Fritz H. Grupe and Jeanne Yamaura
Counseling, therapy and advice giving services have increasingly been appearing on the Internet. The capacity to deliver these services has advanced, in some cases, more rapidly than has our ability to understand the ethical implications of how these services create, not only new opportunities, but also new ethical issues for practitioners. Client/patient relationships with professionals (and with unlicensed “professionals”) who assist in the resolution of their clients’ problems are seen in disciplines as diverse as religious counseling, family and marriage counseling, psychotherapy, college selection and financial aid assistance, career counseling, telemedicine, research support, business consulting, substance abuse counseling and personal/professional coaching. Some professional organizations (e.g., the American Counseling Association) have begun to address the online practices of their members through the adoption of codes of ethics for online counseling that supplement their off-line codes of ethics. Most practitioners of these forms of counseling and advice giving are not governed by or even aware of those codes that have been promulgated. Many professional groups have not adopted codes of ethics that specifically address the use of the Internet for service delivery, leaving these practitioners with little ethical guidance.
This paper discusses the structure for a successful interactive relationship between an adviser and a client. Following a discussion of the pros and cons for offering helping services of this nature online, this paper will review and examine the codes of ethics that have been promulgated and of guidelines that have been created. It will synthesize points of agreement and differences among them. Even with the emergence of some guidelines, issues about the delivery of such advice giving services exist. A summary of how various technologies are being employed to deliver counseling services will be developed (e.g. email, interactive web sites, newsgroups, LISTSERVs, virtual reality, chat rooms, instant messaging, etc.). This paper will identify and describe the key issues that have begun to appear. It will also summarize the consensus as to how professionals should deal with this issue. Some debate exists, for example, particularly among licensed and certified professionals, over the desirability of even offering therapeutic or some identifiable subset of services in online formats, as opposed to strictly limiting these services to traditional, one-on-one and group settings. Other issues include:
- Do the principles adopted by licensed and certified professionals apply to services in
- Do ethical considerations change when services are provided for a fee or given away for free?
- What are the various forms of online advice delivery and does the ethical framework for evaluating the
desirability of such delivery change.
- Are the standards for online service delivery more restrictive than they are for online than for the
delivery of equivalent services in real-life?
- What are the relative advantages and disadvantages of various online media and how are they best employed?
- What levels and forms of security are needed to protect client identity and to prevent the disclosure of
personally identifiable information? Under what conditions?
- Does the essence of a relationship of a client with a professional advice/care dispenser suffer as a consequence of delivering services online?
- What are the protections end users have or should expect when contracting for or receiving online services?
- Are there any problems that indicate that some forms of advice giving should be proscribed from online service delivery because they are exacerbated by the nature of the delivery system
- Is an informed consent form necessary? Desirable? Under what conditions should they be used?
- What steps should the deliver of services take to protect himself/herself and to properly inform the client (e.g., types of disclaimers and other range of competence indicators)?
- Do web site managers that mediate contacts between multiple practitioners and clients have any special responsibilities to the parties involved?
The paper will present taxonomy of questions that both the user and the advisor should be asking about their relationship in order to ensure that the relationship is beneficial and ethical. It will include examples of ethical problems that have affected online counselors as they have practiced their profession. The paper will also highlight the key literature in this field for practitioners to review when evaluating their own, online delivery mechanisms.