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It's More Than Just a Call: Ethical Issues in Providing Behavioral Telehealth - Test
by Gerald P. Koocher, Ph.D., ABPP and Patricia Keith‑Spiegel, Ph.D.

Course content © copyright 2023 by Gerald P. Koocher, Ph.D. and Patricia Keith-Spiegel, Ph.D.. All rights reserved.

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1. When offering telehealth services to clients who live in a different state, mental health clinicians: Help
Automatically qualify to treat all appropriate clients.
 Need to investigate whether the state where the client sits will recognize the clinician's license as valid for practice.
 May rely on the client's insurance company to approve practicing.
 Can rely on existing presidential executive orders to assure their authority to practice across state lines.
2. When treating clients via telehealth, practitioners should: Help
Adhere to regulatory standards and adequate skill in delivering services remotely.
 Always wear headphones to assure the best sound quality.
 Make sure to collect payment information from clients in advance of rendering services.
 Store records only in the cloud.
3. In order to deliver mental health services ethically using telemetry, clinicians should re-evaluate their professional competence by: Help
Assuring that they have adequate equipment, communication network access, and technical skill to deliver services as planned.
 Establishing a record-keeping system that includes client documentation (e.g., consent documents, clinical notes, billing records) equivalent to records kept for clients seen in person.
 Addressing client confidentiality and privacy issues with telehealth in one's consent form.
 All of the above
4. Which of the following clients would NOT be suitable for treatment via telehealth? Help
One who wanted to have sessions via a shared computer at the local library.
 One who had persistent delusions about being monitored by government authorities.
 One who preferred to remain anonymous and declined to fully identify their name and location.
 None of these clients would be suitable for telehealth services.
5. Which of the following clients would present the greatest contraindications for teletherapy? Help
A 33 year old with depression and anxiety related to COVID-19 in their community and the inability to sustain important social relationships.
 A 73 year old experiencing anger, difficulty falling asleep, weight loss and depression related to social isolation from friends and family members.
 A 25 year old with unstable paranoid delusions, a history of psychotic decompensation, intermittent homicidal ideation, and a pattern of non-adherence with prescribed medication.
 A 16 year old experiencing parental conflicts and academic failure in the context of fully-online schooling.
6. Just as one would do in a standard office setting. Practitioners using telehealth are ethically required to: Help
Obtain consent for treatment.
 Assure confidentiality.
 Do no harm.
 All of the above
7. When setting up one's office for providing telehealth services, the most important elements to consider are: Help
Robust internet service, video and sound equipment in good working order, back-up technology plans.
 Updated record storage, billing, and calendar systems.
 Comfortable seating, access to snacks, and good childcare.
 Stationery and business cards containing Internet and web site information.
8. Therapists should assume that: Help
Clients will search for information about them on the Internet.
 Clients will almost always discuss their therapy on social media.
 None of the mental health professions has taken a position on the ethics of patient targeting Googling.
 Very little information about therapists is available via public Internet searches.
9. While engaged in a telehealth session with an adult client, the therapist sees another adult in the background slapping a child and knocking them to the ground. In this situation, the therapist: Help
Should remind the client to find a quiet location.
 May have an obligation to file a mandated child abuse report in the client's jurisdiction.
 Has no obligation if the client is sitting in a different state from the therapist.
 Should place an immediate 911 call to the client's location.
10. Which of the following would NOT be an essential factor to consider when assessing one's computer setup for telehealth services: Help
Assuring use of a secure password
 Protecting your Wi-Fi router's Service Set Identifier (SSID)
 Considering multifactor authentication (MFA) for account access
 Avoiding buying a computer assembled in Asia.
11. Which of the following would qualify as the most secure password for confidential materials? Help
1234abcd
 princesstreewalrusdeliver
 Password4me!
 Password
12. With respect to privacy and confidentiality, the clinician is expected to: Help
Assure absolute protection to the client.
 Take reasonable precautions and notify clients of limitations in much the same ways they would for any client.
 Take reasonable precautions and notify clients of any incremental privacy/confidentiality hazards posed by telemetry use.
 Conform to HIPAA standards, alert clients to any incremental privacy/confidentiality hazards, and advise them how best to assure privacy in their home site.
13. Which of the following statements is true? Help
HIPAA requirements are waived for telehealth services.
 State laws pre-empt HIPAA for interstate telehealth service confidentiality.
 Clinicians should use HIPAA-compliant telehealth platforms and obtain business agreements.
 Under HIPAA rules clinicians may not release client information obtained via telehealth without an electronic associate treaty.
14. Record keeping for telehealth services: Help
Requires higher standards of HIPAA precautions.
 Generally, has the same requirements for security and records kept for in-person services.
 Record keeping requirements for telehealth were waived during the COVID pandemic.
 Do not require documentation of sessions lasting 20 minutes or less.
15. With respect to billing for telehealth services: Help
Clients should have full information about fees at the start of the professional relationship.
 There is no need to report that services were delivered via telehealth when filing insurance claims.
 Clients who pay by credit card should be charged a service fee.
 Sessions under 20 minutes do not generally require payment.
16. Use of a professional web site and educational postings on social media are: Help
Never ethically acceptable.
 Wide open venues in an ethical sense, as there are no limits on commercial advertising by professionals.
 Have not proved useful in attracting new clients.
 Ethically acceptable so long as they are accurate and not misleading.
17. Which of the following steps are NOT essential to ethical telehealth practice? Help
Using a secure VPN with peer to peer encryption.
 Confirming compliance with current laws and regulations.
 Documenting client's consent to use the proposed platform and mode of conducting therapy.
 Conducting an adequacy or quality check for both the clinician's and client's equipment and Internet service.
18. Which of the following actions are NOT essential for ethical practice via telehealth? Help
Identify all new clients via photo ID or other means.
 Assure your technology and equipment are in working order and consider backup options.
 Assure that your client has adequate technology and equipment to connect with privacy.
 Validate each client's credit card for online payment.

 

 

  
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