Clinical, Ethical, and Legal Issues in E-therapy

In recent years, many social workers have joined the ranks of virtual or e-therapists. While this offers exciting new opportunities for social work practice, the advent of e-therapy has come with a host of challenges particular to Internet communication that may not be reconcilable with current social work regulation. This paper reviews the social work codes of ethics in both the United States and Canada, legislation governing treatment, and case law with respect to several important issues related to e-therapy. The paper begins with a discussion of jurisdictional issues and expertise to practice e-therapy. Next, it suggests that if e-therapy fits within the purview of acceptable social work practice, the establishment of therapist–patient relationships creates professional duties of care owed to patients and to the public. Four of the most critical duties in a therapeutic encounter are considered: the duty to obtain informed consent, the duty to maintain confidentiality, the duty to warn third parties of harm, and the duty to maintain professional boundaries.