While I share your enthusiasm and appreciate the time and energy involved in the process you seem to have undertaken, I have to agree to some degree with the OPA precautions, simply because of the work I’ve done in this field. A lot of that is documented in my text books or the coursework we are beginning to bring online at the TeleMental Health Institute (http://telementalhealth.com). In essence, just because someone wants to use your system, or encrypted email or Google Talk — or even traditional telephone service to deliver professional services doesn’t mean they are de facto “safe” to do so.

Our degree of “safety” depends on our use not only of good, reliable equipment, but much more importantly, good clinical judgment, based on training, and tailored to the individual or family in front of us… Unfortunately, those areas are not as well defined as many of us would like. Please see my next post about “safety” for details.

If you are a front runner as I suspect you are, then join us in trying to educate our colleagues by encouraging them to get at least 15-20 hours of relevant continuing education in this area before treating patients remotely – whatever equipment they use. Many of the above issues can be handled. However, it takes a fair amount of exposure to the issues to understand them and figure out who is a reasonable candidate for remote treatment, how to authenticate clients every session, how to best set up lighting, background, control sound, images, which technology to use, which clinical protocols to use, how to set up emergency backup procedures, etc.

In essence, working online is a new form of practice. Without being able to prove our approaches are indeed acceptable and we that we are competent not only legally/ethically/technically but clinically to do so, we could run into far more trouble ever brought by than HIPAA, or other relevant privacy laws that make HIPAA look like pablum.

Furthermore, most professional association guidelines (such as the APA) literally require specialized continuing education when delivering services via the new technologies.

I hope I’ve given enough of an answer here. If not, ask more questions, and I will encourage others to join in the answering process.
Let’s figure this out and shape it together, and not wait for others to do it for us.

Best Regards,
Marlene M. Maheu, Ph.D.