9.1 Ethical Use of Technology & Electronic Communication

9.1 Ethical Use of Technology & Electronic Communication

Exam Focus: Task 47 carries eight knowledge statements, the most of any task in content area 2.3 — electronic media, service delivery through technology, upholding client well-being, managing confidentiality with technology, assessing one's own competence with technology, managing emergencies during telehealth, managing technological disruptions, and gathering, managing, and storing information electronically. Chapter 6 covered California telehealth law; this section covers the ethics the outline tests separately.

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Technology Competence Is Its Own Competence

ACA H.1.a (Knowledge and Legal Considerations) requires counselors who engage in the use of distance counseling, technology, or social media to develop knowledge and skills regarding the technical, ethical, and legal considerations specific to those practices. Competence to treat panic disorder in an office is not competence to treat it by video.

Distinct skills the code and the blueprint expect:

• Assessing whether a specific client is appropriate for distance counseling (acuity, technology access, privacy at home, ability to be located in an emergency).
• Managing the reduced nonverbal channel and screen fatigue.
• Handling a session interruption without leaving a distressed client alone.
• Choosing and configuring platforms, and understanding what the vendor actually does with data.
• Knowing the licensure geography rules that determine where the counselor may practice.

ACA H.1.b requires counselors to understand the additional legal considerations of practicing across state and international boundaries. The California rule to carry: a California LPCC license authorizes practice with clients located in California; a client who travels to another state is generally subject to that state's licensure law, and the counselor must check that state's rules before continuing.

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Technology-Specific Informed Consent

ACA H.2.a and H.4 require consent that goes beyond the standard intake form:

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Emergencies and Disruptions

BEFORE EACH SESSION
  [ ] Confirm the client's CURRENT physical address, not the address on file
  [ ] Confirm a working call-back number
  [ ] Confirm an emergency contact and whether the client consents to its use
  [ ] Know the local emergency resources for THAT location (PSAP, county
      crisis line, nearest emergency department)

IF THE CONNECTION DROPS
  1. Attempt to reconnect on the same platform (agreed number of tries)
  2. Call the client's phone
  3. If the client was in distress and cannot be reached, use the agreed
     emergency contact or request a welfare check at the confirmed address
  4. Document the disruption and every step taken

Verifying location each session is not bureaucratic. It is what makes a welfare check possible, and it is also how the counselor knows whether the client has crossed a state line.

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Social Media and Digital Boundaries

ACA H.6 governs social media:

• H.6.a: counselors clearly explain to clients, as part of the informed consent, the benefits and limitations of using social media.
• H.6.b: counselors maintain separate professional and personal social media presences.
• H.6.c: counselors respect the privacy of clients' presence on social media unless given consent to view such information.
• H.6.d: counselors take precautions to avoid disclosing confidential information through public social media.

The practical rules: do not accept friend or connection requests from clients; do not search for clients online absent a documented clinical justification such as an active safety concern, and disclose the practice in the consent if it may occur; never respond to an online review in a way that confirms someone is a client — even "thank you" confirms the relationship and is a confidentiality breach; and treat texting as a scheduling channel, not a clinical one.

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Electronic Records and Vendors

• Encryption at rest and in transit; device-level encryption on laptops and phones.
• Access controls — unique credentials, multifactor authentication, automatic timeouts, and audit logs.
• Business Associate Agreements with every vendor that creates, receives, maintains, or transmits ePHI on the counselor's behalf: EHR, telehealth platform, cloud backup, transcription, billing.
• AI and transcription tools are vendors. Pasting session content into a general-purpose consumer tool without a BAA, and without client consent, is an unauthorized disclosure.
• Retention and disposal per BPC § 4999.75 (seven years after termination; for a minor, seven years after the client turns 18), with disposal that renders data unreadable.
• Breach response — contain, assess, notify the client, notify as required under CMIA and HIPAA, remediate, and document.

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Vignettes

Vignette 1 — The client on vacation. A California client asks to keep her weekly video sessions while spending a month in Oregon. Best answer: the counselor checks Oregon's licensure and temporary-practice rules before agreeing. If Oregon does not permit it, the counselor discusses options: pausing, arranging local care, or limited crisis coverage consistent with that state's law.

Vignette 2 — The dropped call. Mid-session, a client describing suicidal thoughts disconnects and does not answer callbacks. Best answer: follow the agreed protocol — reconnect attempts, phone call, then the emergency contact or a welfare check at the address confirmed at the start of the session — and document each step. This is why location verification happens every session.

Vignette 3 — The online review. A client posts a negative public review naming the counselor. Best answer: do not respond in any way that confirms the person is or was a client. The counselor may post a general statement about not discussing clients online, consults, documents, and addresses the matter with the client directly only if the client raises it in session.