In consultation with the Division 29 Board of Directors, the Division 29 Research Committee is seeking nominations for The Distinguished Publication of Psychotherapy Research Award. This award recognizes the best empirical (i.e., data-based) published peer reviewed article on psychotherapy in the preceding calendar year. Articles appearing in any journal (i.e., they need not have appeared in the Division’s journal) are eligible for this award.

We ask members of the Division to nominate articles for consideration by April 1. Nominations should include the complete citation for the article, and should be emailed to the Chair of the Research Committee, Dr. Michael Constantino, mconstantino@psych.umass.edu

A selection committee appointed by the Chair of the Research Committee, in consultation with the President of the Division, will evaluate all nominated articles, and will make a recommendation to the Division’s Board of Directors by May 1. Upon approval by the Board, the author(s) of the winning article will be notified so that they may be recognized and receive the award at the upcoming APA Convention. Accompanying this award is a plaque.

All methods of research will be equally valued (experimental, quasi-experimental, qualitative, descriptive/correlational, survey). Current members of the Research Committee and the Selection Committee will not be eligible for the award, so no articles by members of the Research Committee will be considered. Also, committee members will recuse themselves from voting on articles by current or former students, as well as collaborators. Self-nominations are accepted.  

The criteria for the award appear below.

• the rationale for the study and theoretical soundness
• the methods
• the analyses
• the explanation of the results
• the contribution to new knowledge about psychotherapy (e.g., the work is innovative, creative, or integrative; the work advances existing research in a meaningful way); greater weight will be given to novel/creative element than to methodological/statistical rigor
• relevance to psychotherapy practice.

The Distinguished Publication of Psychotherapy Research Award is accompanied by a $500 cash award sponsored by Wiley and Sons.

NORINE JOHNSON, PH.D., PSYCHOTHERAPY RESEARCH GRANT

Brief Statement about the Grant:

The Norine Johnson, Ph.D., Psychotherapy Research Grant, offered annually to qualifying individuals, provides $20,000 toward the advancement of research on psychotherapist factors that may impact treatment effectiveness and outcomes, including type of training, amount of training, professional degree or discipline of the psychotherapist, and the role or impact of psychotherapists’ personal characteristics on psychotherapy treatment outcomes.

Eligibility: Doctoral-level researchers with a successful record of publication are eligible for the grant.

Submission Deadline: April 1, 2012

Request for Proposals

NORINE JOHNSON, PH.D., PSYCHOTHERAPY RESEARCH GRANT

Description

This program awards grants for research on psychotherapist factors that may impact treatment effectiveness and outcomes, including type of training, amount of training, professional degree or discipline of the psychotherapist, and the role or impact of psychotherapists’ personal characteristics on psychotherapy treatment outcomes.

Program Goals

• Advance understanding of psychotherapist factors that may impact treatment effectiveness and outcomes through support of empirical research
• Encourage researchers with a successful record of publication to undertake research in these areas

Funding Specifics

• One annual grant of $20,000 to be paid in one lump sum to the researcher, to his or her university’s grants and contracts office, or to an incorporated company. Individuals who receive the funds could incur tax liabilities (see Additional Information section below).

Eligibility Requirements

• Doctoral-level researchers
• Demonstrated competence in the area of proposed work
• IRB approval must be received from the principal investigator’s institution before funding can be awarded if human participants are involved
• The selection committee may elect to award the grant to the same individual or research team up to two consecutive years
• The selection committee may choose not to award the grant in years when no suitable nominations are received

Evaluation Criteria

• Conformance with goals listed above under “Program Goals”
• Magnitude of incremental contribution in topic area
• Quality of proposed work
• Applicant’s competence to execute the project
• Appropriate plan for data collection and completion of the project

Proposal Requirements for All Proposals

• Description of the proposed project to include title, goals, relevant background, target population, methods, anticipated outcomes, and dissemination plans: not to exceed 3 single-spaced pages (1 inch margins, no smaller than 11-point font)
• CV of the principal investigator: not to exceed 2 single-spaced pages and should focus on research activities
• A 300-word biosketch that describes why your experiences and qualifications make you suited for successfully carrying out this research proposal. This will be a blind review so please exclude identifying information.
• Timeline for execution (priority given to projects that can be completed within 2 years)
• Full budget and justification (indirect costs not permitted), which should take up no more than 1 additional page (the budget should clearly indicate how the grant funds would be spent)
• Funds may be used to initiate a new project or to supplement additional funding. The research may be at any stage. In any case, justification must be provided for the request of the current grant funds. If the funds will supplement other funding or if the research is already in progress, please explain why the additional funds are needed (e.g., in order to add a new component to the study, add additional participants, etc.)

Additional Information

• After the project is completed, a full accounting of the project’s income and expenses must be submitted within six months of completion
• Grant funds that are not spent on the project within two years of receipt must be returned
• When the resulting research is published, the grant must be acknowledged by footnote in the publication
• All individuals directly receiving funds from the division will be required to complete an IRS w-9 form prior to the release of funds, and will be sent a 1099 after the end of the fiscal year (December 31^st)

Submission Process and Deadline

• All materials must be submitted electronically
• All applicants must complete the grant application form, in MSWord or other text format
• CV(s) may be submitted in text or PDF format. If submitting more than 1 CV, then all CVs must be included in 1 electronic document/file
• Proposal and budget must be submitted in 1 file, with a cover sheet to include the name of the principal investigator and complete contact information (address, phone, fax, email)

• Submit all required materials for proposal to: Tracey A. Martin in the Division 29 Central Office, assnmgmt1@cox.net
• You will receive an electronic confirmation of your submission within 24 hours, which will provide you with an assigned application number. If you do not receive confirmation, your proposal was not received. Please resubmit.
• Deadline: April 1, 2012

Questions about this program should be directed to the Division of Psychotherapy Research Committee Chair (Dr. Michael Constantino at mconstantino@psych.umass.edu), or the Division of Psychotherapy Science and Scholarship Domain Representative (Dr. Norman Abeles at abeles@msu.edu), or Tracey A. Martin in the Division 29 Central Office, assnmgmt1@cox.net

CHARLES J. GELSO, PH.D., PSYCHOTHERAPY

RESEARCH GRANT

Brief Statement about the Grant:

The Charles J. Gelso, Ph.D., Psychotherapy Research Grant, offered annually to qualifying individuals, provides $2,000 toward the advancement of research on psychotherapy process and/or psychotherapy outcome.

Eligibility: In alternating years, graduate students/predoctoral interns or doctoral level psychologists/postdoctoral fellows will be eligible for the Charles J. Gelso Grant. In 2012, graduate students in psychology and predoctoral interns who are in good standing at an accredited university will be eligible.  In 2013, doctoral level psychologists, including postdoctoral fellows, will be eligible. The grant will rotate biannually between graduate students/predoctoral interns and doctoral level psychologists/postdoctoral fellows, such that nominations will be accepted in even number years for the former group and odd number years for the latter group.

Submission Deadline: April 1, 2012

Request for Proposals

Charles J. Gelso, Ph.D. Grant

Description

This program awards grants for research projects in the area of psychotherapy process and/or outcome. In alternating years the grant is awarded to graduate students or doctoral level psychologists. 

Program Goals

• Advance understanding of psychotherapy process and/or psychotherapy outcome through support of empirical research
• Encourage talented graduate students towards careers in psychotherapy research
• Support psychologists engaged in quality psychotherapy research

Funding Specifics

• One annual grant of $2,000 to be paid in one lump sum to the researcher, to his or her university’s grants and contracts office, or to an incorporated company. Individuals who receive the funds could incur tax liabilities (see Additional Information section below).

Eligibility Requirements

• In alternating years, graduate students/pre-doctoral interns in psychology (even-numbered years) or psychologists/postdoctoral fellows (odd-numbered years) will be eligible
• In 2012, graduate students/pre-doctoral interns who are in good standing at an accredited university will be eligible 
• In 2013, doctoral level psychologists and postdoctoral fellows will be eligible
• Demonstrated or burgeoning competence in the area of proposed work
• IRB approval must be received from the principal investigator’s institution before funding can be awarded if human participants are involved
• The same project/lab may not receive funding two years in a row

Evaluation Criteria

• Conformance with goals listed above under “Program Goals”
• Magnitude of incremental contribution in topic area
• Quality of proposed work
• Applicant’s competence to execute the project
• Appropriate plan for data collection and completion of the project

Proposal Requirements for All Proposals

• Description of the proposed project to include, title, goals, relevant background, target population, methods, anticipated outcomes, and dissemination plans: not to exceed 3 single-spaced pages (1 inch margins, no smaller than 11-point font)
• CV of the principal investigator: not to exceed 2 single-spaced pages and should focus on research activities

• A 300-word biosketch that describes why your experiences and qualifications make you suited for successfully carrying out this research proposal. This will be a blind review so please exclude identifying information.

• Timeline for execution (priority given to projects that can be completed within 2 years)
• Full budget and justification (indirect costs not permitted), which should take up no more than 1 additional page (the budget should clearly indicate how the grant funds would be spent)
• Funds may be used to initiate a new project or to supplement additional funding. The research may be at any stage. In any case, justification must be provided for the request of the current grant funds. If the funds will supplement other funding or if the research is already in progress, please explain why the additional funds are needed (e.g., in order to add a new component to the study, add additional participants, etc.)
• No additional materials are required for doctoral level psychologists who are not postdoctoral fellows
• Graduate students, predoctoral interns, and postdoctoral fellows should refer to the section immediately below for additional materials that are required.

Additional Proposal Requirements for Graduate Students, Predoctoral Interns, and Postdoctoral Fellows

• Graduate students, pre-doctoral interns, and postdoctoral fellows should also submit the CV of the mentor who will supervise the work
• Graduate students and pre-doctoral interns must also submit 2 letters of recommendation, one from the mentor who will be providing guidance during the completion of the project (note that this letter must indicate the nature of the mentoring relationship)
• Postdoctoral fellows must submit 1 letter of recommendation from the mentor who will be providing guidance during the completion of the project (note that this letter should indicate the nature of the mentoring relationship)

Additional Information

• After the project is complete, a full accounting of the project’s income and expenses must be submitted within six months of completion
• Grant funds that are not spent on the project within two years must be returned
• When the resulting research is published, the grant should be acknowledged
• All individuals who directly receive funds from the division will be required to complete an IRS w-9 form prior to the release of funds, and will be sent a 1099 after the end of the fiscal year (December 31^st)

Submission Process and Deadline

• If the grant is to be used to support a thesis or dissertation, the thesis/dissertation proposal must be approved by the thesis/dissertation committee (this should be noted in the letter of recommendation from the mentor)

• All materials must be submitted electronically
• All applicants must complete the grant application form, in MSWord or other text format
• CV(s) may be submitted in text or PDF format. If submitting more than 1 CV, then all CVs must be included in 1 electronic document/file
• Proposal and budget must be submitted in 1 file, with a cover sheet to include the name of the principal investigator and complete contact information (address, phone, fax, email)

• Submit all required materials for proposal to: Tracey A. Martin in the Division 29 Central Office, assnmgmt1@cox.net
• You will receive an electronic confirmation of your submission within 24 hours, which will provide you with an assigned application number. If you do not receive confirmation, your proposal was not received, then please resubmit.
• Deadline: April 1, 2012

Questions about this program should be directed to the Division of Psychotherapy Research Committee Chair (Dr. Michael Constantino at mconstantino@psych.umass.edu), or the Division of Psychotherapy Science and Scholarship Domain Representative (Dr. Norman Abeles at abeles@msu.edu), or Tracey A. Martin in the Division 29 Central Office, assnmgmt1@cox.net

As psychologists, we acknowledge, welcome, and respect the diversity in the individuals and families whom we serve.  Whether it is the result of culture, religious affiliation, lifestyle, gender or some other aspect of identity, psychologists may find themselves limited by their lack of experience or prior training in multicultural responsiveness. We developed these resources as a way to support those practitioners in providing ethical and culturally responsive information that will, hopefully, enhance services to their clients. 

It is our hope that the information contained on the Division 29 and Division 42 websites serves as a resource when we find ourselves at a loss with our clients, yet have the desire to expand our “toolkit” with additional information.  Even when our clientele are not so different from us, as professionals, we are called on by the highest professional standards to educate ourselves in these areas.  We encourage and support multicultural responsiveness as divisions of the APA and recognize that it is our responsibility to provide ongoing opportunities to enhance these skills. 

This multicultural toolkit has been designed so that you will find opportunities to explore your own worldview and those of others and assess your multicultural responsiveness.  We have included research articles, books, art, quick references and multiple other forms of resources to help you understand the perspective of multicultural communities.  Hopefully these resources will allow you to expand your working knowledge base as you strive to work with multicultural communities. Finally, this resource will also serve as a “cyber community” consisting of open and honest professionals, at different stages of development, serving as a collective, mutual resource. What you see here are our first steps in developing these resources.  We are in the process of adding interviews with experts in the field, additional resources and tools and as way for practitioners to communicate and dialogue with one another.  Check back often as we continue to add additional information and resources. 

Enjoy and let us know how we continue developing this site to better serve you.

Sincerely,

The Multicultural Toolkit Task force

Members of the task force include:
Doug Haldeman, Ph.D. (co-chair, Division 42)
Miguel E. Gallardo, Psy.D. (co-chair, Division 29)
Rosemary Adam-Terem, Ph.D. (Division 29)
Caryn Rodgers, Ph.D. (Division 29)
Konjit Page, Ph.D. (Division 42)
Kirstyn Yuk Sim Chun, Ph.D. (Division 42)
Rochelle Balter, Ph.D. (Division 42)
Bonita Cade, Ph.D. (Division 29)

Clinician self-reference refers to the clinician’s revelations about themselves. McCarthy Veach (2011) discusses her perspective on the conceptual distinctions of clinician self-reference and its implications for research and practice.

Click here to view full article!

John Norcross, PhD.

APA presents this Presidential Citation to John C Norcross, PhD., for his outstanding contributions as a prolific scholar, engaging teacher, exemplary mentor, and influential leader. 

Dr. Norcross is internationally recognized as an authority on psychotherapy, clinical training and behavior change.  He has co-written or edited 22 books, over 300 publications, and has provided numerous presentations in 30 countries.  As a dedicated scholar, he is editor of the Journal of Clinical Psychology: In Session and has been on the editorial boards of several other journals. He has served as clinical and research consultant to a number of organizations, including the National Institute of Mental Health. His dedication to the field of psychology is evident through his numerous effective, respectful and inclusive leadership roles, including as past president of APA Division 29, Psychotherapy; as past president of APA Division 12, the Society of Clinical Psychology; as an APA Council Representative; and as Director of the National Register of Health Service Providers in Psychology. He has promoted the best of psychology through hundreds of media interviews, and through appearances on many national television shows, including the Today Show, CBS News, Sunday Morning, and Good Morning America. In recognition of his many, important contributions to psychology, the American Psychological Association presents Dr. Norcross this Presidential Citation.

Linda Campbell, PhD.

APA presents this Presidential Citation to Linda Campbell, PhD., for her commitment to serving as a role model for an ethics centered professional life and for her contributions to education, training, and practice in psychology.

Dr. Campbell is professor and director of the Center for Counseling at the University of Georgia. On the national, state, and local level, Dr. Campbell’s service to the profession has included shaping, explaining and upholding the ethical code of psychologists in the context of an ever changing and complex world. In addition, she has championed quality education and training through efforts such as advancing the culture of competency in practice, research and teaching, co-chairing the task force that created a model curriculum for training for prescriptive authority, serving as chair of the Board of Educational Affairs and advocating for federal funds. Her extensive research and scholarship focus on ethics, supervision and psychotherapy. Dr. Campbell is an exemplary and dedicated leader, teacher, scholar and colleague who has devoted much of her time to serving psychologists, students and clients through her wisdom, high energy, positive outlook, wit and exquisite humor.

The minimum standards for Fellowship under APA Bylaws are:

1. The receipt of a doctoral degree based in part upon a psychological dissertation, or from a program primarily psychological in nature;
2. Prior membership as an APA Member for at least one year and a Member of the division through which the nomination is made;
3. Active engagement at the time of nomination in the advancement of psychology in any of its aspects;
4. Five years of acceptable professional experience subsequent to the granting of the doctoral degree;
5. Evidence of unusual and outstanding contribution or performance in the field of psychology; and
6. Nomination by one of the divisions which member status is held.

There are two paths to fellowship.  For those who are not currently Fellows of APA, you must apply for Initial Fellowship through the Division, which then sends applications for approval to the APA Membership Committee and to the APA Council of Representatives.  The following are the requirements for initial Fellow applicants:

1. Completion of the Uniform Fellow Blank;
2. A detailed curriculum vitae;
3. A self-nominating letter (which should also be sent to your endorsers);
4. Three (or more) letters of endorsement of your work by APA Fellows (at least two must be Division 29 Fellows) who can attest to the fact that your “recognition” has been beyond the local level of psychology;
5. A cover letter, together with your CV and self-nominating letter, to each endorser.

Division 29 members who have already attained Fellow status through another division may pursue a direct application for Division 29 Fellow by sending a curriculum vitae and a letter to the Division 29 Fellows Committee, indicating specifically how you meet the Division 29 criteria for Fellowship.   

Initial Fellow Applications can be attained online at:  http://apa.org/membership/fellows/

You may also contact Tracey Martin at APA:

Tracey Martin

Division of Psychotherapy

6557 E. Riverdale St.

Mesa, AZ 85215

Phone: 602-363-9211

Fax: 480 854-8966

Email: assnmgmt1@cox.net

DEADLINE FOR SUBMISSION:  The deadline for submission to be considered for 2012 is December 15, 2011. 

Initial nominees (those who are not yet Fellows of APA in any Division) must submit the following electronically as a packet:

(a) a cover letter, (b) the Uniform Fellow Application, (b) a self-nominating letter, (c) three (or more) letters of endorsement from current APA Fellows (at least two Division 29 Fellows), and (d) an updated CV. 

Current Fellows of APA who want to become a Fellow of Division 29 need only send a letter attesting to their qualifications with a current CV. 

Completed (electronic) applications should be sent by the nominee directly to:

Micki Friedlander

Chair, Division 29 Fellows Committee

mfriedlander@uamail.albany.edu

 (phone: 518-442-5049)

Incomplete submission packets after the deadline cannot be considered for this year. 

Please feel free to contact Micki Friedlander or other Fellows of Division 29 if you think you might qualify and you are interested in discussing your qualifications or the Fellow process.  Also, Fellows of our Division who want to recommend deserving colleagues should contact Micki with their names.

Click on the provided links below for free pdf downloads of the latest Psychotherapy Bulletins!

Bulletin46-3onlineVersion

Bulletin46-4_OnlineVersion

Report from the Task Force on Telepsychotherapy

Division 29 (Psychotherapy)

Task Force:   Ann B. Judge, PhD (chair); Norm Abeles, PhD;  Shane P. Davis, PhD; Rosemary Adam-Terem, PhD;  Jeffrey N. Younggren, PhD

 PREAMBLE

Division 29 (Psychotherapy) of the American Psychological Association has embarked on establishing practice recommendations for telepsychotherapy. This document was developed by a taskforce of Division 29 board members with the hope of providing a set of recommendations for psychologists providing therapeutic services using electronic media.

Scope

According to the American Psychological Association (2010), the term “telehealth” is an encompassing term used to describe services that include all interactions that are not in person between health care professionals and their patients. However, there are numerous terms used to describe the provision of mental health services using technology, with no universally agreed-upon nomenclature. 

In this document, the term “telepsychotherapy” will describe the use of electronic media via telephone (i.e., landlines and cellular phones) and videoconferencing to deliver psychotherapeutic services.  Although other electronic media may be used, this document specifically excludes the use of Internet services via email, instant messaging, text messaging, facsimile, chat, blogging, video blogging, webinars, blackboards, social or professional networking or web pages.  Additional recommendations may be needed to address these methods when used alone or as an adjunct to psychotherapy; however, in the interest of brevity, we will limit this first document to real-time psychotherapy sessions with clients via phone and video.

Why We Need Telepsychotherapy Recommendations

For many psychologists, face-to-face psychotherapy has been their preferred and only mode for delivering clinical services until recently, when modern technology has made it possible to increase access to mental health care. Telepsychotherapy has the potential of improving services and reducing risks for substandard practice in the treatment of patients; however, without clear and defined guidelines for this type of practice, psychologists may be putting themselves at ethical and legal risk and may not provide clients with optimal psychotherapy services.

To date studies are showing that such services are as effective as face-to-face services (Barak et al., 2008; Folen at al., 2010). Indeed, studies concerning the effectiveness of telepsychotherapy have shown favorable findings, providing scientific support for the use of such technologies in practice in areas of pain, depression (Kroenke et al., 2010), post-traumatic stress disorder, and anxiety (Guay, 2010). Studies have also shown no differences between telephone-delivered psychotherapy and face-to-face delivery in the perception of the therapeutic relationship, post-session mood, or general satisfaction with services (Morgan, Patrick, & Magaletta, 2008).

It should be noted that telepsychotherapy is not for everyone.  We believe that telepsychotherapy should not be a substitute for regular in-person psychotherapy when possible and should not be used only for the sake of convenience.  Indeed, there should be a compelling reason for doing this kind of work.  The advantages of practicing remotely are clear where access to care is an issue, such as in rural areas with limited or no public transportation, or where the client is disabled or house-bound. Telepsychotherapy is efficient in terms of time for both client and psychotherapist, and it provides ease of access.

PRACTICING TELEPSYCHOTHERAPY IN STATE

Most psychologists are already familiar with provision of services over the telephone, as when conducting an intake screening with a prospective client or handling questions or crises that may emerge during the course of psychotherapy. In the first case, this is the initial contact with the client and obviously little is known at that time. It may mark the beginning of the professional relationship. In the second, psychologists are speaking with known clients who are engaged in ongoing treatment. The provision of an entire course of psychotherapy over the phone is, however, relatively new to most psychotherapists accustomed to the face-to-face, in-office setting. The increasing availability of facilities for videoconferencing provides psychologists and clients with a broader range of possibilities for psychotherapy.

It would be important for psychologists to check with their state laws and regulations to ensure that there is no prohibition against the provision of telepsychotherapy in that jurisdiction. Most states are silent on the matter, and psychologists who choose to use these methods are expected to provide the usual standard of care and to act as any reasonable and ethical practitioner would (APA, 2010).

PRACTICING TELEPSYCHOTHERAPY ACROSS STATE LINES

Statutory problems are not new to the practice of psychology. The profession is largely regulated by state licensing boards that have different regulations impacting out of state practice.  Some state licensing boards allow limited out of state practice without registration, some require registration, and others prohibit such practice.  The psychologist who chooses to do telepsychotherapy needs to know that some licensing boards have opined that the regulatory authority for this type of activity is not determined by the physical location of the psychologist but, rather, where the client is. Thus, those who choose to practice in this manner can run afoul of state boards that might consider this practice to be illegal and even criminal, that is, practicing psychology without a license in that jurisdiction.

Psychologists who provide telepsychotherapy need to check whether the state where the patient is located allows for this activity.  In addition, if the state has administrative requirements regarding this type of practice, these must be complied with.  APA has developed a chart that summarizes a 50 state review describing temporary and guest licensure.  The report cautions that one still must check with the individual state licensing board. The APA chart is available at APA Practice Central: apapracticecentral.org/advocacy/state/telehealth-slides.pdf.

If a psychologist wishes to gain permanent licensure in another state, the National Register (NR) of Health Service Providers in Psychology credentials psychologists who meet requirements for education, internship, and experience as health care professionals. The NR expedites licensure mobility for psychologists in 47 jurisdictions in the US and Canada as well as internationally. Its website (www.nationalregister.org) provides the psychologist with a listing of states that accept NR credentials. For psychologists who seek licensure in other states, the National Register can be quite helpful and saves considerable time and effort.

The Association of State and Provincial Psychology Boards (ASPPB) also offers possible solutions to those who choose to engage in interstate practice like telepsychotherapy.  First, they offer the Certificate of Professional Qualification in Psychology (CPQ).  This is a program that promotes mobility for licensed doctoral psychologists in the United States and Canada.  The CPQ documents that the individual holding the certificate has met specific requirements in licensure, education, examination and training and has never had disciplinary actions taken against his or her license.  Those who possess this credential do not have to submit further credentials to meet the requirements for licensure in that state (http://www.asppb.net/i4a/pages/index.cfm?pageid=3451).

In addition, ASPPB has also recently developed the Interjurisdictional Practice Certificate (IPC).  This is a mechanism for licensed psychologists to practice temporarily in another jurisdiction more easily. Those who possess this certificate will be able to practice in ASPPB member jurisdictions. It will offer the boards in those states better oversight and regulation of licensed psychologists wishing to practice temporarily in their state, province or territory. According to ASPPB, “the concept behind the IPC is one of notification and temporary permission to practice rather than full licensure” (http://www.asppb.net/i4a/pages/index.cfm?pageid=3459). While this certificate is currently in development, it potentially offers a good solution to those who choose to practice temporarily in another state when they do not possess a credential to do so. Currently five states accept the IPC as meeting their licensure requirements for temporary practice, and two are in the process of so doing.

A final comment should be made about temporary, unlicensed practice under reasonable circumstances.  Psychologists who provide telepsychotherapy must remember that all that can be expected of them is “reasonable” conduct.  In that spirit, there may be strong legal and professional arguments that allow for temporary interstate practice without licensure under unique circumstances.  For example, if a long-term psychotherapy patient was traveling in another state, or was going to reside there briefly, it seems impractical to require a psychologist to refer that individual to another licensed professional who would see her/him until s/he returned or to require the psychologist  to obtain temporary licensure in that state.  Clearly, such administrative requirements run afoul of continuity of care and good practice standards. Thus, remaining in contact with a patient who is in another jurisdiction may be consistent with the APA Ethics Code and the standard of care. That being said, this concept has not been tested legally.

GENERAL PRACTICE RECOMMENDATIONS

Assuming that a psychologist is providing telepsychotherapy in a jurisdiction in which one holds a license (permanent or temporary, if practicing across state lines), many issues should be considered.  Following is a brief discussion of some such issues and related practice recommendations.

Informed Consent. In a decision to hold psychotherapy sessions electronically, the informed consent should include issues unique to the medium, such as privacy, confidentiality, fees, reimbursement, security and reliability of video or phone connection, limits of communication, record keeping, termination, availability for emergencies, and cancellation policy.

With regard to confidentiality, the chosen medium may offer more or less privacy.  The most private and secure medium is a landline telephone call.  Clients should be informed that cell phone calls do not have the security of a landline contact so that they can make informed decisions about whether to speak about confidential matters on a cell phone.

The Internet is not regulated and not currently protected by privacy laws.  Skype, for example, is not an encrypted site and is, therefore, not a confidential means of communication.  Providing psychotherapy on unencrypted sites is ill advised and thus, informed consent is important.  Clients may prefer to meet via Skype and express no concern about the absence of encryption.  Therefore, we suggest that clients be made fully aware of the confidentiality concerns, and if they choose to meet through this medium, that the decision be documented by the psychologist. 

Malpractice Insurance. Psychologists should check with their malpractice insurance carriers for coverage. Malpractice insurance carriers generally provide coverage as long as the practice is legal.

Licensure. Psychologists should check with the applicable licensing board(s) to ensure that the practice of telepsychotherapy is approved.  For example, when planning to provide services to someone across state lines where the psychologist is not licensed, it is important to contact that state licensing board to determine how to temporarily practice there.

Billing. For practitioners, billing for telepsychotherapy services can be problematic; however, as the practice increases, we believe many insurers will be turning their attention to reimbursement for this type of psychotherapy. Psychologists need to check with the insurance carrier for each prospective client to be sure that there is a proper provision for reimbursement.

Types of Clients. Our preference is for telepsychotherapy to be performed with ongoing clients with whom one already has an established psychotherapy relationship rather than starting a new relationship electronically.  However, we recognize that exceptions may be possible and that for some people because of location, disability, or diagnosis, starting a course of psychotherapy in this manner is perhaps preferable. 

We recommend this type of work only with clients who are not considered high risk.  Some clients who are not at risk, however, become at risk.  For this reason, if psychotherapy will be provided at a distance, it is important that the treating psychologist establish clinical support in the patient’s geographic location in case of emergency so that standards of care can be met.

Technical Issues.  Volume control, video quality, phone quality, and reliability are all important to consider (Folen et al., 2010), and a back-up care plan should be made for potential technical failure.  Folen et al. (2010) note that psychologists and patients both adapt well even to relatively distorted visual presentation but that deviation in sound quality was not well-tolerated.  A stand-by phone may be recommended.

Training in Telepsychotherapy Skills. It is vital that psychologists acquire the necessary skill sets to manage not only the technological issues of telepsychotherapy, but also the more subtle interpersonal aspects of providing psychotherapy remotely.

Addressing the Experience of Telepsychotherapy.  The psychologist and client can discuss:

• Agreement on the frequency and length of treatment (short term vs. open ended), willingness to continue if the modality is effective and to discontinue if the modality is not working.

• Management of technical problems in the sessions.

• Their assessment of the effectiveness of the psychotherapy via phone or web conferencing.  This would ensure a consistent evaluation of the effectiveness of the modality.

If at all possible, scheduling intermittent in-person sessions with the client is recommended.  This will allow for monitoring and evaluation of the telepsychotherapy for effectiveness.

FREQUENTLY ASKED QUESTIONS

In this document, we present a small number of FAQs below, recognizing that a multitude of questions about the practice of telepsychotherapy exists.

l. I am engaged in telepsychotherapy with a client who lives out of state. Last night the client called me to say he is suicidal. He asked if he should drive the three hundred miles to see me in person.

Response:  Your first action should be a referral to a qualified mental health professional in the client’s home town. It is recommended that psychologists who do telepsychotherapy arrange for emergency backup prior to initiating this type of treatment. For example, it would be important to know about local resources, such as hospital emergency rooms, crisis hotlines, and the like.  Also, one should know the phone number for the local police department or emergency response team in the client’s jurisdiction in case it is needed.

2. I am a licensed psychologist.  Do I need to be licensed in the state where my client lives before starting telepsychotherapy?

Response: In many jurisdictions it is assumed that therapy occurs in the state where the client lives. You need to check with your licensing board and the licensing board in the state where your client lives.

3. How would I know if I am providing the acceptable standard of care in my state whenever I provide telepsychotherapy?

Response:  You should look carefully at the APA Ethical Principles of Psychologists and Code of Conduct (APA, 2002) as well as the laws and regulations of psychology in the jurisdiction(s) you are practicing in.  You should also review the information provided to your client about limits of confidentiality, including the limits of the technology that you are using.

4. Do I have to keep record of what goes on during telepsychotherapy?

Response: Yes. Telepsychotherapy does not exempt you from record keeping. All professional services provided should be documented similarly regardless of the medium.

5. Will my malpractice insurance cover telepsychotherapy? 

Response: The APA Insurance Trust covers all legitimate forms of psychotherapy. The American Professional Agency notes that “tele-media psychotherapy services are not excluded. However, the Program Administrator would review the application based upon the percentage of time this type of psychotherapy services are being provided for acceptability” (email correspondence with Lucile Kaleck, January 2011). We believe that one should still contact his/her malpractice insurance carrier in order to obtain further information. Remember: if such practice is considered criminal, it is likely not covered by the malpractice insurance carrier.

6. How do I handle payment of fees?

Response: As in face-to-face therapy, this is a matter that you and your patient have to discuss prior to providing telepsychotherapy. This should include discussion of canceled appointments and rescheduling of appointments.  Medicare pays for some telehealth activities in areas designated as rural health professional shortage areas and counties not in a Metropolitan Statistical area. Your patient should check with third-party payers concerning coverage.

CONCLUDING COMMENTS

As we noted in our preamble, we believe this is the time to assist our Division 29 members in thinking about telepsychotherapy. In this electronic age, our graduate students, early career psychologists, and seasoned psychologists will need to think about possible new avenues for providing psychotherapy. We noted that telepsychotherapy is not for every practitioner, nor is it suitable for every client.  Future research will provide additional help, and as telehealth continues to develop, telepsychotherapy will follow closely.

We recognize that these recommendations may well need to be further refined and modified in the future.  Indeed, we believe strongly that the next revision of APA’s Ethical Principles of Psychologists and Code of Conduct will need to include more explicit ethical guidance concerning telepsychotherapy and telehealth. The recommendations we have presented here will hopefully provide steps in that direction.