

up … see text messages/caller ID?• Can be intercepted• Voice Mail

Text Messaging

• Evolving Etiquette, style• Rules elucidated • because they are broken!

• Don’t text while in a face-to-face conversation

• SMS shouldn't be used for formal communications, such as breaking up

• Don’t jump to conclusions or get offended if you don’t get a reply.

• Be aware of your tone. (You will be misconstrued.)

• Don't SMS while you're driving.

• Leave the slang to the kids. • Remember that SMS can be traced.• Be conscientious of others' schedules. • If it's immediate, make a voice call. • Remember that your phone does have

an off button. • +• Make sure you have the right address!• DON’T WRITE IN ALL CAPITALS

Abbreviations

• A3  Anytime, anywhere, anyplaceAAF  As a matter of factAAK  Asleep at keyboardAAMOI  As a matter of interestAAP  Always a pleasureAAR  At any rateAAS  Alive and smilingACK  AcknowledgeADD  AddressADN  Any day nowADR  AddressAEAP  As early as possible

• AFAIK  As far as I knowAFK  Away from keyboardAFPOE  A fresh pair of eyesAIGHT  AlrightAISB  As it should beAKA  Also known asALCON  All concernedAML  All my loveAOTA  All of the aboveASAP  As soon as possibleA/S/L  Age/sex/locationASL  Age/sex/locationAT  At your terminalATM  At the momentAWOL  Away without leavingAYEC  At your earliest convenienceAYOR  At your own riskAYSOS  Are you stupid or somethingAYTMTB  And you're telling me this because

B/F  BoyfriendB4  BeforeB4N   Bye for nowBAK  Back at keyboardBAU  Business as usualBB  Be backBBIAF  Be back in a fewBBIAM  Be back in a minuteBBIAS  Be back in a secBBL  Be back laterBBQ  Be back quicklyBBS  Be back soonBBT  Be back tomorrowBC  BecauseBCNU  Be seein' youBCOS  BecauseBF  Best friend

• BDN  Big damn numberBFN  Bye for nowBG  Big grinBGWM  Be gentle with meBFG  Big  f***ing grinBIOYN  Blow it out your noseBLNT  Better luck next timeBM&Y  Between me and youBOL  Best of luckBPLM  Big person little mindBRB  Be right backBRT  Be right thereBTA  But then againBTDT  Been there, done thatBTW  By the wayCMIIW  Correct me if I'm wrongCMON  Come onCOB  Close of businessCOS  BecauseC/P  Cross postCR8  CreateCRB  Come right backCRBT  Crying really big tearsCU  See youCUA  See you aroundCUL  See you laterCUL8R  See you laterCWYL  Chat with you laterCYA  See yaCYO  See you onlineD/L  DownloadDL  DownloadDEGT  Don't even go thereDIKU  Do I know you?DQMOT  Don't quote me on thisDTS  Don't think soDV8  DeviateEBKAC  Error between keyboard and chairEF4T  EffortEG  Evil grinEMA  E-mail addressEMFBI  Excuse me for butting inEMSG  E-mail messageENUF  EnoughEOD  End of dayEOM  End of messageEVA  EverEZY  EasyF2F  Face to faceF2T  Free to talkFBM  Fine by meFC  Fingers crossedFICCL  Frankly I couldn't care a lessFISH  First in, still hereFOMCL  Falling off my chair laughingFITB  Fill in the blank

• FRT  For real thoughFWIW  For what it's worthFYEO  For your eyes onlyFYI  For your informationG  GrinG/F  GirlfriendG2CU   Good to see youG2G   Got to goG2R   Got to runG9  GeniusGA   Go aheadGAL  Get a lifeGB   GoodbyeGBU  God bless youGDR  Grinning, ducking, and runningGD/R  Grinning, ducking, and runningGFI  Go for itGG   Gotta Go or Good GameGIAR  Give it a restGIGO  Garbage in, garbage outGL  Good luckGL/HF  Good luck, have funGLNG  Good luck next gameGMTA  Great minds think alikeGOI  Get over itGOL  Giggling out loudGR8  GreatGR&D  Grinning, running and duckingGT  Good tryGTG  Got to goGTRM  Going to read mailH&K  Hugs & kissesH2CUS  Hope to see you soonH8  HateHAGN  Have a good nightHAGO  Have a good oneHAND  Have a nice dayHF  Have funHHIS  Head hanging in shameHOAS  Hold on a secondHRU  How are you?HTH  Hope this helpsHV  HaveIAC  In any caseIANAL  I am not a lawyerIB  I'm backIC  I seeICBW  It could be worseIDK  I don't knowIDTS  I don't think soIDUNNO  I don't knowIG2R   I got to runIIRC  If I remember correctlyILBL8  I'll be late

• ILU  I love youILY  I love youIM  Instant messageIMHO  In my humble opinionIMNSHO  In my not so humble opinionIMO  In my opinionIMS  I am sorryINAL  I'm not a lawyerIOW  In other wordsIRL  In real lifeIRMC  I rest my caseIUSS  If you say soIYKWIM  If you know what I meanIYO  In your opinionIYSS  If you say so

• J00R   YourJAC   Just a secJIC   Just in caseJJA    Just joking aroundJK   Just kiddingJMO   Just my opinionJP   Just playingK8T   Katiek/b   KeyboardKB   KeyboardKISS   Keep it simple, stupidKIT   Keep in touchKOC   Kiss on cheekKOTC   Kiss on the cheekKOTL   Kiss on the lipsKNIM   Know what I mean?l33t   Leet, meaning "elite"L8R   LaterLD   Later, dude / Long distanceLERK   Leaving easy reach of keyboardLMAO   Laughing my a** offLOL   Laughing out loudLTM   Laugh to myselfLTNS   Long time no seeLYLAS   Love you like a sisM8   MateMFI   Mad for itMorF   Male or female?MoS   Mother over shoulderMSG   MessageMTF   More to followMTFBWU   May the force be with youMUSM   Miss you so muchMYOB   Mind your own businessn00b   NewbieN1   Nice oneNBD   No big dealNE   AnyNE1   AnyoneNFM   None for me / Not for meNIMBY   Not in my back yard

• NLT   No later thanNM   Nothing much / Never mindNMH   Not much hereNO1   No oneNOYB   None of your businessNP   No problemNRN   No response/reply necessaryNVM   Never mindNW   No wayNW)   No way outOIC   Oh, I seeOMG   Oh my GodOMW   On my wayOO   Over and outOOH   Out of hereOOTD   One of these daysOP   On phoneOTB   Off to bedOTL   Out to lunchOTOH   On the other handOTT   Over the topOTTOMH   Off the top of my headOTW   Off to workOVA   OverPCM   Please call mePDQ   Pretty darn quickPLMK   Please let me knowPLS   PleasePLZ   PleasePM   Private MessagePMFI   Pardon me for interruptingPMFJI   Pardon me for jumping inPOAHF   Put on a happy facePOS   Parent over shoulderPPL   PeoplePROLLY   ProbablyPRT   PartyPRW   People/parents are watchingPTL   Praise the LordPTMM   Please tell me morePXT   Please explain thatPU   That stinks!Q   QueueQIK   QuickQT   Cutie

• RL   Real lifeRP   Role playRME   Rolling my eyesROFL   Rolling on floor laughingROTFL   Rolling on the floor laughingROTFLUTS  Rolling on the floor laughing unable to speakRSN   Real soon nowRTFM   Read the f***ing manualRUOK   Are you okay?

• SAL  Such a laughSC  Stay coolSETE  Smiling Ear-to-EarSICNR  Sorry, I could not resistSIG2R   Sorry, I got to runSIS  Snickering in silenceSIT  Stay in touchSLAP  Sounds like a planSMHID  Scratching my head in disbeliefSNAFU  Situation normal all fouled upSO  Significant otherSOL  Sooner or laterSOMY  Sick of me yet?SOTMG  Short of time, must goSPK  SpeakSPST  Same place, same timeSRY  SorrySS  So sorrySSDD  Same stuff, different daySSINF  So stupid it's not funnySTR8  StraightSTW  Search the WebSUITM  See you in the morningSUL  See you laterSUP  What's up?SYL  See you laterT+  Think positiveTA  Thanks a lotTAFN  That's all for nowTAM  Tomorrow a.m.TBC  To be continuedTBD  To be determinedTBH  To be honestTC  Take careTGIF  Thank God it's FridayTHX  Thanks

• THNX  ThanksTHNQ  Thank-youTIA  Thanks in advanceTIAD  Tomorrow is another dayTLK2UL8R Talk to you laterTMB  Text me backTMI  Too much informationTMOT  Trust me on thisTMWFI  Take my word for itTNSTAAFL There's no such thing as a free lunchTPM  Tomorrow p.m.TPTB  The powers that beTSTB  The sooner, the betterTTFN  Ta ta for nowTTTT  These things take timeTTYL  Talk to you laterTTYS  Talk to you soonTU  Thank youTY  Thank youTYT   Take your timeTYVM  Thank you very muchUCMU  You crack me upUGTBK  You've got to be kiddingUKTR  You know that's rightUL  UploadUR  Your / You'reUV  Unpleasant visualUW  You're welcomeVEG  Very evil grinVFM  Value for moneyVGC  Very good conditionVIP  Very important personVM  Voice mailVSF  Very sad faceWAM  Wait a minuteWAN2TLK  Want to talkWAYF  Where are you from?W/B  Write backWB  Welcome backWC  Who caresWCA  Who cares anywayWIBNI  Wouldn't it be nice ifWDALYIC  Who died and left you in chargeWDYK  What do you know

• WIIFM  What's in it for me?WISP  Winning is so pleasurableWITW  What in the worldWIU  Wrap it upWK  WeekWKD  WeekendWRT  With regard toWOMBAT  Waste of money, brains and timeWRK  WorkWRUD  What are you doing?WTB  Wanted to buyWTF  What the f**kWTG  Way to goWTH  What the heck? or What the hell?WU?  What's up?WUCIWUG What you see is what you getWUF?  Where you from?WWJD  What would Jesus do?WWYC  Write when you canWYLEI  When you least expect itWYSIWYG What you see is what you getX  KissXLNT  ExcellentYA  YourYBS  You'll be sorryYCMU  You crack me upYGBKM  You've got to be kidding meYKWYCD  You know what you can doYMMV  Your mileage may varyYR  Your YR  Yeah rightYRYOCC  You're running your own cookoo clock YSYD  Yeah sure you do YW  You're welcomeZZZZ  Sleeping (or bored)

• @TEOTD   At the end of the day143   I love you2Day   Today2G2BT   Too good to be true2MORO   Tomorrow2NITE   Tonight404   I don't know4EAE   Forever and ever

Computer• Password required to boot up?• Password-protected files• Password Protected/encrypted

Bit Locker (Windows 7/VistaEnterprise and Ultimate)

Virtual disk encryption: free otfe

• Password complexity/security• Backup• Hard to erase hard drive (drill bit)

Firewall

 Windows pretty good, but hackers target  VPN (Virtual Private Network): home/office

computer remote access with encrypted connection (LT2P is highest level)

 USB stick can carry virus

WifiWireless Local Area Network (WLAN)

Password protection?

• Without encryption, data can be monitored and recorded

• WPA2(WifiProtectedAccess 2); • WEP (Wired Equivalent Privacy)

easier to crack• Wireless Printer

Email

 • Mom:

“You don’t know where that’s been!”

• Email: “You don’t know where that’s going.”

• Who else has your email password?

• (Office staff? Family?)

• Protect it from hijacking• Password complexity• Alert to viruses• Phishing

E-mail Policies and Procedures

• Standard Turnaround Time for Response

• Acceptable Message Content/Purpose

• When Not To Use E-mail• Emergencies or Crises

• Confidentiality and Privacy Identifying code word/phrase Encryption 

• Informed Consent to use email• Part of record?• Is it psychotherapy?

Advantages• Expanded access/ geographical

availability • email avoids scheduling issues • no pressure to think quickly • precise recordkeeping • computer doesn’t interrupt or react in a

triggering manner;• travel time & expense, • agopraphobia/social phobics/other trust

issues; anxiety/stigma; comfort of home; may feel safer

Disadvantages • Miss subtle cues of sound/body language • Miss emotional reassurance and mirroring • Unexpected technical difficulties • Competence in new medium (rhythm) • Boundaries: are emails a session? • Does client have legal recourse? • Informed consent? • What if mandated to clients • Cultural competency if anonymous? • Crises

Instant Messaging?Hybrid of email and text

BlogsPersonalProfessional

Internet

• Password complexity• Unknown sites may try your password

elsewhere• Phishing:

realistic/official/urgent looking • Don’t click on link to sensitive sites,

eg. Bank, email, etc.• Avoid opening files of unknown origin

even if you know the “from” • Antivirus software

Facebook

 • Hard for some students/recent

graduates to imagine being without it.

• Grads becoming cognizant of image they project

• What does it mean to “friend” someone? Invitation to your social circle.

Facebook• Privacy Settings

“Friends Only”“Friends of Friends” (who knows who?)

• Groups/Fans of../specialty pages may reveal your personal information

• Professional-only page• How do you respond to Wall posts• Do you offer advice? Consolation?

Encouragement?• Will “members” identify other members

from wall posts?

Twitter

• Don’t mix professional and personal; could have separate accounts (but keep them straight!)

• Tweets are publicly visible by default; however, senders can restrict to just their followers

• What would you use it for?

Yahoo Listserv

• “Members Only”

• Best Practices sharing• Brainstorming• Resource referrals

• Avoid unnecessary client information.

• Is your email secure?

e-counseling • Medicare… Fraud, Waste and Abuse

Compliance definition includes• “ Providing services over the

telephone or Internet and billing using face-to-face codes”

• BUT individual /group psychotherapy codes are specified for telehealth

e-counseling• Medicare: Remote Patient Face-To-

Face, Interactive Services• must be provided to an eligible Medicare beneficiary• in an eligible facility (originating site) • located outside of a metropolitan area.• “The use of a telecommunications system may substitute

for a face-to-face, "hands on" encounter for consultation, office visits, individual psychotherapy …

• Missouri Telehealth … institutional based videoconferencing bills 7 insurance companies

e-counseling

• Skype/video • www.ismho.org

(International Society for Mental Health Online)

• http://acto-uk.org/ (Association for Counselling and Therapy

Online)

e-counseling

California claims jurisdiction over any activity in CA S. Carolina State Board of Examiners in Psychology“According to statute, jurisdiction is determined by

the residence of the provider.  … can regulate the activities of only those providers who reside in South Carolina.... Should you “go out of state” for psychological

treatment, you do so at your own risk.

e-counseling

• Some states: have created limited or special licenses to practice telemedicine which offer out-of-state providers a restricted license for infrequent or irregular contacts.

• Many, but not all, licensing laws allow temporary practice by persons not licensed in that jurisdiction

e-counseling• Rules for temporary practice vary

• Number of days varies from 0 to unlimited with 30 days most common

• Notification/registration with board varies from advanced authorization for specific service to no notice required

• Scope of practice allowed under temporary authority varies from consultative or forensic work to full range of psychological services

e-counseling• Option A. Simply ignore the laws since they

are out of date. • Option B. Skirt laws by flying "under the radar" • Option C. Challenge the laws by flaunting

unlicensed practice • Option D. Support Efforts to Update & Improve

Telepsychology Provisions in Licensing Law

"I don't know one person who has been pursued by a licensing board for practicing online...

but you don't want to be the poster case."

e-counseling …or ?• What if you call it something else, like

“Coaching”• "You can NOT do the things described as

being within the purview of a profession…- unless you are licensed to practice that profession.

• “If someone says they are a “life coach” but is providing psychological services, they are practicing psychology…"whether they call themselves a psychologist or not."

Stephen T. DeMers, Ed.D.

Online or telephone therapy may be…• Adjunctive; e.g. a regular face to face client

while one of you is out of town.• Continuity: continue with a client who has

moved; or temporarily housebound• Based in scarcity: provide services to rural

areas with few therapists; or where home visits are unavailable.

• Marketing strategy: significant or predominant part of your caseload as a means of reaching new clients

• Clinical consideration: reach clients who might be overwhelmed in person, or concerned with confidentiality.

• Intra- or inter-state

American Counseling Association

Records of Electronic Communications(Approved by the ACA Governing Council, October 1999;

subsequently incorporated into Code of Ethics)

http://mooramoora.org.au/bobrich/psych/ethical.html • Professional counselors maintain

appropriate procedures • for ensuring the safety and

confidentiality of client information • acquired through electronic

communications, • including but not limited to …

American Counseling Association

• encryption software; • proprietary on-site file servers with fire

walls; • saving on-line or e-mail communications

to the hard drive or file server computer systems;

• creating regular tape or diskette back-up copies;

• creating hard-copies of all electronic communications; and the like

American Counseling Association

• Clients are informed about the length of time for,

• and method of, preserving session transcripts.

• Professional counselors warn clients of the possibility or frequency of technology failures andtime delays in transmitting and receiving information.

NASW Code of EthicsSW who provide services via electronic media (such as

computer, telephone, radio, and television) should inform recipients of the limitations and risks associated with such services.

SW should protect the confidentiality of clients’ written and electronic records and other sensitive information. Social workers should take reasonable steps to ensure that clients’ records are stored in a secure location and that clients’ records are not available to others who are not authorized to have access.

SW should take precautions to ensure and maintain the confidentiality of information transmitted to other parties through the use of computers, electronic mail, facsimile machines, telephones and telephone answering machines, and other electronic or computer technology. Disclosure of identifying information should be avoided whenever possible.

American Psychological Association

American Association of Marriage and Family Therapists

• Electronic media • referenced in a few areas by • adding to a list of various ways • services may be delivered and • to which admonishments apply.

American Counseling Association-2005

A.12. Technology ApplicationsA.12.a. Benefits and Limitations Counselors inform clients of the benefitsand limitations of using information technology applications in thecounseling process and in business/billing procedures. Such technologiesinclude but are not limited to computer hardware and software, telephones, the World Wide Web, the Internet, online assessment instruments and other communication devices.A.12.b. Technology-Assisted Services When providing technology-

assisteddistance counseling services, counselors determine that clients are intellectually, emotionally, and physically capable of using the

application and that the application is appropriate for the needs of clients.A.12.c. Inappropriate Services When technology-assisted distancecounseling services are deemed inappropriate by the counselor or client,counselors consider delivering services face to face.

A.12.d. AccessCounselors provide reasonable access to computer

applications When providing technology-assisted distance counseling

services.A.12.e. Laws and Statutes Counselors ensure that the use oftechnology does not violate the laws of any local, state,

national, or international entity and observe all relevant statutes.A.12.f. Assistance Counselors seek business, legal, and

technical assistance when using technology applications, particularlywhen the use of such applications crosses state or national boundaries.

A.12.g. Technology and Informed Consent As part of the process of establishinginformed consent, counselors do the following: 1. Address issues related to the difficulty of maintaining the confidentiality of electronically transmitted communications.2. Inform clients of all colleagues, supervisors, and employees, such as Informational Technology (IT) administrators, who might have authorized or unauthorized access to electronic transmissions.3. Urge clients to be aware of all authorized or unauthorized users including family members and fellow employees who have access to any technology clients may use in the counseling process.4. Inform clients of pertinent legal rights and limitations governing the practice of a profession over state lines or international boundaries.5. Use encrypted Web sites and e-mail communications to help ensure confidentiality when possible.6. When the use of encryption is not possible, counselors notify clients of this fact and limit electronic transmissions to general communications that are not client specific.7. Inform clients if and for how long archival storage of transaction records are maintained.8. Discuss the possibility of technology failure and alternate methods of service delivery.9. Inform clients of emergency procedures, such as calling 911 or a local crisis hotline, when the counselor is not available.10. Discuss time zone differences, local customs, and cultural or language differences that might impact service delivery.11. Inform clients when technology assisted distance counseling services are not covered by insurance. (See A.2.)

A.12.h. Sites on the World Wide WebCounselors maintaining sites on the World Wide Web (the Internet) dothe following:1. Regularly check that electronic links are working and professionallyappropriate.2. Establish ways clients can contact the counselor in case of technologyfailure.3. Provide electronic links to relevant state licensure and professionalcertification boards to protect consumer rights and facilitate addressing ethical concerns.4. Establish a method for verifying client identity.5. Obtain the written consent of the legal guardian or other authorizedlegal representative prior to rendering services in the event the client isa minor child, an adult who is legally incompetent, or an adult incapableof giving informed consent.6. Strive to provide a site that is accessible to persons with disabilities.7. Strive to provide translation capabilities for clients who have a different primary language while also addressing the imperfect nature of such translations.8. Assist clients in determining the validity and reliability of informationfound on the World Wide Web and other technology applications.

Special thanks to Jeremy Peterson

Micro Center 4/11/12

AppendixSAMPLE: Standards for

Communication If you have a life threatening emergency, and your are

unable to reach me, I suggest you call Life Crisis Services Hot Line (647-4357), Behavioral Health Response(800-811-4760), or “911”.

Paper: Paper records created in intake, therapy sessions, or related correspondence will be maintained in a client file. The client file will only be accessible to me and you, unless explicit permission is granted by you, or there is a requirement under law to disclose information (consistent with limits of confidentiality reviewed at intake, and my Notice of Privacy Practices.) On occasion, I may contract with staff to assist with billing and other administrative

matters, and they would also have access to files.

AppendixSAMPLE: Standards for

CommunicationTelephone: Messages left on my voice mail are secure,

accessible only by me with a password. You can normally expect a response within 24 hours. If you are requiring a more urgent response, follow instructions on the voice mail message to flag it as an urgent message, and I will respond appropriately. If there are occasions when I may be out of the office and checking my voice mail less frequently, I will leave special notice and instructions in the voice mail message.

If you give me a phone number, as a general contact number, or a call back number in a voice mail message, I will assume it is acceptable to leave a message at that number with basic information, such as an answer to a question or scheduling information, unless you advise me

otherwise.

AppendixSAMPLE: Standards for

CommunicationFax: Faxes are received by me in an electronic form and access is

password protected, only viewed by me. I can typically be expected to access a fax message within 24 hours. Response will be determined by the priority I determine. If you require a particularly prompt response, talk with me directly to make arrangements.

Email Email is received by me and access is password protected, only viewed by me. I can typically be expected to access an email message within 24 hours. Response will be determined by the priority I determine. You should normally expect I will respond at the next session. If you require a particularly prompt response, talk with me directly to make arrangements. I will assume that your email communication is safe and secure if I choose to respond by email, unless you advise me otherwise. Email can be a convenient way of passing along information you want to remember to discuss in a session, or even as a way of journaling for emotional expression. It is not a usually a good choice for addressing a crisis.

AppendixSAMPLE: Standards for

CommunicationText Messaging (SMS): Text Messages appear on my phone as

soon as they are received. However, I may not read the message until a later time. If a response is requested, I will typically respond within 24 hours. If a response is not explicitly requested, I will choose whether to respond. Text messages may be convenient to communicate simple information such as scheduling, but is not usually a good medium for discussing emotional or cognitive issues.

Social Media (e.g. Facebook, Twitter, Linked In, etc): As a matter of policy, I do not join a client’s Social Media Network, or include a client in Social Media Networks I may participate in. This helps maintain the privacy and personal boundaries of our therapeutic relationship.

In-person: There may be occasions when we unexpectedly “run into each other” outside of the office, such as at a store, or event, etc. I will typically ignore or not acknowledge knowing a client to protect your privacy. This may seem awkward, but it also avoids the awkwardness of deciding how to explain to someone how we know each other.