Online Therapy and Online Counselling Ethics

Broader ethical guidelines, not specifically tailored for the internet, are included in the section on Ethics in Counselling.

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Online Service Provision and Technology

Ethics and Best Practice Guidelines

ACA (1999) 'Ethical Standards for Internet Online Counseling', American Counseling Association. [available online]

This early set of guidelines remains useful.

APA (1997) APA Statement on Services By Telephone, Teleconferencing, and Internet. Washington, DC: American Psychological Association. [available online]

This early statement refers primarily to the importance of individual responsibility in ensuring that psychologists operate within their boundaries of competence, and in particular the relevant section of the ethical code in force at the time, the precursor of the guidelines effective from June 2003, (APA 2002) -- which, notably, do not treat telephone or internet services any differently than other services.

BACP (2003b) Guidelines for Online Counselling and Psychotherapy. British Association for Counselling and Psychotherapy.

This best practice guidelines document will not be reviewed here until the BACP decides to permit ordinary members of the public to see it. As of this writing (July 2004), the BACP has for over a year steadfastly refused to open the document to evaluation and scrutiny by the general public. This constrasts starkly with every other professional organization in the field which publishes any document purporting to provide guidelines to best practice, all of which have been made freely available to the consumer. To gain access to the document on the BACP website -- a site which, incidentally, apparently violates British law prohibiting discrimination against disabled users -- BACP members must first mail in a paper cheque to pay for the privilege. Yes, members need to send a paper cheque before being allowed to read the BACP's advice on providing services over the internet...

HON (1997) 'HON Code of Conduct (HONcode) for medical and health Web sites', Health On the Net Foundation. [available online]

This frequently-used code of conduct applies to a wide range of medical services provided online. However, take note of Principle 2 of the HONcode, entitled 'Complementarity', which states, "The information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician." As of late 2004, the organisation's Executive Director, Celia Boyer, claimed in personal communication that "It is our position that online psychological counselling contravenes this principle, and that websites whose main purpose is to support or promote this activity cannot be considered for HONcode accreditation at this time". This effectively renders HONcode largely irrelevant for online practitioners. (Of course, despite Boyer's claim, several sites which exist to "support or promote" online mental health services have already been HONcode-accredited. Perhaps there is more than one standard at work? Or perhaps there is just one standard, but with radically inconsistent application?)

IHC (2000) 'e-Health Code of Ethics', Internet Healthcare Coalition. [available online]

This draft code of ethics is well thought-out but doesn't seem to have caught on in the way many others have.

ISMHO (2000) 'ISMHO/PSI Suggested Principles for the Online Provision of Mental Health Services', International Society for Mental Health Online. [available online]

For a short time, until the appearance of NBCC (2001), this was probably the most widely-cited list of guidelines for online mental health services.

ISMHO (2001) 'Assessing a Person's Suitability for Online Therapy', Clinical Case Study Group of the International Society for Mental Health Online. [available online]

These common-sense guidelines explore a range of questions -- not all of which have clear answers -- which both clinicians and potential clients may wish to consider before undertaking an online therapeutic relationship.

Kane, B. and D.Z. Sands (1998) 'Guidelines for the Clinical Use of Electronic Mail With Patients', Journal of the American Medial Informatics Association 5(1). [available online]

Although focused specifically on healthcare, these guidelines contain much that will be of use to counsellors and psychotherapists who are relatively new to the concept of communicating with clients via email. There is limited detail offered here, but then the article is intended to provide guidelines, not an in-depth how-to.

Morrissey, M. (1997) 'NBCC WebCounseling Standards Unleash Intense Debate', Counseling Today 40 (5).

See this article for an overview of the chaos which ensued when the NBCC first released its guidelines for online service provision (guidelines since superseded by NBCC 2001). The initial reaction was notably negative, and the debate is thought-provoking both from the standpoint of the issues themselves and from a sociological perspective: some counsellors can really (as they say in the UK) throw their toys out of the pram.

NBCC (2001) 'The Practice of Internet Counseling', National Board for Certified Counselors and Center for Credentialing and Education. [available online]

This set of guidelines is becoming increasingly influential in the US and provides a useful framework for counsellors everywhere.


This page was last reviewed by Dr Greg Mulhauser, Thursday, 14 October 2021.