Prologue: Your feedback needed! The Technology Tutor column has returned and will be published more often (bimonthly instead of quarterly). With more opportunities to bring you information about technology use in counseling, I want to know what you want to read about. In the past we’ve covered practice management systems, websites, HIPAA/HITECH, telehealth, the 2014 ACA Code of Ethics and more. With more frequent columns, we can get into more detail and even answer some direct questions. Please write to me and let me know what technology topics you’re interested in. Thanks to all of you who have already written in with your comments and ideas.
In June 2013, Edward Snowden, a former employee of the CIA and contractor with the National Security Agency (NSA), leaked classified documents that shed light on certain NSA practices that blurred the lines between the nation’s security and the privacy of its people. The practices included secretly accessing the email and phone records of American citizens. Some of these practices extended beyond our borders, creating tensions between the United States and some of its allies.
Regardless of whether you see Edward Snowden as a patriotic whistleblower or a traitor to his country, he has some valuable insights into technology and privacy — insights to which counselors would be wise to pay heed. The Guardian recently interviewed Snowden and released a teaser video (theguardian.com/world/video/2014/jul/17/edward-snowden-video-interview) that includes information all health care professionals should consider. His ideas are congruent with the changes we have seen in the ACA Code of Ethics, as well as the most recent updates of HIPAA/HITECH (Health Insurance Portability and Accountability Act/Health Information Technology for Economic and Clinical Health Act).
Early in the interview, Snowden is asked which professionals, besides journalists, should be changing their behaviors based on what we now know. His reply: “Anyone who has an obligation to protect the privacy interests of their clients is facing a new and challenging world, and we need new professional training and new professional standards to make sure that we have mechanisms to ensure that the average member of our society can have a reasonable measure of faith in the skills of all the members of these professions.”
Later, he re-emphasized this policy when queried about the potential for the average person to even know what questions to ask about technology. He stated, “We need to think of it in terms of literacy, because technology is a new system of communication, it’s a new set of symbols that people have to intuitively understand. It’s like something that you learn, just like how you learn to write letters at school, you know, you learn to use computers — how they interact, how they communicate. And technical literacy in our society is a rare and precious resource.”
Snowden also said “there shouldn’t be a distinction between digital information and printed information.” He noted that this is integral to maintaining privacy and that a free state should have the same privacy rights associated with digital information as with other forms of data.
The important takeaway here is that our clients will be trusting us to use technology in a responsible manner. They will expect us not only to be technologically literate but also to know what we need to do to keep their protected health information (PHI) secure.
It’s almost impossible to avoid technology use in counseling these days. Even if some counselors are still dedicated to keeping their charts and calendars on paper, their clients are likely increasingly using email, smartphones and other forms of technology to communicate with them. Therefore, it’s important that we all become literate in this new “language.”
Of course, it’s important not only for our clients but also for our profession. We are all on the same team in a seemingly endless struggle to obtain parity. We know that we are as qualified and effective as other mental health professionals. Convincing some others, however, has been an ongoing challenge. One of the many ways we can help ourselves in this effort is to consistently demonstrate our knowledge about technology use in the provision of mental health care. The 2014 revision to the ACA Code of Ethics shows that our profession is giving technology the attention that it deserves. Now it is our responsibility as counselors to follow suit.
With all of the privacy issues revealed by the Snowden leaks, we might ask whether it is safe to use technology in our work. Despite all the concerns raised about the NSA and privacy by Snowden, he is still an advocate for technology. When asked if technology is compatible with privacy, he responded, “Absolutely! Technology can actually increase privacy, but not if we sleepwalk into new applications of it without considering the implications of the new technology.”
This speaks directly to HIPAA’s requirement for a risk assessment and analysis — the process of identifying, documenting and addressing security risks in storing and transmitting electronic PHI (see tameyourpractice.com/blog/think-youre-too-small-hipaa-fine).
In short, counselors have an opportunity to improve the protection of their clients’ privacy through the use of technology. To do so, however, we must become literate in the language of technology so that we can adequately assess risks, provide informed consent and advocate for client privacy. The added bonus is that in doing so, we can further bolster our arguments for parity with other mental health professionals.
Rob Reinhardt, a licensed professional counselor supervisor, is a private practice and business consultant who helps counselors create and maintain efficient, successful private practices. Before becoming a professional counselor, he worked as a software developer and director of information technology. Contact him at firstname.lastname@example.org.
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