Standards and Guidelines
Thus conscience dooes make cowards And thus the native hiew of resolution Is sicklied o'er with the pale cast of thought, And enterprises of great pitch and moment With this regard their currents turn awry And loose the name of action.
Act iii, Scene 1, Line 98
Mental health professionals thinking about using the psychotechnologies should review current ethical guidelines when considering practice innovations. The technological landscape is so diverse and changeable that most codes and rules are subjected to complaints, appeals, and desperate searches for loopholes by professionals and clients alike. Mental health professionals have only begun to collect data about the degree to which members believe in or comply with their professional associations' standards of conduct (e.g., Pope, Tabachnick, & Keith-Spiegel, 1987). Data are not readily available to inform either the clinical decisions of individual practitioners or the attempts of relevant professional associations to extend formal standards of practice to new areas, such as online clinical practice.
This chapter focuses on the many statements and publications of state and professional associations that address ethical issues related to online clinical practice. These documents contain essential information for mental health professionals considering practice in this area. Both the risks and the benefits of such practice are high. On one hand, enforcers and attorneys await the missteps of professionals who make uninformed decisions about online clinical practice. On the other hand, practitioners and patients look eagerly toward the possibilities inherent in new forms of service delivery.
Before we introduce relevant publications, let us remember how media can change perception. First, online clinical practice may markedly flatten the social hierarchy. Even though this result may be helpful in some circumstances, it may lower the barrier for a dissatisfied patient to initiate litigation. For example, when communicating through newspaper columns, radio, television, or stage, mental health professionals often try to reduce social unease by minimizing their status, such as by giving themselves a diminutive name— “Dr. Pat. ” However, the reverse is needed when using some technologies, particularly the text-based media. For instance, in communicating chiefly through e-mail, discussion forum, or chat room, the professional's image needs shoring up, not whittling down. The combination of ready accessibility, physical