How to Text with Your Clients Session 1: Ethics, Safety & HIPAA Compliance

1 CE Credit Hour. Legal-Ethical. Continuing Education Session Replay.

Developed by: Roy Huggins, LPC NCC
Presented By: Roy Huggins, LPC NCC; Liath Dalton

Course Description

Man tapping screen of smartphone

Texting allows clients and clinicians alike to communicate with speed and convenience. Unlike phone calling, texting is “asynchronous.” That means either of you can fire off a message without the other being immediately available. You can tell each other when you’re running late or need to reschedule without playing phone tag ever again.

Can something so handy come without a price? The good news is that texting can be compatible with ethics, HIPAA, and general client safety! We simply need to understand the relevant issues in order to make sure it remains a clinical benefit and doesn’t become a source of potential harm.

This introductory-level course for counselors, clinical social workers, marriage and family therapists, and clinical and counseling psychologists will help learners to navigate the security, privacy, and documentation issues, as defined by HIPAA and professional ethics codes, that arise with the use of texting in clinical relationships. This is the first of two sessions on the topic of texting. Session 2, which will occur late Summer or Fall, will cover clinical and ethical concerns such as languaging, boundaries, and other practical concerns regarding texting with clients.

Educational Objectives

  • Describe the security-related legal-ethical concerns inherent in texting or messaging with clients.
  • Develop procedures and tools for texting or messaging with clients in a secure and HIPAA-compliant manner
  • Document messages exchanged with clients securely, with client informed consent, and according to the attendee’s documentation requirements.


  1. A few caveats about texting that will be covered in more detail in Session 2 of this program.
  2. What is “texting” and how does it relate to HIPAA and ethical standards?
    • Classic “SMS” texting vs. messaging with apps.
    • Confidentiality-related issues in sending information over the Internet.
      1. Risks to confidentiality.
      2. Client rights regarding their confidentiality.
    • HIPAA and the Transmission Security standard.
  3. Is “transmission security” the only ethical-professional concern around texting?
    • Safety of client phones and computers.
    • Safety of clinician phones and computers.
      1. Confidentiality concerns.
      2. Availability concerns.
    • Texting service providers and the HIPAA Business Associate Rule.
  4. What tools are available to make texting work legally and ethically?
    • Secure texting apps, including some example.
      1. When is an app a “conduit” under HIPAA’s Business Associate Rule?
    • When is nonsecure texting appropriate?
  5. What do I do with text messages that I am in possession of?
    • Text messages and the client record.
      1. What must be retained?
      2. Informed consent regarding text messages and record-keeping.
    • Techniques for securely documenting text messages.


  • American Association of Marriage and Family Therapists. (2015). Code of Ethics . Alexandria, VA: Author.
  • American Counseling Association. (2014). ACA Code of Ethics. Alexandria, VA: Author.
  • American Psychological Association. (2010). American Psychological Association Ethical Principles of Psychologists and Code of Conduct . Washington, DC: Author.
  • National Association of Social Workers. (2017). Code of Ethics . Washington, DC: Author.
  • National Board for Certified Counselors. (2012). Code of Ethics . Greensboro, NC: Author.
  • US Dept. of Health and Human Services. (2006). HIPAA Administrative Simplification . Washington, DC: Author.
  • US Dept. of Health and Human Services. (2013). HIPAA Omnibus Final Rule . Washington, DC: Author.
1 CE Credit Hour.

Presented/Developed By

Roy Huggins, LPC NCCRoy Huggins, LPC NCC, is a counselor in private practice who also directs Person-Centered Tech. Roy worked as a professional Web developer for 7 years before changing paths, and makes it his mission to grow clinicians’ understanding of the Internet and other electronic communications mediums for the future of our practices and our professions.

Roy is an adjunct instructor at the Portland State University Counseling program where he teaches Ethics, and is a member of the Zur Institute advisory board. He has acted as a subject matter expert on HIPAA, security and clinical use of technology for Counseling licensure boards and both state and national mental health professional organizations. He has co-authored or authored 2 book chapters, and he routinely consults with mental health colleagues on ethical and practical issues surrounding tech in clinical practice. He served for 5 years on the board of the Oregon Mental Health Counselors Association and then the Oregon Counseling Association as the Technology Committee Chair.

He really likes this stuff.

Course Co-Presenters

Liath Dalton is a Ph.D candidate in Religious Studies. She began her academic career at Reed College and continued her graduate work at the University of Cape Town.

Liath is the Deputy Director for Person Centered Tech and runs our HIPAApropriateness review program. Through her combination of experience evaluating products for their utility and security in regards to how they can meet risk management needs and providing guidance to members around what product options will best meet their specific practice needs, Liath has an intimate knowledge of both what the practice tech needs are for mental health professionals and what it takes for a product to meet those needs.

Program Notices

Accuracy, Utility, and Risks Statement: The contents of this program are based on publications and reports from the federal Department of Health and Human Services and the National Institutes for Standards and Technology; consultation with experts on HIPAA Security standards and their implementation; relevant professional ethics codes of the professions served by this program; and personal study from the program developers. Some interpretation and analysis presented is made by the presenter, in consultation with knowledgeable colleagues and expert consultants. Statements about applications to technology are according to presenter’s understanding of the technology at the time of the program. The presenter may not know how to apply all principles discussed to every technology type or product. This program discusses strategies for complying with HIPAA and covered ethics codes. It may not include information on all applicable state laws. Misapplication of the materials, or errors in the materials, could result in security problems, data breaches, or non-compliance with applicable laws or ethics codes.

Conflicts of Interest: None.

Commercial Support: None.

This course is subject to our cancellation/refund policy and complaint policy.

1 CE Credit Hour.
Man tapping screen of smartphone

1 CE Credit Hour. Legal-Ethical. Continuing Education Session Replay.


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