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.
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,
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
National Board for Certified Counselors (NBCC) Policy Regarding the Provision of Distance
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
Renewed Vision Counseling Services www.renewedvisiontraining.com
Zur Institute www.zurinstitute.com/