INFORMED CONSENT FOR TELETHERAPY

Audio/visual services by electronic means is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. Psychotherapy conducted in this way is known as teletherapy.

Because we may engage in teletherapy, I am informing you that:

• All existing confidentiality protections (of in-person sessions) are equally applicable.
• There are potential risks/limitations and benefits of telemedicine.

Potential risks/limitations include, but are not limited to:

• The therapist’s inability to make visual and olfactory observations of therapeutically potentially relevant factors (your physicality including coordination, mannerism or gestures, injuries, appearance, eye contact, and facial and body language) and thus not being aware of what she would consider important information that you may not recognize as significant to present verbally the therapist
• Potential disruption to session due to poor Internet/service connection
• Difficulty providing support (including crisis support) due to lack of proximity

Potential benefits include, but are not limited to:

• Better continuity of care
• Improved access to therapy
• Reduction of travel time & related costs

Teletherapy is most effective when both parties are in private, quiet spaces without distractions and have reliable Internet service, reliable video and audio, and good lighting quality. So when you agree to teletherapy, you also acknowledge that is your responsibility to conduct your teletherapy sessions from a private area with reliable Internet access in order to protect your own confidentiality and ability to participate effectively.