Ethics and Electronic Communication and Social Media Use in VR 1

Ethics and Electronic Communication and Social Media Use in VR – 1

Maine Bureau of Rehabilitation Services, June 12, 2014

Mary Ann Bedick, M.ED., CRC

[logo – New England TACE Center (region 1)]

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With Special Thanks to…

Rob Froehlich, Ed.D., LPC, CRC, ~ Assistant Director

Region 3 TACE Center at

The George Washington University

202-973-1547 (DC)

804-794-6667 (Richmond, VA)

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Objectives

Participants will learn about the most recent updates to the CRC Code of Ethics that may directly or indirectly give guidance to this topic

Participants will learn about behavioral differences between in-person and at-a-distance tools/interventions

Participants will review “top” social media tools and their use in VR communication and for employment seeking.

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Striking a balance

For many of our topics today, the essential question are:

‘How can I use technology without letting it take over?’

‘What is the right balance to harness the energy behind the technology while not becoming overwhelmed by the information and options it presents?’

‘How do I provide counseling and guidance in our sound byte/140 character limit culture?’

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Rehabilitation Counselor
Internet Practices

Lehmann & Crimando examined internet practices and also examined ethics codes regarding guidance relative to technology.

Lehmann, I. S., & Crimando, W. (2011). Internet practices of certified rehabilitation counselors and analysis of guidelines for ethical internet practices. Rehabilitation Research, Policy, and Education, 25(3&4), 99-112.

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Lehmann & Crimando (2011)

Most reported activities were: visiting government sites, emails, information on specific disability, reading the news, buying a product

Least reported: visiting a virtual world, using Google Docs, participating in online groups, maintaining a “blog”, Twitter

CRC’s “take work home”

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Some Responses Raise Some Questions

Emailing a client from home

Using Google to search a client by name

Emailing a client’s records

Seeking professional consultation using a listserv

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Clients might Interact with Counselors

Chat rooms

Online games

Reading personal blogs written by counselors

Finding comments counselors left on other websites ( movie reviews, news posts or others’ blogs)

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Also….

By social networking sites (SNS)

CRC’s (38%) have SNS & blogs (8.2%)

Information included on SNS by CRC’s are: marital status, age, interests and hobbies, education and gender.

Fewer included their religion and sexual orientation

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We’ll use this framework as a basis in moving through our discussion

Basic electronic communication tools

Google

Texting

Tweeting

Facebook

Others?(Webinars, Listservs, GoogleDocs, etc.)

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Continuing Education Is…

Particularly for topic mandated CE like this, the intent is for you to be able to revisit topics about which you have knowledge and to enhance or allow you to view them in a new light.

This is a way to require us to look at, for example the Code, and to come away with 1 or 2 new thoughts to add to our fund of knowledge.

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It’s not as obvious as we’d like to think!

While some ethical decision making can seem like common sense, our day to day lives are filled with examples of rationalizations and sometimes denial of basic ethical principles

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CRCC Code Review

Dual Relationships

Confidentiality

Technology

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Counseling Relationship (Section A)

Primary responsibility respect dignity & promote welfare of clients

Autonomy of clients

Respect diversity

Informed consent

Developmental & cultural sensitivity

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Professional Disclosure Statement (A.3.a)

Review with clients:

1.Qualifications of rehabilitation counselors

2.Purpose, goals, limitations, risks & benefits of services

3. Frequency & length of service

4. Confidentiality & limitations of such

5. Contingencies for continuation of services

6. Fees

7. Record preservation / release policies

8. Risk associated with electronic communication

9.Legal issues affecting services

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Roles & Relationships with Clients
( A.5)

Prohibited sexual / romantic relationships with current clients

Prohibited sexual / romantic relationships with former clients (5 years)

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Cont’d

Prohibited sexual / romantic relationships with former clients even after 5 years if:

1.History of physical, emotional or sexual abuse

2. Psychosis / personality disorders

3. DD or marked cognitive impairment

4. Clients who remain in need of long-term therapy

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Nonprofessional Relationships
(A.5.d)

Avoid nonprofessional relationships except when potentially beneficial to client

Are time limited or context specific

Examples:

Formal ceremony (weddings, graduations)
Purchasing a service or product provided by client / former client

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Cont’d

3. Hospital visits

4. Mutual membership in professional associations, organizations or communities

Extended free-standing friendships are prohibited

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Confidentiality, Privileged Communication & Privacy

Diversity Considerations

Explanation of Limits

Exceptions

Danger & Legal Requirements
Contagious / Life Threatening Diseases
Court Ordered
Minimal Disclosure

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Information Shared with Others

Work Environment

Client Assistants (PCA’s, Interpreters)

Clients Served by Others

Deceased Clients

Group Work

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Technology & Distance Counseling
(Section J)

21 current standards, 31 in revised code

Application

Possible Problems

Determining Client Capabilities

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Confidentiality & Informed Consent

Provide Sufficient Information to Client

Technology used
Ensuring confidentiality
Other staff who have access
Other authorized / unauthorized users
Legal rights
Technology failure

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Cont’d

Transmitting information

Security

Imposters

Records management

Permission to record /observe

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Compromised Confidentiality

Transmission
Client-end
Counselor-end
Legal Subpoenaed

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TECHNOLOGY

We have at our disposal more tools for communicating with one another than at any point in our past.

Let’s define the word tool…

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Tool – Merriam-Webster Dictionary

1 a: a handheld device that aids in accomplishing a task

2 a: something (as an instrument or apparatus) used in performing an operation or necessary in the practice of a vocation or profession <a scholar's books are his tools

b: an element of a computer program (as a graphics application) that activates and controls a particular function <a drawing tool

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Choosing the right tool

We don’t want to use a sledge hammer to swat a mosquito

Gamma Knife Surgery versus a butter knife

One of the major tasks expected of us as Rehabilitation Professionals is the ability to exercise good professional judgment

We’re going to talk today about some resources to assist in exercising good professional judgment relating to technology and counseling

Remember – Technology is a means to an end, not an end itself

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GOOD REHABILITATION
APPLICATION OF TECHNOLOGY

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Twitter Hashtags

[screenshot – “Results for #jobs Colorado showing Tweets: JuanSrchAllJobs, tmj_cob_health1, tmj_lax_finance, jobsincosprings]

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AND THEN THE BAD…

[graphic of red circle with diagonal line (“No symbol”) and of thumb down]

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Really?!?!?

[image of puppet scratching chin, “Say out loud, or to yourself: ‘When I feel anxiety it is a signal for me to use this app and do this exercise.’”]

The "Shrinky" App is a comforting, Muppet-like figure that visually guides users through a series of scientific, therapy-based techniques.

Shrinky was designed to save consumers time and money by “providing fast emotional relief at a cost of $2.99 with unlimited access, rather than $5,000 or more per year for weekly in-person counseling," said Glenn Berger, PhD, LCSW. "It's like a portable psychologist you can take to the airport, the office, a speaking engagement -- anywhere you might need immediate support.”

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SO HOW DO I KNOW WHAT TOOLS TO USE AND WHEN?

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Framework

CRCC Code of Ethics

Your Agency’s/work setting/University’s Policies

It is essential to be familiar with your own organization’s policies

This information can be quite helpful when unexpected dilemmas arise

We’re going to look at some general considerations based upon a multi state review of social networking policies shortly…

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CRCC CODE AND TECHNOLOGY

Section J and Some General Observations

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Some Highlights

Section J.1.a -a.APPLICATION AND COMPETENCE.

Rehabilitation counselors are held to the same level of expected behavior and competence as defined by the Code regardless of the technology used (e.g., cellular phones, email, facsimile, video, audio, audio-visual) or its application (e.g., assessment, research, data storage).

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J.2

a –Determining Client Capabilities -When providing technology-assisted services, rehabilitation counselors determine that clients are functionally and linguistically capable of using the application and that the technology is appropriate for the needs of clients.

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J.2

b – Accessing Technology -Based on functional, linguistic, or cultural needs of clients, rehabilitation counselors guide clients in obtaining reasonable access to pertinent applications when providing technology-assisted services.

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WebAim May 2012 Screen Reader Survey

only 54.2% of screen reader users surveyed found social media sites to be “very accessible” or “somewhat accessible”, while 33.7% of respondents said social media sites were “very inaccessible” or “somewhat inaccessible”.

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Accessibility- web

Some common accessibility issues with sites like Twitter, Facebook, LinkedIn and YouTube include:

Lack of section headings

Poor color contrast

Inability to navigate using keyboard only

Inability to operate functionality using keyboard only

Missing text equivalents for images

Inability to resize text

Videos lacking captioning

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Accessibility and Social Media

Not a ton out there relating to accessibility and social media…

Social Media Community of Practice – Spearheaded by ODEP (Department of Labor’s Office of Disability and Employment Policy)

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BEHAVIORAL DIFFERENCES BETWEEN IN-PERSON AND AT-A-DISTANCE TOOLS/INTERVENTIONS

Objective 2

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Recent Publication

For a summary of the technology areas in the code, see Barros-Bailey and Saunders (2010)…

‘The sanctity of the client-counselor relationship has the prospect to be threatened through lack of technical knowledge of both parties but, more importantly through limited awareness that behaviors are different when using technology…’

Barros-Bailey, M. B., & Saunders, J. L. (2010). Ethics and the use of technology in rehabilitation counseling. Rehabilitation Counseling Bulletin, 53(4), 255-259.

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Online Disinhibition Effect

What might some of those behavioral differences be?

What do you think this means?

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Online Disinhibition Effect

People do and say things online that they wouldn’t in a face-to-face world. Suler, J. (2004).

CyberPsychology and Behavior, 7, 321-326

You don’t know me

You can’t see me

It’s all in my head

It’s just a game

We’re equals

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Section J.1.b

b.PROBLEMATIC USE OF THE INTERNET. Rehabilitation counselors are aware of behavioral differences with the use of the Internet, and/or methods of electronic communication, and how these may impact the counseling process.

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Potential Misunderstandings

Does anyone have a good example of a time when you misinterpreted an email or when one of your consumers misinterpreted an email from you?

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J.1.c

C.POTENTIAL MISUNDERSTANDINGS

Rehabilitation counselors educate clients on how to prevent and address potential misunderstandings arising from the lack of visual cues and voice intonations when communicating electronically.

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Email and Texting

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Challenges

Current workplace culture would not function without the use of email.

Leaders’ challenges are in drafting policy and modeling good behavior (for example vacation) relating to email.

Placement challenges are in communicating effectively and balancing in person/digital communication.

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Email and Confidentiality

Use of email both at work and work at home

Risks of home use work email

Significant privacy limitations

Encryption compromised

Wi-Fi risks

40% CRC sent email to wrong person

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Email from Home

Dual Relationship?

Boundary Violation?

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Confidentiality and Email

Are there pieces of information you would not put in an email or a text? What examples do you have?

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J.3. CONFIDENTIALITY, INFORMED CONSENT, AND SECURITY

a.CONFIDENTIALITY AND INFORMED CONSENT. Rehabilitation counselors ensure that clients are provided sufficient information to adequately address and explain the limits of: (1) technology used in the counseling process in general; (2) ensuring and maintaining complete confidentiality of client information transmitted through electronic means; (3) a colleague, supervisor, and an employee, such as an Information Technology (IT) administrator or paraprofessional staff, who might have authorized or unauthorized access to electronic transmissions;

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J.3 Continued

(4) an authorized or unauthorized user including a family member and fellow employee who has access to any technology the client may use in the counseling process; (5) pertinent legal rights and limitations governing the practice of a profession over jurisdictional boundaries; (6) record maintenance and retention policies; (7) technology failure, unavailability, or crisis contact procedures; and, (8) protecting client information during the counseling process and at the termination of services.

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Survey - Email

I have on occasion thought about whether or not an email I received from a consumer was actually from that consumer…

True

False

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J.3.d

d.IMPOSTERS. In situations where it is difficult to verify the identity of rehabilitation counselors, clients, their guardians, and/or team members, rehabilitation counselors: (1) address imposter concerns, such as using code words, numbers, graphics, or other non-descript identifiers; and (2) establish methods for verifying identities.

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Some Netiquette Sites

These recommendations are both 1) appropriate for us to consider individually and 2) good for us to share with our consumers as modeling of best practice for their job searches, etc.

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Netiquette – Virginia Shea

THE CORE RULES OF NETIQUETTE

The Core Rules of Netiquette are excerpted from the book Netiquette by Virginia Shea. Click on each rule for elaboration.

Introduction

Rule 1: Remember the Human

Rule 2: Adhere to the same standards of behavior online that you follow in real life

Rule 3: Know where you are in cyberspace

Rule 4: Respect other people's time and bandwidth

Rule 5: Make yourself look good online

Rule 6: Share expert knowledge

Rule 7: Help keep flame wars under control

Rule 8: Respect other people's privacy

Rule 9: Don't abuse your power

Rule 10: Be forgiving of other people's mistakes

Next page...Previous page...Core Rules...Netiquette Contents

Web Albion Home | Netiquette | Netdictionary | Security

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Various Tips on Emailing
For Consumers and For Professionals Langland (2009)

Read all questions and respond to all questions

Avoid sending confidential information via email

Make greeting appropriate to recipient (“Hey” may not work for all)

Pay attention to tone – non-verbal cues can’t be inferred

Respond promptly – if you can’t do it right away let the person know

If an issue requires more that 3 emails, pick up the phone and call.

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