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

Course Materials


  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 examples.
      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.

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