Order ID:89JHGSJE83839 Style:APA/MLA/Harvard/Chicago Pages:5-10 Instructions:
Risk Management in the Digital World Assignment
Eric Harris and Jeffrey N. Younggren American Psychological Association Insurance Trust, Rockville, Maryland
The literature is replete with articles addressing how the electronic age has created new and improved ways to deliver health care services. This change, however, has raised many questions regarding how professionals can utilize this new technology in a fashion that is consistent with both ethics and law. In this article we attempt a point in time survey of the problems created by practicing psychotherapy in the digital age focusing on a conceptual overview of two specific areas. We review various perceptions of the current state-based regulation of digital interstate practice by psycholo- gists and provide an overview of some basic ethical and risk management principles that have to be addressed by practitioners before proceeding to offer these services given an uncertain regulatory environment.
Keywords: telepsychology, law, ethics, licensing, liability, risk management
European commerce during the Dark Ages was limited and stifled by the existence of a multitude of small kingdoms that were independently regulated and who suppressed the movement of goods across their borders through a confusing and inconsistent morass of taxation, tariff, and regulation. This forced merchants to find another solution to move their goods, one that would avoid the strangulation that resulted from this cumbersome regulatory model. These merchants chose to move their goods by sea without being subject to the problems that were created by this feudal and
archaic design, a move that changed the world. The little kingdoms took hundreds of years to catch up.
Most of us have heard about the dual meanings of the Chinese ideograph for crisis: danger and opportunity. This is a great de- scriptor of the situation psychology finds itself in with regard to the rapid development of digital technologies that will likely revolutionize the way psychological services are delivered. The provision of remote psychological services electronically is devel- oping rapidly and has been identified as a priority by several federal agencies, including the Office for the Advancement of Telehealth in the Department of Health and Human Services. Insurance companies and health care reimbursement programs such as Medicare and Medicaid are already reimbursing these services in limited circumstances, and psychologists are already involved in this process (American Psychological Association [APA] Practice Organization, 2010). In addition, 12 states have already mandated that health insurers reimburse for telehealth services (Baker, 2011). Consequently, it makes both professional and economic sense for psychologists to take full advantage of this use of technology.
Although several forces are moving forward to facilitate the use of technology in provision of psychological services, there remain limitations to be overcome. Most state-based professional licens- ing boards are conservative and geared to protect consumers within the state’s borders, and a major hurdle to resolve is the absence of information from the regulatory system in this area—a system that was developed on the basis of the model of the provider of psychological services and the recipient being in the same room. Unfortunately, then, because the standards for provid- ing psychological services remotely have yet to be established (APA Practice Organization, 2010), psychologists who want to do so will expose themselves to a risk that others will question as ethical and/or legal.
In this article, we review various perceptions of the current state-based regulation of digital interstate practice by psycholo- gists. We also provide some specific ethical and risk management principles that have to be addressed by practitioners before they
This article was published Online First November 7, 2011. Editor’s Note. This is one of 19 accepted articles received in response to an open call for submissions on Telehealth and Technology Innovations in Professional Psychology. —MCR
ERIC A. HARRIS EDD, JD, a member of the Massachusetts Bar since 1970, received his law degree from Harvard Law School in 1969 and his doctorate in clinical psychology and public practice from Harvard Univer- sity in 1978. In addition to his part-time private clinical practice since 1982, he has served as a consultant to the Legal and Regulatory Affairs Division of the American Psychological Association’s (APA’s) Practice Directorate and was legal counsel for Choate Health Management. He is a faculty member at the Massachusetts School of Professional Psychology. He has served as a member of the APA’s Committee for the Advancement of Professional Practice, the Committee on Legal Issues, and the Board of Directors Task Force on Child Issues, as well as treasurer of Division 31. He is a risk management consultant for the APA Insurance Trust. JEFFREY N. YOUNGGREN received his PhD in clinical psychology from the University of Arizona. He is a clinical and forensic psychologist in Rolling Hills Estates, CA. A clinical professor at the University of California, Los Angeles, David Geffen School of Medicine, he serves as a risk manage- ment consultant for the APA Insurance Trust. He is a past chair and member of the APA Ethics Committee and the Ethics Committee of the California Psychological Association. He also served on the APA Com- mittee on Accreditation for 6 years. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Jeffrey N. Younggren, 827 Deep Valley Drive, Suite 309, Rolling Hills Estates, CA 90274. E-mail: jyounggren@jeffreyyounggren.com
RUBRIC
Excellent Quality
95-100%
Introduction 45-41 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Literature Support
91-84 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Methodology
58-53 points
Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score
50-85%
40-38 points
More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.
83-76 points
Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.
52-49 points
Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality
0-45%
37-1 points
The background and/or significance are missing. No search history information is provided.
75-1 points
Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.
48-1 points
There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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