Practicing via Telemental Health III: The Clinician-Client Relationship

2 CE Credit Hours. Continuing Education Session Replay w/ Review Exercises.

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

Course Description

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Mental health pros are great at maintaining professional and therapeutic relationships, but we’re not always aware of how the telemental health-mediated relationship differs from the in-person one. The differences apply to everything from intake and informed consent, to client safety, and to how we evaluate the strength of therapeutic alliances and the context for transference and countertransference. This course will cover those legal-ethical issues involved in telemental health informed consent and planning for crises and emergencies. It will also cover clinical issues including the appropriateness of telemental health for the therapist-client dyad, managing the impacts of online disinhibition effect, and boundaries in the always-on world of mobile communications.

This introductory-level course for counselors, marriage and family therapists, clinical social workers, and counseling and clinical psychologists will equip learners to establish and support clinically effective relationships with online clients.

Educational Objectives

  • Establish clinically effective and safety-supporting norms, procedures and boundaries with telemental health clients
  • Manage the detriments and leverage the benefits of the online disinhibition effect
  • Evaluate appropriateness of the telemental health medium for each client relationship and take appropriate action when it is discovered to be inappropriate


  1. Onboarding telemental health clients
    • Securely delivering and receiving intake paperwork
    • Norming the telemental health relationship and processes
  2. TMH informed consent elements
  3. Evaluating appropriateness for telemental health
    • The dyadic and contextual aspects of appropriateness for telemental health
    • Psychological and contextual conditions requiring special consideration
    • Norming the clients’ role in modulating their own behavior to support effectiveness of the telemental health service delivery medium
  4. Crisis/emergency planning
    • Backup communications methods
    • Crisis planning in telemental health
  5. Working with clients from intake to termination via telemental health
    • Intake considerations
    • Considerations at each session
    • Considerations from time-to-time through the relationship
    • Termination considerations
  6. Managing and leveraging online disinhibition effect
    • How the effect can impede therapy and how to mitigate that
    • How the effect can improve therapy and how to leverage that
  7. Communicating with clients outside of video (e.g. email, text, phone, etc.)
    • Between-session boundaries
    • Content of messages
    • Secure vs. nonsecure communication methods


  • American Counseling Association. (2014). ACA Code of Ethics. Alexandria, VA: Author.
  • American Telemedicine Association. (2009). Practice Guidelines for Videoconferencing-Based Telemental Health. Author.
  • American Telemedicine Association. (2009). Evidence-Based Practice For Telemental Health. Author.
  • American Telemedicine Association. (2013). Practice Guidelines for Video-Based Online Mental Health Services. Author.
  • American Telemedicine Association. (2014). Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions. Author.
  • National Board for Certified Counselors. (2012). Code of Ethics . Greensboro, NC: Author.
  • Suler, J. (2004). Psychology of Cyberspace – The Online Disinhibition Effect. Retrieved August 20, 2018, from

This course is part of our Telemental Health Certification Program, and cannot be purchased individually. 

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 primarily on publications from the US Department of Health and Human Services, publications from attorneys, and on guidelines and/or ethics codes of these professional organizations: AAMFT, ACA, APA, ATA, NASW, and NBCC. 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 covered ethics codes and HIPAA, and for legally and ethically providing telemental health services. 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.

This course is part of our Telemental Health Certification Program, and cannot be purchased individually. 

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2 CE Credit Hours. Continuing Education Session Replay w/ Review Exercises.

This course is part of our Telemental Health Certification Program, and cannot be purchased individually. 

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