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For all behavioral health professionals

Taken from:


54-5704.  SCOPE OF PRACTICE. A provider offering telehealth services must at all times act within the scope of the provider's license and according to all applicable laws and rules, including, but not limited to, this chapter and the community standard of care.






54-5705.  PROVIDER-PATIENT RELATIONSHIP. (1) If a provider offering telehealth services in his or her practice does not have an established provider-patient relationship with a person seeking such services, the provider shall take appropriate steps to establish a provider-patient relationship by use of two-way audio and visual interaction; provided however, that the applicable Idaho community standard of care must be satisfied. Nothing in this section shall prohibit electronic communications:

(a)  Between a provider and a patient with a preexisting provider-patient relationship;

(b)  Between a provider and another provider concerning a patient with whom the other provider has a provider-patient relationship;

(c)  Between a provider and a patient where the provider is taking call on behalf of another provider in the same community who has a provider-patient relationship with the patient; or

(d)  In an emergency.

(2)  As used in this section, "emergency" means a situation in which there is an occurrence that poses an imminent threat of a life-threatening condition or severe bodily harm.


[(54-5705) 54-5605, added 2015, ch. 121, sec. 1, p. 308; am. and redesig. 2016, ch. 47, sec. 30, p. 122.]



Telehealth Guidelines for Professional Counselors and Marriage and Family Therapists
All Idaho licensed counselors and therapists, and those practicing under supervision are required to be
knowledgeable and comply with Idaho statutes and rules governing their profession, including the 2015
Telehealth Access Act and their profession’s Code of Ethics. These guidelines do not supersede and
are subordinate to those laws and rules and Codes of Ethics. They are intended to provide information
and clarification and do not take the place of education or training necessary to engage in telehealth
practice. They may be periodically reviewed and modified by the Board.
Reviewed and approved by the Board of Professional Counselors and Marriage and Family Therapists
on May 6, 2016.
I. Competency and Training
Counselors and therapists provide telehealth services only after they take reasonable steps to ensure
their competence with the issues pertaining to this method of service delivery. Specifically counselors
and therapists need to obtain education, training and supervision in the unique clinical, technical and
administrative challenges which arise in telehealth service delivery. Telehealth services include any
written, video or audio transmission of client information for clinical or supervisory purposes using any
form or format of electronic technology. These include, but are not limited to, telephones, smartphones
and applications, telephone answering machines, faxes, email, social media and internet-based
applications, and data storage devices or media. Counselors and therapists keep current with emerging
knowledge, technology, and research in telehealth and insure their competency in the delivery of
telehealth services through continuing education, consultation, or supervision.
II. Competency and Training - Supervisors
The use of technology for providing supervision falls into three categories:
• Distance supervision of non-telehealth services.
• Distant supervision of telehealth services.
• Traditional supervision of telehealth services.
These three categories create different issues that need to be addressed in the supervisor/supervisee
agreement. The responsibility to be competent in the delivery of telehealth lies with the supervisor when
working with supervisees who are employing telehealth services. Similar to other emerging services
and methods of treatment, if the supervisor chooses not to provide technology assisted services they
are ethically bound to refer their supervisee or recommend they receive additional supervision for that
area of their work.
Those providing supervision of telehealth services review the types of telehealth services being
provided to ensure appropriateness for client care. The supervisor should review the supervisee’s
policies to ensure that telehealth delivery risks and benefits are adequately addressed and there are
adequate safety plans for both client emergencies and technology failures.
III. Informed Consent and Disclosure
Prior to commencing telehealth treatment, counselors and therapists provide clients with a professional
disclosure statement and obtain verbal and written informed consent from the individuals seeking their
services. In addition to following informed consent laws and rules currently in place, telehealth
providers inform clients of their level of competency, experience and training in telehealth, and the
specific benefits and risks associated with technology-assisted services. They review their policies
regarding the use of e-mail, internet messaging, phone texting and social media.
They verify the identity of the client/s and attempt to obtain information about alternative means to
contact them in case of emergency situations. They clearly state their policies regarding response time
to routine electronic messages and to emergencies.
IV. Confidentiality and Security of Client Information
Counselors and therapists inform clients about their responsibilities regarding maintaining
confidentiality, including legally required reporting situations, and the potential risks to confidentiality
when using technology. They use secure electronic transmissions in all telehealth communications and 
make reasonable efforts to secure the confidentiality of information transmitted to other parties.
Counselors and therapists notify clients as soon as possible of any breach of confidentiality as a result
of electronic transmission of confidential information, and document it in the client file.
V. Appropriate Use of Telehealth and Client Assessment
Counselors and therapists recognize that telehealth services are not appropriate for every client. They
establish a relationship with new clients by use of two-way audio and visual interaction. They assess
whether potential clients have the capacity to benefit from online and remote services, including
intellectual, emotional, and physical ability to use electronic technology. They consider the potential
benefits from treatment via telehealth services and the potential risks to the individual, couple, family or
group. If they determine a client/s cannot be provided appropriate treatment through technology
assisted services, and the client/s cannot be seen in person, they provide appropriate referrals.
VI. Referral to Other Services
Counselors and therapists are responsible for monitoring the effectiveness of telehealth services
throughout the treatment, and evaluate the client/s need for in person services or an appropriate
referral. They are responsible for ensuring and documenting that the quality of the telehealth services
meet the appropriate standard of care. Counselors and therapists providing telehealth services shall be
familiar with and have appropriate contact information for available medical resources, including
emergency resources near the client's location, in order to make appropriate client referrals when
medically indicated. “911” may not provide direct access to emergency services in the client’s location.
VII. Records and Documentation
Counselors and therapists providing telehealth services maintain records in compliance with any
applicable state and federal laws, rules and regulations, including the health insurance portability and
accountability act (HIPAA). Such records shall be accessible to other providers and to the client in
accordance with applicable laws, rules and regulations. Counselors and therapists inform clients that
digital and non-digital communications will be included in the clients’ record (including email messages,
text messages, instant messages). Clients are informed of the type of security assigned to the records
and the length of time records will be stored. Counselors and therapists take steps to ensure that
confidential information stored electronically cannot be recovered or accessed by unauthorized persons
when they dispose of or destroy computers and other information storage devices. They have
documentation that such disposal has occurred.
VIII. Jurisdiction/State Boundaries
Idaho licensees who want to offer telehealth services outside the state of Idaho are advised to research
the legal and regulatory requirements of the state or country in which the potential client resides.
Telehealth service is deemed to occur where the client is located at the time of service, the originating
site. The provider’s location (distant site) is not considered the location where the services occur.
Guidelines adapted from: Idaho Board of Psychologist Examiners Guidelines for Electronic
Transmission and Telepsychology in the State of Idaho (2012), Georgia Composite Board of
Professional Counselors, Social Workers and Marriage and Family Therapists Rule 135-11-.01
TeleMental Health (2015), 2014 ACA Code of Ethics, 2015 AAMFT Code of Ethics, Model Regulatory
Standards for Technology and Social Work Practice, 2013-2014,
Further Resources
It is the Board's opinion that any licensed counselor or therapist who wishes to engage in telehealth
services needs to do his/her research to understand the clinical benefits and risks, best practices, and
logistical requirements. The Board has developed this list as a way to assist counselors and therapists
in this endeavor. Listing by the Board does not mean endorsement and exclusion from this list does not
mean rejection.
National Board for Certified Counselors (NBCC) Policy Regarding the Provision of Distance
Professional Services
American Counseling Association (ACA) 2014 Code of Ethics, Section H, Distance Counseling,
Technology and Social Media
American Mental Health Counselors Association (AMHCA), (2000). Code of Ethics of the American
Mental Health Counselors Association, Principle 14, Internet On-Line Counseling
American Association of Marriage and Family Therapists (AAMFT) Code of Ethics 2014, Principle II
Confidentiality and Principle III Professional Competence and Integrity
American Psychological Association (APA) (July/2013). Guidelines For The Practice of Telepsychology
Guidelines for Electronic Transmission and Telepsychology in the State of Idaho
American Telemedicine Association. (ATA)
Practice Guidelines for Video-Based Online Mental Health Services (May/2013)
Quick Guide to Store-Forward and Live-Interactive Teledermatology for Referring Providers (April/2012)
Telemental and Behavioral Health (August 2013)
Canadian Psychological Association (2006). Ethical Guidelines for Psychologists Providing
Psychological Services via Electronic Media
National Board for Certified Counselors and Center for Credentialing and Education (2012). The NBCC
Policy Regarding the Provision of Distance Professional Services
Ohio Psychological Association (2010). Telepsychology Guidelines
New Zealand Psychological Association (2011). Draft Guidelines: Psychology services delivered via the
Internet and other electronic media
Training Resources
Renewed Vision Counseling Services www.renewedvisiontraining.com
Zur Institute www.zurinstitute.com/
Telehealth Certification Institute at https://telementalhealthtraining.com/

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This course was short yet informative.
Annette Cornish
Therapist / Dust 2 Destiny Counseling & Wellness
Great training!
Jacqueline Hayes, M.Ed., LPC, LMHP
Professional Counselor 4 / State of LA
Ray was a wonderful, interactive instructor who really captured the heart of counseling in the world of Telehealth. The course was thorough and beneficial. Two thumbs up!
Rachel Morales
Licensed Professional Counselor
Ray does a spectacular job presenting the ethics in technology! Thank you!
Elaine Marie Barclay
Licensed Professional Counselor/ Assistant Professor / Shorter University/ Capella University
Very beneficial and useful to the direction i am moving of providing therapy
Linda Marie Margosian, MS, NCC, LMHC
I thought the video was very informative and gave me a good back ground on Telehealth , hippa laws and things I needed to know to run an ethical and hippa complent practice .
Meg Maginn
Director /private practitioner / Eating Disorder Associates

I believe this is a good course to take because this is the new wave of society. As a therapist I would like to be able to offer clients the best tools available.

Wihletta Michelle Davis MA, LPC
Therapist / Find the Miracle Within...
This course was very informative for me as a clinician and for my profession
Roseline Ngoeh
Community Clinician / NPS

Thank you for the introduction to telemental health.

Michele Frances Purvin
Psychotherapist / Michele Frances Purvin, LCSW, LCDC

Very good.

Franklin Castillo

Really excellent training full of valuable information and resources - surpassed my expectations!

Dori Ryherd
Therapist / The Cognitive Refinery

Great information with step by step instructions

Donna Tucker
Addiction Counselor / Spectrum Health

What a superb introduction to telemental health, well organized and packed with useful tips. I so appreciate this. Thank you.

Ann P Cahouet
Owner - Clinician / Equine Assisted Solutions LLC

Awesome job! This is a very insightful presentation.

Licensed Therapist, LPC / Seasons of Change Behavioral Health Services, Inc
Ray is down-to-earth, warm, pragmatic and exceptionally well-informed.
G. Reid Doster, LPC, LMFT
Director of Behavioral Health, EXCELth Inc.Primary Health Network & Private Practice Psychotherapist / www.excelth.com

An excellent course, but needs more legal information regarding where the patient needs to reside.

Barry Barmann
Clinical Psychologist / Behavior Therapy & Family Counseling Clinic
This legal course was phenomenal saturated with much detail and clarity!
Elaine Marie Barclay
Licensed Professional Counselor, Assistant Professor / Capella University and Shorter University
Great and very informative! Will help me take my skills to a new level. Gave me a great idea of how the session should go.
Jessica Latin
LPC / JL Counseling

Course provided several case scenarios regarding Interstate counseling and resource websites for further research.

Cowenda Jefferson
Clinical Director / Wise Life Choices LLC
Course provided additional information regarding the legal aspects of TeleMental Health.
Cowenda Jefferson
Clinical Director / Wise LIfe Choices LLC
I have completed prior training by Raymond and greatly appreciate his detailed and thorough trainings.
Dr Lynn Duffy, PsyD, LCPC, NCC, CCMHC, BCPCC, BC-TMH, Diplomate/CMH in Trauma
Director/Counselor/Mediator / Lighthouse Counseling & Consulting Services
This course was most helpful in helping me make my practice more compliant for me and my clients.
Marlene Small
Private Psychotherapist
This is the 4th TMH course I have taken with Ray and it is BY FAR the best TMH training out there. I've learned so much that I can use every day in my practice.
Dawn Ferrara

Very Informative

Naomie Pierre
community clinician / nps
I loved this course. It was very informative and provide a great deal of information about ethics.
Tracey Marshall
Easy to learn and easy to follow. User friendly on-line course.
Kelly Johnson
Licensed Mental Health Therapist


Melissa J Davis
LAPC- counselor
This was a phenomenal training and necessary for the continued growth of all helping professionals. This will certainly improve the manner in which I conduct counseling.
Elaine Marie Barclay
This training was extremely informative and supportive for professionals looking to gain further knowledge in Telemental health.
Marcy Abramsky
LCSW / Marcy Abramsky LCSW, InspireAmind TM Counseling and Consulting
I found this video to be very informative and helpful.
Michelle Parker
Contract Therapist

Great course, very informative!

Ashley Simmons
BCBA / Northstar Psychological Services

Love the course, worth every penny!!! Definitely helped jump start my Tele-mental health services!

Nakia Clark
Owner/ Therapist / Insightfullly You, LLC

This gave me and my staff some important insights and information regarding telehealth..

Larry Cowan
Executive Director / Samaritan Counseling and Growth

This course was easy and user friendly

Vanessa Reiser
Social Worker / JBFCS

I learned a great deal from this program and look forward to implementing telemental health in my therapy practice.

Michelle Hitchcock

It was fantastic! Just the forms he provides are worth the cost of the course!

Mark Wagemaker, LPC, NCC, DCC, CPCS
Counselor, Clinical Supervisor / Transitions Counseling

This was an excellent class and worth my time.  Ray provided great information and is clearly an expert in TMH!

Jennifer Stuckert
Director / Restoration Counselor of Atlanta, LLC

I found these courses informative and helpful. They make establishing best practices policies and procedures for telemental health services and supervising those who provide them. so much easier. I highly recommend his courses.

Nena Rybarczyk, MA, EMBA, LPC, NCC, CPCS
Counselor / Strategies for Life Counseling, LLC

Ray's workshop was one of the most informative I have taken in years. He brought clarity to took a topic which has been intimidating and I left feeling empowered!

Clinical Supervisor and Play Therapist / Georgia Association for Play Therapy