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teletherapies, cybertherapy, telepsychiatry, telepsychology, telemental health, and telebehavioral health. TMH may be
facilitated via video conferencing, email, text messages, chat tools, and/or telephone. TMH is subject to all practice and
ethical considerations discussed in this document and stated by the laws, rules and regulations governing licensed
practice in the State of Hawaii.
Potential Benefits
• Increased access to care.
• Increased convenience.
• Possible cost savings by eliminating the costs for travel and time.
• Barrier removal. Those who struggle with certain conditions might feel less threatened by online counseling than
by in-person sessions.
• Accommodates stigma and/or privacy concerns inherent in in-person services.
• May allow for more authentic emotional expression.
• Equal effectiveness. The growing body of research on TMH indicates that it (specifically the use of
videoconferencing) can be an effective mode of treatment with equivalent therapeutic alliance ratings to face-
to-face therapy.
Potential Risks
• Increased difficulty assuring confidentiality and verification of student’s identity.
• Cannot guarantee privacy and confidentiality. There is potential for people to overhear sessions if both
counselor and student are not in a private place.
• Potential for interception of sensitive data.
• Potential for technical difficulties and service interruptions to occur.
• Increased difficulty with unexpected crisis intervention. Counselor and student must develop an emergency plan
and procedures.
• Inability to see context of communication. The ability to see the details of facial expressions and nonverbal
communication is limited. More than 80% of communication is nonverbal.
• Increased difficulty administering assessment tools.
• Lack of infrastructure and technological competence.
• Limited access to needed equipment and private space.
Confidentiality
The extent of confidentiality and the exceptions to confidentiality that are outlined in the Informed Consent still apply in
TMH services.
Emergencies and Technology
Assessing and evaluating threats and other emergencies can be more difficult when conducting telehealth than in
traditional in-person therapy. To address some of these difficulties, your Ka’au Program provider may create an
emergency plan before engaging in telehealth services. You will need to provide an emergency contact in case of a
disruption or technological connection failure. Your Ka’au Program provider will try to reconnect with you, do not
contact them. If you are in need of immediate and urgent assistance call 911 or go to your nearest emergency room.
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f the session is interrupted and you are not having an emergency, disconnect from the session and your Ka’au program
provider will wait two (2) minutes and then re-contact you via the telehealth platform on which we agreed to conduct
therapy. If you do not receive a call back within two (2) minutes, then call the Ka’au Program office at (669) 200-4353
and leave a message, your provider will call you back.
