Download Ethics in the - The Online Abstract Submission and Invitation System

Ethics in the “i" world:
Internet, telehealth, social
media, texting, and e-mail
PATRICK B. MCGRATH, PH.D.
MODERATOR
Mary Karapetian Alvord, Ph.D.
President-Elect, APA Division 46, Media
Psychology
Alvord, Baker & Associates, LLC
11161 New Hampshire Ave.
Suite 307
Silver Spring, MD 20904
301-593-6554 X14
April 13, 2012
3200 Tower Oaks Blvd.
Suite 200
Rockville, MD 20852
301-593-6554 X14
[email protected]
www.alvordbaker.com
Disclaimer
I have no conflicts of interest to disclose.
I have not received any funding from any commercial
entities that may be mentioned or discussed in this
presentation.
All information and opinions shared are mine alone.
We are living technolgy history


An example – prior to 1973, cell phones were limited to those installed in
vehicles.
In 1983, Motorola introduced the 16-ounce "DynaTAC" phone which cost
$3,500.
Fir
st
Cel
l
Ph
one
(19
73)
:
2012 – there are more cell phone users across the world, than land line
users.
Mot
orol
a

Dyn
a-
Tac
Siz
e: 9
x 5
x
1.7
5
inch
es
We
igh
t:
2.5
pou
nds
Dis
pla
y:
Non
e
Nu
mb
er
of
Cir
cui
t
Boa
rds
: 30
Tal
k
tim
e:
35
min
ute
s
Rec
har
ge
Tim
e:
10
hou
rs
Fea
tur
es:
Tal
k,
liste
n,
dial
What is Telehealth?
Audio Technology (land
line & cell phones;
MP3’s; i-tunes; digital
Video conferencing
technology/internet/print
(social media platforms)
Mental
Health
Services
(APA Ethics codes
& state licenses)
www.alvordbaker.com
company will focus solely on its digital encyclopedia and
education tools.
.
HIPAA (Health Insurance Portability and
Accountability Act)
 Privacy Rule – now standard of care
 Business associate agreements!!
 Security Rule –
 Adminstrative procedures to safeguard
confidentiality and access
 Physical safeguards
 Technical security
Telecommunication
system
Programmable!
T-1 lines or
VPN .
Voice over IP phones,
etc.
HAPPY 21ST
BIRTHDAY
Facilitating gamesmanship and generalizing behaviors through
real-life play activities
Clinical Applications
Exposures
- Endless Loops, sounds,
DVD’s, you tube http://www.youtube.com/watch?v=F5na4nE21-c
Relaxation
Executive
–MP3’s
function skills (scheduling,
timers, phone alerts, alarms)
Technology: Clinical applications
Interactive
“screen” systems → face
recognition, social skills prompts.
Technology in the Practice
 Sending assignments for group and other therapies
via encrypted email
 Testing scoring software
 Research online – APA research , Google, etc.
Tele-health
 http://www.youtube.com/watch?v=4DkezwHawXY
 Tele = technology
 Health = psychological services (tx, testing, etc.)
 Internet speed and bandwidth
 Encrypted doesn’t mean HIPAA compliant
 HIPAA compliant → HIPAAA Certified
 Secure Platforms PC’s vs. MAC’s
 Computer Memory
 HD Cameras
Thank you!
 References:

HIPAA regulations
DeAngelis, T. (2012) Practicing distance therapy, legally and ethically
 Monitor on Psychology; 43(3).


Highmark launches telehealth service. (2012). Health & Beauty Close - Up, , Retrieved
from: http://search.proquest.com/docview/957428259?accountid=11243

Wolper, L. (2011) The E-Healthcare Movement: Virtual Communities, Web Services, and
Other Enterprisewide, Interoperable HCITs for US Healthcare Reform . Health Care
Administration . Retrieved from:
http://www.r2library.com.proxygw.wrlc.org/contents/content_resource_frame.aspx?isb
n=0763757918&Offset=2&SectionId=ch0008s0350&ChapterId=ch0008&library=Medic
ine&Cache=true
Disclaimer
 I have no conflicts of interest to disclose, and have
not received any funding from any commercial
entities that may be mentioned or discussed in this
presentation.
 All information and opinions shared are those of the
presenter.
Ethics in the “i" world:
Internet, telehealth, social
media, texting, and e-mail
TELEHEALTH IN THE
TREATMENT OF
ANXIETY:
EFFECTIVE TECHNOLOGICAL
INTERVENTIONS FOR ANXIETY DISORDERS
NIKKI GODINE
Disclaimer
 I have no conflicts of interest to disclose, and have
not received any funding from any commercial
entities that may be mentioned or discussed in this
presentation
 All information and opinions shared are those of the
presenter
Technologies
Administrative
 Telephone
 Computer
 Fax machine
Clinical
 Telephone
 Computer
 Cell phone (talking,
texting, apps)
 IATV
 Internet (chat, forums,
message boards)
 Virtual reality
Panic Disorder
 Treatment via the Internet: an effective way to
reduce panic symptoms (Bergstrom et al., 2009;
Wims, Titov, Andrews, & Choi, 2010)
 Types of treatment:

Clinician-assisted CBT
 Settings in which this type of treatment can be used
 Clinical outcomes
Post-Traumatic Stress Disorder
 Treatment via videoconferencing and the
Internet can improve symptoms of PTSD
(Germain, Marchand, Bouchard, Drouin, &
Guay, 2009; Lange, Rietdjik, Hudcovicova, van
de Ven, Schrieken, & Emmelkamp, 2003)
 Internet treatment

Cognitive-behavioral writing assignments
 Videoconferencing treatment
 CBT
 Clinical outcomes
Generalized Anxiety Disorder
 Symptoms of GAD can be successfully treated
through the Internet, virtual reality, and the use of
biofeedback and mobile phones (Gorini et al.,
2010; Pallavicini, Algeri, Repetto, Gorini, & Riva,
2009; Titov et al., 2009).
 Types of treatment



Clinician-assisted CBT
Virtual reality with biofeedback
Stress management and relaxation techniques
 Settings in which this type of treatment can be
used
 Clinical outcomes
Social Phobia
 Internet-based treatment for social phobia
reduces symptoms of social phobia and other
comorbid disorders (Berger, Hohl, & Caspar,
2009; Titov, Gibson, Andrews, & McEvoy,
2009)
 Types of treatment:


Clinician-assisted CBT
CBT without clinician guidance
 Clinical outcomes
Child and Adolescent Anxiety
 Treatment delivered primarily via the Internet can
be effective for a number of child and adolescent
anxiety disorders (Spence, Holmes, March, & Lipp,
2006)
 Type of treatment

Clinician-assisted CBT
 Clinical outcomes
 How effective is it compared to in-person CBT?
References
 Andersson, G., Carlbring, P., Holmstrom, A., Sparthan, E.,
Furmark, T., Nilsson-Ihrfelt, E. … Ekselius, L. (2006).
Internet-based self-help with therapist feedback and in vivo
group exposure for social phobia: A randomized controlled
trial. Journal of Consulting and Clinical Psychology, 74,
677-686. doi:10.1037/0022-006X.74.4.677
 Berger, T., Hohl, E., & Caspar, F. (2009). Internet-based
treatment for social phobia: A randomized controlled trial.
Journal of Clinical Psychology, 65, 1021-1035.
doi:10.1002/jclp.20603
 Bergstrom, J., Andersson, G., Karlsson, A., Andreewitch, S.,
Ruck, C., … Lindefors, N. (2009). An open study of the
effectiveness of Internet treatment for panic disorder
delivered in a psychiatric setting. Nordic Journal of
Psychiatry, 63, 44-50. doi:10.1080/08039480802191132
References cont’d
 Botella, C., Gallego, M. J., Garcia-Palacios, A., Banos, R. M., Quero,
S., & Alcaniz, M. (2009). The acceptability of an Internet-based
self-help treatment for fear of public speaking. British Journal of
Guidance and Counseling, 37, 297-311.
doi:10.1080/03069880902957023
 Carlbring, P., Nordgren, L. B., Furmark, T., & Andersson, G.
(2009). Long-term outcome of Internet-delivered cognitivebehavioral therapy for social phobia: A 30-month follow-up.
Behavior Research and Therapy, 47, 848-850.
doi:10.1016/j.brat.2009.06.012
 Germain, V., Marchand, A., Bouchard, S., Drouin, M., & Guay, S.
(2009). Effectiveness of cognitive-behavioral therapy administered
by videoconference for posttraumatic stress disorder. Cognitive
Behaviour Therapy, 38, 42-53. doi:10.1080/16506070802473494
 Gorini, A., Pallavicini, F., Algeri, D., Repetto, C., Gaggioli, A., &
Riva, G. (2010). Virtual reality in the treatment of generalized
anxiety disorders. Studies in Health Technology and Informatics,
154, 39 – 43.
References cont’d
 Klein, B., Austin, D., Pier, C., Kiropoulos, L., Shandley, K.,
Mitchell, J., … Ciechomski, L. (2009). Internet-based
treatment for panic disorder: Does frequency of therapist
contact make a difference? Cognitive Behavior Therapy, 38,
100-113. doi:10.1080/16506070802561132
 Klein, B., Mitchell, J., Abbott, J., Shandley, K., Austin, D.,
Gilson, K., … Redman, T. (2010). A therapist-assisted
cognitive behavior therapy Internet intervention for
posttraumatic stress disorder: Pre-, post- and 3-month
follow-up results from an open trial. Journal of Anxiety
Disorders, 24, 635-644. doi:10.1016/j.janxdis.2010.04.005
 Klein, B., & Richards, J. C. (2001). A brief Internet-based
treatment for panic disorder. Behavioural and Cognitive
Psychotherapy, 29, 113-117.
References cont’d
 Knaevelsrud, C., & Maercker, A. (2007). Internet-based treatment
for PTSD reduces distress and facilitates the development of a
strong therapeutic alliance: A randomized controlled clinical trial.
BioMed Central Psychiatry. Retrieved from
http://www.biomedcentral.com/1471-244X/7/13
 Knaevelsrud, C., & Maercker, A. (2010). Long-term effects of an
Internet-based treatment for posttraumatic stress. Cognitive
Behavior Therapy, 39, 72-77. doi:10.1080/16506070902999935
 Lange, A., Rietdijk, D., Hudcovicova, M., van de Ven, J., Schrieken,
B., & Emmelkamp, P. M. G. (2003). Interapy: A controlled
randomized trial of the standardized treatment of posttraumatic
stress through the Internet. Journal of Consulting and Clinical
Psychology, 71, 901-909. doi:10.1037/0022-006X.71.5.901
 Pallavicini, F., Algeri, D., Gorini, A., & Riva, G. (2009).
Biofeedback, virtual reality and mobile phones in the treatment of
generalized anxiety disorder (GAD): A phase-2 controlled clinical
trial. Journal of Cybertherapy and Rehabilitation, 2, 315 – 327.
References cont’d
 Ruwaard, J., Broeksteeg, J., Schrieken, B., Emmelkamp, P., &
Lange, A. (2010). Web-based therapist-assisted cognitive
behavioral treatment of panic symptoms: A randomized
controlled trial with a 3-year follow-up. Journal of Anxiety
Disorders, 24, 387-396. doi:10.1016/j.janxdis.2010.01.010
 Spence, S. H., Donovan, C. L., March, S., Gamble, A., Anderson,
R., Prosser, S., … Kenardy, J. (2008). Online CBT in the
treatment of child and adolescent anxiety disorders: Issues in
the development of BRAVE-ONLINE and two case illustrations.
Behavioral and Cognitive Psychotherapy, 36, 411-430.
doi:10.1017/S135246580800444X
 Spence, S. H., Holmes, J. M., March, S., & Lipp, O. V. (2006).
The feasibility and outcome of clinic plus Internet delivery of
cognitive-behavioral therapy for childhood anxiety. Journal of
Consulting and Clinical Psychology, 74, 614-621.
doi:10.1037/0022-006X.74.3.614
References cont’d
 Titov, N., Andrews, G., Choi, I., Schwenke, G., & Johnston, L.
(2009). Randomized controlled trial of web-based treatment of
social phobia without clinician guidance. Australian and New
Zealand Journal of Psychiatry, 43, 913-919.
doi:10.1080/00048670903179160
 Titov, N., Andrews, G., Robinson, E., Schwenke, G., Johnson, L.,
Solley, K., & Choi, I. (2009). Clinician-assisted Internet-based
treatment is effective for generalized anxiety disorder:
Randomized controlled trial. Australian and New Zealand
Journal of Psychiatry, 43, 905-912.
doi:10.1080/00048670903179269
References cont’d
 Titov, N., Gibson, M., Andrews, G., & McEvoy, P.
(2009). Internet treatment for social phobia reduces
comorbidity. Australian and New Zealand Journal of
Psychiatry, 43, 754-759.
doi:10.1080/00048670903001992
 Villani, D., Riva, F., & Riva, G. (2007). New
technologies for relaxation: The role of presence.
International Journal of Stress Management, 14, 260
– 274. doi: 10.1037/1072-5245.14.3.260
 Wims, E., Titov, N., Andrews, G., & Choi, I. (2010).
Clinical-assisted Internet-based treatment is effective
for panic: A randomized controlled trial. Australian
and New Zealand Journal of Psychiatry, 44, 599-607.
doi:10.3109/00048671003614171
Thank you!
Ethics in the “i” World: Social Media
Ethics
© 2012 K. Kolmes. All rights
reserved
ADAA
APRIL, 13, 2012
KEELY KOLMES,
PSY.D., PRIVATE
PRACTICE, SF, CA
HTTP://DRKKOLMES.
COM
DRKKOLMES@GMAIL.
COM
 I have no conflicts of interest to disclose.
 I have not received any funding from any
commercial entities that may be mentioned or
discussed in this presentation.
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Search Engines & Social Media: Who is
looking for you?
 Clients
 Colleagues
 Students/Supervisees & Professors/Supervisors
 Training programs & employers
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Setting Up a Google Alert
 http://www.google.com/alerts
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Clinical & Ethical Issues for Clinicians
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Clients seeking psychotherapist information on
the Internet (Kolmes & Taube, 2011)
In a survey of 332 clients, 70% reported
finding personal information about their
therapist on the Internet.
 87% of these individuals found it intentionally
while 13% found it accidentally.
 78% found the information via Google, 42%
found it via Facebook, 17% found information
on LinkedIn. 10% found it on a blog.

© 2012 Keely Kolmes, Psy.D. All
rights reserved
Clinical & Ethical Issues for Clinicians
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Tips for Taking Control of Your Web
Visibility
 Carefully choose which email address you use to
join sites.
 Understand the privacy settings on your own
(and family members’) profiles.
 Correct misinformation.
 Google’s URL Removal Tool for URLs that
urgently need to be removed. (URLs that
accidentally expose confidential data)
https://www.google.com/webmasters/tools/removals
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Social Media And Your Practice
 Consider your intent when you join a
social networking site: personal or
professional?
 Implement a Social Media Policy

http://www.drkkolmes.com/docs/socmed.pdf
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Digital Ethics?
 Applying existing Ethical Standards to online activity.
 Ethical Standards offer a guide for ethical behavior.
 Development of standards is ongoing.
 Ethical dilemmas on the Internet mirror ethical dilemmas
that also occur offline.
 Ethics Codes refer only to our professional activities, not
personal ones.
 Distinction between professional and personal is getting
blurred online.
Clinical & Ethical Issues for Clinicians
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Relevant Ethical Standards
 Ethical Standard 3.10 Informed Consent
 Ethical Standard 3.05 Multiple
Relationships
 Ethical Standard 4.01 Maintaining
Confidentiality
 Ethical Standard: 4.04 (b): Psychologists
discuss confidential information obtained in
their work only for appropriate scientific or
professional purposes and only with
persons clearly concerned with such
matters.
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Relevant Ethical Standards (cont.)
 Ethical Principle 5.05: Psychologists do not solicit
testimonials from current therapy clients/patients or
other persons who because of their particular
circumstances are vulnerable to undue influence.
 Ethical Principle 4.06 Consultations: When
consulting with colleagues, (1) psychologists….
disclose information only to the extent
necessary to achieve the purposes of the
consultation. (See also Standard 4.01, Maintaining
Confidentiality.)
Clinical & Ethical Issues for Clinicians
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Beware Online
Pseudonyms
 Invitations from
people you do not
know.
 Caution when
replying to
“strangers” in
public.
 Online
impersonation is
fairly easy.
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Closing Remarks
 Know what's out there about you.
 Take responsibility for your web presence.
 Be proactive about cleaning it up or correcting inaccuracies.
 Consider whether access to posted information could




damage a client, another professional relationship, or you.
Distinguish between personal and professional use on social
networking sites.
Understand and use privacy settings.
Be prepared to manage it clinically when internet activity
comes into the room.
Develop a social media policy for your practice.

Include it as a part of informed consent and discuss it.
Clinical & Ethical Issues for Clinicians
© 2012 Keely Kolmes, Psy.D. All
rights reserved
References
 American Psychological Association. (2010). Ethical principles
of psychologists and code of conduct. Retrieved from:
http://www.apa.org/ethics.
 Donner, M., The Ethical Use of the Listserv: Privacy and
Professional Conduct, The California Psychologist,
November/December 2007, 22. Retrieved from
http://bit.ly/vsKFAW
 , Florence W.; Patterson, Terence; Gottlieb, Michael. Ethical
dilemmas in psychologists accessing Internet data: Is it
justified? Professional Psychology: Research and Practice, Vol
42(2), Apr 2011, 105-112.
 Kolmes, K. (2010, April). Private practice social media policy.
[PDF file]. Retrieved May, 2010, from
© 2012 Keely Kolmes, Psy.D. All
http://www.drkkolmes.com/docs/socmed.pdf
rights reserved
References (cont.)
 Kolmes, K. & Taube, D.O. (2011) Summary of client-
therapist encounters on the web: The client experience.
[PPT file]. Retrieved June 2011, from
http://drkkolmes.com/research/
 Lehavot, K., Barnett, J., & Powers, D. (2010).
Psychotherapy, professional relationships, and ethical
considerations in the MySpace generation. Professional
Psychology: Research and Practice. Vol 41(2), Apr 2010,
160-166.
 Martin, S. (2010, August 13). More than one-fifth of grad
students have Googled their clients. [Web log posting].
Retrieved from http://bit.ly/ajRjWX. (2011, March 20).
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Contact Me
Keely Kolmes, Psy.D.
[email protected]
415-501-9098
http://www.drkkolmes.com
Twitter: @drkkolmes
© 2012 Keely Kolmes, Psy.D. All
rights reserved
Ethics in the “i" world: Internet,
telehealth, social media, texting,
and e-mail
ETHICS AND LEGAL ISSUES
JEFFREY E. BARNETT, PSY.D., ABPP
LOYOLA UNIVERSITY MARYLAND
Disclaimer
I have no conflicts of interest to disclose and have
not received any funding from any commercial
entities that may be mentioned or discussed in this
presentation.
All information and opinions shared are those of the
presenter only.
What is Telehealth?
 “The use of telecommunications and information
technology to provide access to health assessment,
intervention, consultation, supervision, education,
and information across distance” (Nickelson, 1998,
p. 527).
 The use of the telephone, e-mail, chat rooms, and
other Internet and satellite-based technologies to
provide direct clinical services (e.g. texting, IATV,
etc.).
Teleconferencing and
Interactive Televideo Communications
 Interactive Televideo Communications (IATV)
Consultation and treatment to remote locales
other settings lacking specialized treatment
professionals and for when clients can not access
the professional in-person.
Efficiency of service delivery/cost effective
Increased access to treatment
Superior to telephone and e-mail
Treatment across great distances
Back to the Future?
Areas of Concern with IATV
 Technological limitations impacting audio/visual acuity






and clarity – interpersonal cues
Inadvertent breaches of confidentiality
Technology failures
Difficulty responding to emergencies
Licensure issues
Knowledge of local laws
Behavioral telehealth may not be the most appropriate
medium for all treatment needs
Legal and Ethical Issues
 75% provide services across state lines
 60% inquired about the patient’s state of residence
 74% uncertain or incorrect about states’ telemedicine or
telehealth laws
 50% made advanced arrangements for responding to
emergencies or crises
 48% used a formal informed consent procedure prior to
providing online services
(Maheu & Gordon, 2000)
Recommendations
 Use a comprehensive informed consent procedure
 Learn relevant telehealth and telemedicine laws for
all jurisdictions in which you will be providing
services
 Do not practice outside the scope of your license
 Follow your profession’s ethics code regardless of
the therapeutic medium used
 Utilize all existing technology to protect each
individual’s confidentiality
Recommendations (Cont.)
 Attend to issues of dangerousness, duty to warn
and protect situations, and mandatory reporting
requirements
 Make arrangements in consumers’ local areas for
emergency and crisis situations. Be knowledgeable
of local resources
 Maintain appropriate liability coverage and be sure
malpractice insurance covers these services
 Remain aware of the limitations of both the online
services provided and the technology used to offer
them
Recommendations (Cont.)
 Evaluate the effectiveness of all telehealth services
provided and modify them as needed
 Assess each individual’s appropriateness for this
modality of treatment. Make referrals when
needed and appropriate
 Practice within your scope of practice and areas of
competence
 Attend to cultural, ethnic, language, and other
differences that may impact effective
communication
Recommendations (Cont.)
 Utilize effective documentation, adherence to
termination and abandonment guidelines, and
appropriate practices for fees and financial
arrangements
 Ensure both clinical and technological competence
needed to provide these services online
 Consult with knowledgeable colleagues, relevant
statutes, applicable ethics codes, available
professional standards, and legal counsel
 Participate in telehealth policy, standards,
guidelines, and technology development
Social Networking
Counseling, Psychotherapy,
and Social Networking
 Many clients participate in social networking sites
in their lives and use them as a prime means of
communicating , relating, and managing
relationships.
 Clients may send their counselors or
psychotherapists “friend” requests.
 Challenges to clinician transparency, selfdisclosure, privacy, and the nature of the treatment
relationship.
Counseling, Psychotherapy,
and Social Networking (cont.)
 Potential impact of declining on the treatment
relationship.
 Potential impact of accepting on the treatment
relationship.
 Losing the ability to have “real” relationships?
What is considered “real” may be different for
digital natives.
 Transitioning from the digital world to the “inperson” world.
Implications for Counseling and
Psychotherapy
 Have a Social Networking Policy. See for example:
http://drkkolmes.com
 Address this as part of the informed consent
process with every client.
 Responding to “friend” requests from current and
former clients - to respond or not; implications for
the counseling and psychotherapy process and
relationship.
 Boundary/multiple relationship issues.
Implications for Counseling and
Psychotherapy (cont.)
 Self-Disclosure issues and the blurred line between
your professional life and your personal life
 The fallacy of security settings
 Searching for client information online
 Using a client’s social networking site
therapeutically
 What to do with information obtained via the
Internet
Ethical Issues and Dilemmas
 Boundaries and Multiple Relationships
 Self-Disclosure and Psychotherapist Transparency
 Fidelity, informed consent, and integrity
 Clinician searches for information about a client
online
 Graduate student activities: A faculty member
discovers a student’s blog.
 Trainees: A client discovers a student clinician’s
personal website.
Seeking Ethical Guidance
 In general contacts with clients and former clients online
should be viewed like any other multiple relationship.
“Multiple relationships that would not reasonably be
expected to cause impairment or risk exploitation or harm
are not unethical” (APA, 2010, p. 6).
 With regard to boundaries and self-disclosure the APA
Ethics Code “applies only to psychologists’ activities that
are part of their scientific, educational, or professional roles
as psychologists… Those activities shall be distinguished
from the purely private conduct of psychologists, which is
not within the purview of the Ethics Code” (p. 1).
 See also standards on Informed Consent, Confidentiality,
Avoiding Harm, Exploitative Relationships, Student
Disclosures of Personal Information.
Questions to ask when considering online
disclosures (Lehavot, 2007):
 What are the costs and benefits of posting the
information?
 Is there a high probability that clients will be
significantly and negatively affected?
 How will the disclosure affect my relationship
with my clients?
 Does the disclosure threaten my credibility or
undermine the public’s trust in the profession of
psychology?
References
 American Psychological Association. (2010). Ethical
principles of psychologists and code of conduct.
Retrieved from: http://www.apa.org/ethics.
 Lehavot, K. (2007). “MySpace” or yours? The ethical dilemma of
graduate students’ personal lives on the Internet.
Presentation at the Annual Convention of the American
Psychological Association, San Francisco, CA.
 Maheu, M. M., & Gordon, B. L. (2000). Counseling and therapy
on the Internet. Professional Psychology: Research and
Practice, 31, 484-489.
 Nickelson, D. W. (1998). Telehealth and the evolving health
care system: Strategic opportunities for professional
psychology. Professional Psychology: Research and
Practice, 29, 527-535.