This email is intended to assist registrants as they consider how best to manage emergent practice issues during the COVID-19 pandemic.
This is a stressful time for all. The best way to remain effective is to stay within the frame of your psychological training and ethical decision-making, to review relevant Code of Conduct requirements when facing new challenges, to reach out to other colleagues and/or Practice Support as you navigate emergent issues, and to remember also to attend to your personal well-being. The circumstance we are all facing is new. Your training and existing skills and expertise have not changed, and the Code continues to provide a clear basis for ethical decision-making.
- Please ensure you are keeping up to date with all general email blasts from the College, as this is the mechanism by which the College apprises its registrants of ongoing developments (e.g.s: office closure; relevant updates from Dr. Henry, the Provincial Health Officer, etc.). Read these emails, and ensure you check any links provided for relevant information.
- The College makes every effort to ensure that registrants are apprised of relevant developments that may affect our profession. It is also our responsibility, as per Code of Conduct Standard 18.1, to ensure that we remain aware of and compliant with legal requirements pertaining to our practice. Ensure you keep abreast of directives and guidance from the Provincial Health Officer.
- Dr. Henry’s March 24 and March 26, 2020 updates, links to which were sent to all registrants by the College in emails, sets out clear expectations for all professionals regulated under the Health Professions Act who offer community client services, including the requirement to reduce direct contact to minimal levels with allowable exceptions. Registrants are responsible for providing services in compliance with Dr. Henry’s directive. Decision-making related to specific clients should be documented in the file, consistent with Standard13.6, and limitations, if any, created by the service modality should also be noted, consistent with Standards 3.18 and 11.11.
- The Code of Conduct and Practice Support checklists (which are cross-referenced with the Code of Conduct) are important sources of guidance when considering any new emergent practice issues. The Code sets out baseline expectations for ethical and competent practice while preserving each registrant’s responsibility for clinical decision-making, and the checklists alert registrants to important considerations pertaining to the topics addressed by the checklists.
- For telepsychology services, the Telepsychology Services Practice Support Checklist and the Telepsychology Assessment Practice Support Checklist offer important considerations for your review. You can link to all of the Practice Support checklists here
- As always, it is important to provide services that are within one’s scope of competence. (Standard 3.5) When offering services in a new way, such as via telepsychology, the Code and checklists offer important information regarding relevant considerations. Those seeking consultation regarding specific telepsychology platforms, security issues, etc., may wish to reach out to technology experts and/or colleagues familiar with these issues for consultation. The Code specifies registrant responsibility for knowledgeable, competent, and legally compliant use of telepsychology modalities (e.g.s, Standard 3.30 and 18.1); training or advice regarding specific modalities is outside the purview of the College. Registrants may wish to contact BCPA and/or CPA for information related to training opportunities, telepsychology modalities, or colleagues willing to provide consultation, and to seek legal consultation regarding any legal requirements specific to one’s practice pertaining to use of telepsychology platforms.
- Various jurisdictions across Canada, including BC, have adjusted registration requirements for those offering ongoing temporary services to clients who are in a different jurisdiction during the COVID-19 outbreak. If you have a client who has relocated to another jurisdiction it remains your responsibility, as per Standards 3.30 and 3.31, to determine any registration requirements of the other jurisdiction and to be in compliance with these.
- Self-care during this challenging time is important! Category E of the Continuing Competency Program contains requirements related to this issue.
Practice Support wishes each of you good health as you continue to offer important mental health services to your clients.
Frequently Asked Questions:
If my profession is listed as essential, do I still have to provide my community services from a distance?
Yes, with some exceptions. As stated on the BC government website on which essential services are listed, “In consultation with the PHO (Provincial Health Officer), essential services should and are encouraged to remain open. They must, however, follow the orders and guidance provided by the PHO to ensure safe operations and reduce the risk of transmission of COVID-19.” PHO Dr. Henry’s March 23, 2020 update, a link to which was sent by the College in an email, specifies that “(w)here possible and appropriate, health professionals are encouraged to provide care to patients and clients via telephone and video technology,” with “allowable exceptions.” Dr. Henry’s letter also states that “(h)ealth professionals are in the best position to determine what is essential in their specific practice.” Thus, while registrants have been deemed essential service providers, it is incumbent on each registrant to determine on a case-by-case basis which of their services meet the conditions of “allowable exceptions” before proceeding with in-person service delivery. Dr. Henry’s letter signifies the general expectation of telehealth service delivery for all professionals regulated under the Health Professions Act when providing services in community settings unless exceptions are met. Her letter provides valuable information regarding allowable exceptions and principles for decision-making, and all registrants should familiarize themselves with this information.
My institution/employer wants me to start providing assessment services via telepsychology. How can this be ok?
In-person assessment services remain the ‘gold standard’ for psychological assessment. However, there may be situations in which an in-person assessment is either impossible or on balance represents more potential for harm than a telepsychogy assessment. As an example, during the COVID-19 pandemic, health authorities have emphasized the imperative of minimizing risk of virus transmission and the Provincial Health Officer (PHO) has specified that “(w)here possible and appropriate, health professionals are encouraged to provide care to patients and clients via telephone and video technology,” with “allowable exceptions.” Registrants are responsible for keeping current with directives and advice from the PHO, and for conducting themselves consistently with these. Thus, registrants are responsible on a case-by-case basis for evaluating the relative risks of foregoing or delaying a specific assessment, providing the assessment service via telepsychology, or proceeding with an in-person assessment. The Code of Conduct provides clear requirements regarding decision-making, competent and knowledgeable services, and documentation of professional work, including specifying limitations to opinions, etc. The Telepsychology Services Practice Support Checklist and the Telepsychology Assessment Practice Support Checklist provide valuable information and are cross-referenced with the Code of Conduct, and registrants are strongly encouraged to review these documents and the Code as part of their decision-making.
Does the telepsychology platform I’m considering meet security requirements?
The Code of Conduct specifies registrant responsibility for knowledgeable, competent, and legally compliant use of telepsychology modalities; training or advice regarding specific modalities is outside the purview of the College. Registrants are responsible for taking steps to ensure they are knowledgeable and competent regarding the telepsychology platform(s) they use, are able to provide all appropriate information to clients as part of obtaining informed consent, and are in compliance with any laws relevant to their specific practice.