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Section 3
National Board of Certified Counselors
Written Description of the Distance Counseling Process

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Social Workers, Counselors, MFT's, and Psychologists

NBCC STANDARDS FOR DISTANCE PROFESSIONAL SERVICES

1. NCCs shall adhere to all NBCC policies and procedures, including the Code of Ethics.

2. NCCs shall provide only those services for which they are qualified by education and experience.

NCCs shall also consider their qualifications to offer such service via distance means.

3. NCCs shall carefully adhere to legal regulations before providing distance services. This review shall include legal regulations from the state in which the counselor is located as well as those from the recipient’s location. Given that NCCs may be offering distance services to individuals in different states at any one time, the NCC shall document relevant state regulations in the respective record(s).

4. NCCs shall ensure that any electronic means used in distance service provision are in compliance with current regulatory standards.

5. NCCs shall use encryption security for all digital technology communications of a therapeutic type. Information regarding security should be communicated to individuals who receive distance services. Despite the use of reasonable security safeguards, distance service recipients shall be informed of the potential risks of distance communications. Not the least of these considerations is the warning about entering private information when using a public access or computer that is on a shared network. NCCs shall caution recipients of distance services against using “auto-remember” user names and passwords. NCCs shall also inform recipients of distance services to consider employers’ policies relating to the use of work computers for personal communications.

6. To prevent the loss of digital communications or records, NCCs who provide distance services shall maintain secure backup systems. If the backup system is also a digital mechanism, this too shall offer encryption-level security. This information shall be provided to the recipient of professional services.

7. NCCs shall screen potential distance service recipients for appropriateness to receive services via distance methods. These considerations shall be documented in the records.

8. During the screening or intake process, NCCs shall provide potential recipients with a detailed written description of the distance counseling process and service provision.
--This information shall be specific to the
-- identified service delivery type and
-- include considerations for that particular individual.
These considerations shall include the appropriateness of distance counseling in relation to the specific goal,
-- the format of service delivery,
-- the associated needs (i.e., computer with certain capabilities, etc.),
-- the limitations of confidentiality, privacy concerns,
-- the possibility of technological failure,
-- anticipated response time to electronic communication,
-- alternate service deliveries,
-- and any additional considerations necessary to assist the potential recipient in reaching a determination about the appropriateness of this service delivery format for their need(s).
-- NCCs shall discuss this information at key times throughout the service delivery process to ensure that this method satisfies the anticipated goals, and if not, the NCC will document the discussion of alternative options and referrals in the client’s record.


9. Because of the ease in which digital communications can inadvertently be sent to other individuals, NCCs shall adopt behaviors to prevent the distribution of confidential information to unauthorized individuals. NCCs shall discuss actions the recipient may take to reduce the possibility that they will send information to other individuals by mistake.

10. NCCs shall provide recipients of distance professional services with information concerning their professional credentials and links to the respective credentialing organization web-sites.

11. NCCs, either prior to or during the initial session, shall inform recipients of the purposes, goals, procedures, limitations, potential risks, and benefits of services and techniques. NCCs also shall provide information about rights and responsibilities as appropriate to the distance service. As a part of this type of service provision, NCCs shall discuss with recipients the associated challenges that may occur when communicating through distance means, including those associated with privacy and confidentiality.

12. In the event that the recipient of distance services is a minor or is unable to provide legal consent, the NCC shall obtain a legal guardian’s consent prior to the provision of distance services. Furthermore, NCCs shall retain copies of documentation indicating the legal guardian’s identity in the recipient’s file.

13. NCCs shall avoid the use of public social media sources (e.g., tweets, blogs) to provide confidential information. To facilitate the secure provision of information, NCCs shall provide in writing the appropriate ways to contact them.

14. NCCs shall discuss with recipients the importance of identifying recipient-named contacts in the event of identified emergency situations. As a part of this discussion, NCCs will identify the circumstances in which the individuals will be contacted and what information will be shared with emergency contacts. NCCs will provide recipients of distance services with specific written procedures regarding emergency situations. This information shall include emergency responders near the recipient’s location. Given the increased dangers intrinsic to providing certain distance professional services, NCCs shall take reasonable steps to secure reasonable referrals for recipients when needed.

15. NCCs shall develop written procedures for verifying the identity of the recipient, his or her current locations, and readiness to proceed at the beginning of each contact. Examples of verification means include the use of code words, phrases or inquiries. (For example, “Is this a good time to proceed?”)

16. NCCs shall limit use of information obtained through social media sources (e.g., Facebook, LinkedIn, Twitter) in accordance with established practice procedures provided to the recipient at the initiation of services or adapted through ongoing informed consent process.

17. NCCs shall provide information concerning locations where members of the public may access the internet free of charge or provide information regarding the location of complimentary web communication services. In such cases, the informed consent process shall include the required discussion items, including how this affects confidentiality and privacy.

18. NCCs shall retain copies of all written communications with distance service recipients. Examples of written communications include email/text messages, instant messages, and histories of chat-based discussions even if they are related to housekeeping issues such as change of contact information or scheduling appointments.

19. At a minimum, NCCs shall retain distance service records for a minimum of five years unless state laws require additional time. NCCs shall limit the use of records to those permitted by law, professional standards, and as specified by the agreement with the respective recipient of distance services.

20. NCCs shall develop written procedures for the use of social media and other related digital technology with current and former recipients. These written procedures shall, at a minimum, provide appropriate protections against the disclosure of confidential information and the creation of multiple relationships. These procedures shall also identify that personal accounts are distinct from any used for professional purposes.

-NBCC Policy Regarding the Provision of Distance Professional Services https://www.nbcc.org/Assets/Ethics/NBCCPolicyRegardingPracticeofDistanceCounselingBoard.pdf

National Board for Certified Counselors (NBCC) Code of Ethics

Preamble
The National Board for Certified Counselors (NBCC) administers national certifications that recognize individuals who have voluntarily met standards for general and specialty areas of professional counseling practice. Counselors certified by NBCC may also identify with different professional organizations, and are often licensed by jurisdictions that promulgate standards of behavior. Regardless of any other affiliation, this Code of Ethics is applicable to all NBCC certificants, including National Certified Counselors (NCCs). Counselors are required to adhere to these expectations and all of the Code directives. Candidates and certificants will be sanctioned pursuant to this Code by NBCC when the standards in the NBCC Code of Ethics are found to have been violated. This Code applies to all counselors who are certified by NBCC, candidates for certification, and other counselors subject to this Code.

TELEMENTAL HEALTH, SOCIAL MEDIA, AND TECHNOLOGY
Telemental Health

91. Counselors shall provide only those telemental health services for which they are qualified by education and experience.

92. Counselors shall carefully adhere to legal requirements when providing telemental health services. This requirement includes legal regulations from the State(s) in which the counselor and client are located. Counselors shall document relevant State requirements in the relevant client record(s).

93. Counselors shall ensure that the electronic means used in providing telemental health services are in compliance with current Federal and State laws and regulatory standards concerning telemental health service.

94. Counselors shall ensure that all electronic technology communications with clients are encrypted and secure.

95. Counselors shall maintain records of all clinical contacts with telemental health service clients.

96. Counselors shall set clear expectations and boundaries with telemental health service recipients about the type(s) and timing of communications that will be included in service provision. These expectations and boundaries shall be communicated in writing in disclosure documents provided to clients.

97. Counselors shall provide written information to all telemental health clients regarding the protection of client records, accounts and related passwords, electronic communications, and client identity. This information should include a description of the nature of all communication security measures that are used by the counselor, including any risks or limitations related to the provision of telemental health services.

98. Counselors shall communicate information regarding security to clients who receive telemental health services. Telemental health service clients shall be informed of the potential risks of telemental health communications, including warnings about transmitting private information when using a public access computer or one that is on a shared network.

99. Counselors shall screen potential telemental health service clients to determine whether such services are appropriate. These considerations shall be documented in the client’s record. Counselors shall advise telemental health services clients that they must be intentional about protecting their privacy and confidentiality, including advice concerning viewing employer policies relating to the possible prohibitions concerning the use of work computer systems for personal communications, and not using “auto-remember” usernames and passwords.

100. During the screening or intake process, Counselors shall provide potential clients with a detailed written description of the telemental health counseling process and service provision. This information shall be specific to the identified service delivery type, and include relevant considerations for that particular client. These considerations shall include: the appropriateness of telemental health counseling in relation to the specific goal; the format of service delivery; the electronic equipment requirements such as the need for a computer with certain capabilities; the limitations of confidentiality; privacy concerns; the possibility of technological failure; anticipated response time to electronic communication; alternate service delivery processes; and, any additional considerations necessary to assist the potential client in reaching a determination about the appropriateness of the telemental health service delivery format for their needs. Counselors shall discuss this information throughout the service delivery process to ensure that this method satisfies the anticipated goals. The counselor will document such information and the discussion of alternative service options and referrals in the client’s record.

101. Counselors shall prevent the distribution of confidential telemental health client information to unauthorized individuals. Counselors shall discuss actions the client may take to reduce the possibility that such confidential information is sent to unauthorized individuals in error.

102. Counselors shall provide clients of telemental health services with information concerning their professional preparation and/or credentials related to telemental health, and identify the relevant credentialing organization websites.

103. Counselors, either prior to or during the initial session, shall inform clients of the purposes, goals, procedures, limitations, and potential risks and benefits of telemental health services and techniques. Counselors also shall provide information about rights and responsibilities as appropriate to the telemental health service. Counselors also shall discuss with clients the associated challenges that may occur when communicating through telemental health means, including those associated with privacy and confidentiality.

104. In the event that the client of telemental health services is a minor or is unable to provide legal consent, the counselor shall obtain a legal guardian’s consent prior to the provision of services unless otherwise required by State law. Counselors shall retain documentation indicating the legal guardian’s identity and consent in the client’s file.

105. Counselors will provide clients of telemental health services with specific written procedures regarding emergency assistance situations related to a client. This information shall include the identification of emergency responders near the client’s location. Counselors shall take reasonable steps to secure referrals for recipients when needed for emergencies. Counselors shall provide information to clients concerning the importance of identifying personal contacts in the event of identified emergency situations, and shall ask clients to identify such contacts. Counselors also shall identify to the clients the circumstances in which the counselor will communicate with emergency contacts, and the information that will be shared with emergency contacts.

106. Counselors shall develop written procedures for verifying the identity of each telemental health client, their current location, and readiness to proceed at the beginning of each contact. Examples of verification include the use of code words, phrases, or inquiries, such as “Is this a good time to proceed?”.

107. Counselors shall limit use of client information obtained through social media sources (e.g., Facebook, LinkedIn, Twitter) in accordance with established practice procedures provided to the client at the initiation of services and as adopted through the ongoing informed consent process.

108. Counselors shall retain telemental health service records for a minimum of five (5) years unless applicable State laws require additional time. Counselors shall limit the use of such client records to those permitted by law and professional standards, and as specified by the agreement terms with the respective telemental health services client.

Social Media and Technology
109. Counselors shall provide services pursuant to an appropriate written policy which regulates the use of social media and other related digital technology with respect to current and former clients. This policy shall include terms that protect against the disclosure of confidential client information and the creation of multiple relationships. This Policy shall also identify that client and counselor personal accounts are distinct from social media accounts used for professional purposes.

110. Counselors shall be familiar with the use of privacy and security settings of social media and other electronic platforms utilized for telemental health service provision. Counselors shall understand the purpose of those settings and their impact on client confidentiality, and ensure that such settings are in use.

111. Counselors shall not publish confidential client information on any social media platform, including updates, and blogs, without the consent of the client. To facilitate the secure provision of information, counselors shall inform clients prior to or during the initial session about secure and appropriate ways to communicate with them. Counselors also shall advise clients about the potential risks of sending messages through digital technology and social media sources.

112. Counselors who use digital technology for professional purposes shall only post information related to professional services, such as information concerning advocacy, educational purposes, and marketing, that does not create multiple relationships or threaten client confidentially.

113. Counselors shall respect the privacy of a client’s social media material and accounts, and shall not access client social media accounts without specific client permission, a related discussion with the client, documentation of potential risks and benefits, and a specific clinical purpose.

114. Counselors shall avoid non-professional relationships with clients online. This restriction includes connecting with or following client social media accounts.
- National Board for Certified Counselors, Inc. (2023, May). NBCC Code of Ethics. Retrieved from https://nbcc.org/assets/Ethics/NBCCCodeofEthics.pdf?_zs=KjseE1&_zl=Jlq77

Additional Mental Health Guidelines:
-APA 2013 Guidelines for the Practice of Telepsychology

-NASW, ASWB, CSWE, & CSWA Standard for Technology for Social Work Practice (2017)

Update
A Transcendental Phenomenology
of School Counselors' Lived Experiences
Transforming Remote Counseling Services
During the COVID-19 Pandemic

- Greenidge, T., Smith-Adcock, S., Cakmakci, H., & Su, Y. W. (2023). A Transcendental Phenomenology of School Counselors' Lived Experiences Transforming Remote Counseling Services During the COVID-19 Pandemic. Professional school counseling, 27(1), 2156759X231161524.

Peer-Reviewed Journal Article References:
Boydstun, C. D., Pandita, S., Finkelstein-Fox, L., & Difede, J. (2021). Harnessing virtual reality for disaster mental health: A systematic review. Translational Issues in Psychological Science.

Kneeland, E. T., Hilton, B. T., Fitzgerald, H. E., Castro-Ramirez, F., Tester, R. D., Demers, C., & McHugh, R. K. (2021). Providing cognitive behavioral group therapy via videoconferencing: Lessons learned from a rapid scale-up of telehealth services. Practice Innovations.

Thomas, N., McDonald, C., Boer, K., Brand, R. M., Nedeljkovic, M., & Seabrook, L. (2021). Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems. Psychology and Psychotherapy: Theory, Research and Practice, 94(3), 854–883.

QUESTION 3
According to NBCC, a detailed written description of the distance counseling process and service provision shall include the following information in the intake… To select and enter your answer go to Test.


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