Risk Assessment and Crisis Management in Technology Assisted Therapy - PowerPoint Presentation

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Risk Assessment and Crisis Management in Technology Assisted Therapy

SexTherapy-Online, PLLCRhiannon Beauregard, MA, LMFT-S, CSTLicensed Marriage and Family TherapistAASECT Certified Sex TherapistSpecialist-Problematic Sexual Behavior

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Agenda for Today

10 am – 10:15 am: Introduction to Presenter and Attendees ✔️10:15 am – 11:15 am: Introduction to Online Therapy ✔️11:15 am – 11:30 pm: BREAK- Ask questions, use restroom, self-care

✔️11:30 pm – 12:30 pm: Laws, Rules, Regulations, and Ethics of Online Therapy, including Out-of-State Practice, Online Apps/Programs, International Online Therapy

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12:30 pm – 1 pm LUNCH

✔️1 pm – 2:00 pm: Logistics of Online Therapy: The How To’s including HIPAA Compliance ✔️2:00-2:45 pm: Risk Assessment and Crisis Management when Working Online 2:45 – 3:00 pm: BREAK- Ask questions, use restroom, self-care 3:00 pm – 4:00 pm: Advanced Concepts of Online Therapy: Online Therapy as a Model within Itself

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What's the greater risk? Letting go of what people think - or letting go of how I feel, what I believe, and who I am?

Brene Brown

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Every professional has a different definition of risk and a different level of tolerance of risk.

When assessing for risk, it is important that we understand both within ourselves and within our profession. What do you think the biggest risk factor in doing technology assisted therapy is for you?

What is your biggest fear about technology assisted therapy?

Risk Assessment

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Risk Assessment

Assess for risk to YOU as the provider (malpractice insurance, licensing laws, ethical codes, guidelines to practice, scope of practice)Is this the best modality for YOU to be working in? Is this the best modality for the models you are trained to work in? Assess for risk to THE CLIENTAppropriateness for online servicesIs this the best modality for the presenting issue?

Have we assessed for suicidal ideation, domestic violence, substance abuse issues, and severe mental health issues? Does that immediately exclude this population from technology assisted treatment? Verification of identity and age for non-anonymous services

WHAT OTHER RISKS EXISTS?

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Risk Assessment

Check with your malpractice insurance prior to working online. Mine specifically stated: “In regards to online counseling, there is no specific exclusion within CPH and Associates policies for this practice, so it is covered under policy as long as the services being provided are authorized or allowable under the scope of the policyholder’s license. However, given the new terrain, regulatory boards and professional ethics codes are just beginning to tackle this issue. Be cautioned that the way this service is being handled varies greatly from state to state.”

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Crisis Management

Advanced PlanningRecommended to safety plan with each client as soon as possible. Informed Consent“Providing therapy at a distance arises some unique challenges in case of an emergency. If an emergency occurs, Rhiannon C. Beauregard may speak to a member of your family or another clinician without your consent. If there is good reason to believe you are at imminent risk of harming yourself, Rhiannon C. Beauregard is legally responsible to inform a crisis center, hot line, emergency room, police, etc. and will contact the appropriate authorities in the area that you are located. “

Safety Plan should include (and be kept in a file with your access to it):Closest Emergency Room Closest Police Station

Local Emergency Numbers (fire, police, ambulance)

Closest/Local Psychiatric Inpatient Facilities

Contact phone number and information for local therapist (if available)Local, regional, and state Suicide Prevention HotlinesLocal, regional, and state Crisis lines, including Domestic Violence Hotlines and Sexual Assault HotlinesIn Case of Emergency: Who Do I contact that would know what happened?7

Crisis Management

Coordination of CareI often request the client have a local contact for therapy that I have a prior Authorization to Release Information signed so that can be a point of contact for more intense care. If a client is psychiatrically involved, I may not see them unless they have a local contact that is primarily responsible for their psychiatric care and that I am in contact with regularly. Reassessment of Care After CrisisSometimes clients are appropriate for online work but then transition into needing a higher level of care. This is something I discuss with the client and often provide the levels of care as options and discuss with the client what my role will be in their care.

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Sample of Informed Consent

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Risky Business

Let’s come up as a group with some risky and/or crisis situations and brainstorm how we would handle them, paying special attention to risk assessment/management and crisis issues as well as: How would telehealth and online therapy benefit this case?

How would telehealth and online therapy be challenging for this case?What are the relevant LEGAL

ETHICAL

RISK MANAGEMENT

BEST PRACTICES, SCOPE OF PRACTICE, AND QUALITY OF CARE issues to consider with this case? 10

Any Questions?

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Contact

Rhiannon C. Beauregard, MA, LMFT-S, CST, S-PSBLicensed Marriage and Family Therapist in Maine, Massachusetts, New Hampshire, New York, & Texas www.SexTherapy-Online.com

rhiannon@sextherapy-online.com

rhiannon.c.beauregard@gmail.com

Phone: 603.770.5099

Phone: 512.765.4741Fax: 888.288.8495Follow me on Facebook: @RhiannonBeauregardCSTWatch my YouTube Channel: Rhiannon@SexTherapy-Online.com

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