December 9, 2011
Loretta Bradley, along with two additional authors, recently published two articles about email communication that have received a considerable amount of attention.
In 1971, Ray Tomlinson sent the first email between two computers sitting next to each other. Since then electronic communication has greatly evolved with an estimated 107 trillion emails sent in 2010.
Now counselors and mental health therapists are finding that proliferated use of email communication can change the way they correspond with clients. At Texas Tech, professors Loretta Bradley, lead author, and Bret Hendricks, and doctoral student Douglas Kabell researched unprecedented ethical concerns of email communication in a counseling relationship, including confidentiality and protocol standards. Their findings uncovered the grey areas of the relationship, leading them to suggest recommendations for helping counselors avoid ethical dilemmas in their published article titled “Email Communication With Clients: Some Ethical Concerns.” While the authors are not telling counselors to communicate by email, they are suggesting that if counselors decide to communicate by email, there are ethical issues of which counselors should be aware.
The three authors from the College of Education recently published two articles that have received a considerable amount of attention at the American Counseling Association and American Mental Health Counselors national conferences, and attorneys interested in quoting the content. Other counselors around the nation also have told Bradley that their article solicits conversation about issues the counseling profession needs to address more fully.
Bradley, a Horn professor in Counselor Education, said the first area of concern is identifying if an email constitutes counseling.
“We found there is an administrative email and a counseling email. An administrative email is often a reminder that a client has an appointment at one o’clock tomorrow,” she said. “Then there is the clinical email where some type of counseling occurs.
“No matter how small the level of counseling, it is likely that the email will be defined as counseling.”
Kabell said that with counseling emails another dilemma occurs with payment.
“It may only take a counselor a few minutes to read an email, but the amount of emails some counselors receive could consume hours of their time,” he said. “So how would you charge: by the minute, the hour or by the email? These are all fees that you must inform the client about ahead of time.”
Kabell, Bradley and Hendricks recommend every counselor have client consent forms to sign that explain how email communication will be handled.
Bradley emphasized that more sensitive counselor-client situations can occur especially when clients seek emergency help or when confidentiality is highly sensitive.
“A counselor doesn’t need to check their emails hourly, but they do need a policy for when they will check them daily as well as on holidays, weekends and vacations,” she said. “You have to cover the parameters very thoroughly in case you do have a client in a crisis.”
Hendricks, associate professor in Counselor Education, said the worst scenario would be a suicidal client emailing a counselor during the weekend, and the counselor not responding to the email until after 5 p.m. Monday.
Counselors also assist in contingent situations involving divorce and custody battles, and over the Internet there is no way of guaranteeing who sends emails in these cases.
“A counselor can’t take for granted that their client is sending the email. Absolute confidentiality is not guaranteed online,” Bradley said. “I think there are benefits for email communication, but it should never replace face-to-face counseling.”
Bradley, Hendricks and Kabell recommend every counselor have informed consent forms for clients to sign that explain how email communication will be handled. This precaution can help curb liability issues that may arise later.
Another topic the three researchers explored involved who owns the counseling notes of a client after the client dies. Their second article titled “Postmortem Confidentiality: An Ethical Issue,” stemmed from a New York case in which a daughter inherited all her parents’ property, and also believed she was entitled to their therapist records.
“In many instances,” Bradley said, “I don’t think clients have considered or even thought of mentioning their therapist records in their wills.”
“Although directives are needed, currently our field lacks directions on this issue, and we want to recommend that counselors be proactive to prevent any challenges after death,” she said.
Hendricks said while it is generally advocated that clients have confidentiality in death, what happens when a counselor dies and doesn’t have a professional will? Who would have access to the counselor's notes?
A sequel post-mortem article the authors plan to research will answer the above question about the counselor’s will. Together Bradley, Hendricks and Kabell want to provide as much information as possible to clients to prevent liability problems.
“We use our findings in the classroom, as well, to keep our students aware of ethical dilemmas before they begin their careers,” Bradley said.
“Counselors should take necessary precautions because emails never go away and can be subpoenaed by a court,” she said.
The College of Education at Texas Tech University offers a full range of programs, including eight doctoral degrees, 12 master's degrees and two bachelor's degrees with numerous specializations leading to careers in public or private education as teachers, professors, administrators, counselors and diagnosticians.
Programs in the college are housed in two departments. The Department of Curriculum and Instruction offers undergraduate programs leading to initial teaching certificates and graduate programs in bilingual education, curriculum and instruction, elementary education, language literacy and secondary education.
The Department of Educational Psychology and Leadership offers graduate programs in counselor education, educational leadership, educational psychology, higher education, instructional technology and special education.