AMHCA ANNUAL CONFERENCE
JUNE 22 – 24 , 2022 LINQ HOTEL , LAS VEGAS demands a significant level of technology and financial resources to be able to get online for a therapy session . Internet service itself presents geographic and socioeconomic accessibility issues . Things we take for granted in the clinical setting — confidentiality , privacy , and maintaining a professional relationship — are harder for us to control with telehealth , because we ’ re no longer in control of the therapeutic space . We ’ re only in control of half of it .
THE ADVOCATE MAGAZINE : With telehealth , how does the law affect access and inclusivity ?
Dr . Eric Strom : The law tells us about regulation and licensure and who can provide services to whom wherever , but it doesn ’ t tell us how . The challenge is to ask : “ How are my services accessible or not accessible , and what can I do to extend that ?” Lawsuits will start defining these laws over the next few years . One solution we have now is the multistate Counseling Compact . The Counseling Compact allows states to remain in control of regulating ( which allows the states to continue to protect clients and the general public ), while allowing clinical relationships to continue across state lines .
THE ADVOCATE MAGAZINE : How does your degree in linguistics and your time in the Netherlands affect your work on telehealth ?
Dr . Eric Strom : In my PhD Counseling program , I discovered the happenstance theory of career counseling , which basically says : Forget about figuring out what the best career is for you and then making that happen . Instead , pursue what interests you , stay open to happenstance , gain knowledge and skills , and be willing to shift . That resonated with me . Looping back to telehealth , in that weird happenstance before the pandemic , a small percentage of clinicians gave telehealth ; now , the vast majority to do . They had to be ready and prepared to see that opportunity , and to jump at it and thrive .
THE ADVOCATE MAGAZINE : The pandemic required a sudden shift to telehealth — has it been helpful ?
Dr . Eric Strom : Some clinicians have retired rather than switch to the different format and environment of telehealth . But I think many clinicians have benefited by having had to “ get competent ” right away . Luckily , there was a lot of support . From the beginning of the pandemic , there was conceptual , technical , and regulatory support from AMHCA . Also , the profession recognized that this is a hard transition that we ’ re all trying to make .
THE ADVOCATE MAGAZINE : What would you like clinicians to know related to telehealth ?
Dr . Eric Strom : Clinical work and regulation has always been important . Over the past two years , it has become more relevant and complicated . I tell clinicians all the time that , “ It ’ s a highly regulated field . I know you didn ’ t get into this field because you enjoy the regulation . I do . So , let me handle that .” Also , clinicians often think ethics is scary ; they say : “ You ’ re going to tell me something , and I ’ ll realize , ‘ Crap , I ’ m doing it wrong and I ’ m gonna get in trouble !’” This is not about showing you how you inadvertently violated some weird , nuanced rule . This is about helping you identify what these issues are and how to make the best , most sound decisions to protect you and your clients .
THE ADVOCATE MAGAZINE : What would you like attendees to remember from your keynote ?
Dr . Eric Strom : We need to ask , “ How do we do telehealth so it ’ s not just for my convenience or the client ’ s , but so that
Attend Dr . Ström ’ s keynote address on Friday , June 24 , 2022 , 10:30 a . m .– noon :
“ Telehealth During the Pandemic , Post-Pandemic , and Beyond : Law & Ethics of Access and Inclusivity ”
it ’ s an intentional treatment decision that is safe , effective , and appropriate for the client ? And how do we think through the implications and impacts of telehealth so that we put in place processes and procedures that best protect the client ?
The risk is thinking , “ This is best for the client , so it must be legal and ethical .” Sometimes it ’ s not . Here ’ s an example : Your client , who ’ s very acute , who has a history of suicidality , is relocating outof-state . Do you keep working with that client ? Withdrawing would be abandonment , which would be harmful , so you have to keep working with them . But are you sure ? If you ’ re providing unlicensed services , that ’ s not being supportive of your client because you might be told to immediately terminate . Also , are you sure that your acute client is best-served by telehealth ? Might they actually be better off with an in-person clinician in their new location ? The client ’ s desire isn ’ t always the client ’ s best interest .
The bottom line is we need to really think through how we decide whether telehealth or in-person services are most appropriate . And when we make that decision , how do we leverage the strengths of that format and address its potential limitations ? How do we make sure we are doing as much as we can to make clinical services accessible to a wide range of populations and clients ?
Interview by Kathleen McCarthy , The Advocate Magazine
The 23Advocate The Advocate Magazine Magazine 2022 , Issue 2022 # 1 , Issue American # 1 American Mental Health Mental Counselors Health Counselors Association Association ( AMHCA )( AMHCA ww . amhca ) ww . org . amhca 23 . org