D not exist (Sharkey et al., 2011). The Let’s Chat Pain study took a conservative approach and developed critical incident procedures in consultation with the University ethics committee, an e-health researcher from the host institution who had experience with online adolescent research and the head of adolescent AprotininMedChemExpress Aprotinin services in the local pain clinic. In response to disclosure of harmful health behaviors, such as underage drinking and illicit drug use, participants would be provided with a number of pre-identified help lines and local sources of support. However, more serious safety concerns (e.g., abuse, neglect, self-harm) were to be addressed by suspension of the message board followed by a meeting of the research team to discuss the incident and determine further action (e.g., alerting caregivers, filing a report with child protection services, etc.). Such incidences did not arise during the study, but considerations are critical to contemplate in advance of implementing study procedures so that decision rules can be built that allow for adequate protection of child participants.Delivering Psychological Interventions OnlineAn important ethical issue for licensed psychologists is the consideration of licensure rules in the particular state, province, or territory where the psychologist resides pertaining to the delivery of psychotherapeutic interventions using the Internet. The practice of technology in medicine broadly, and psychology specifically, is beginning to be defined and regulated by professional licensure boards (e.g., APA, 2010). However, e-health research falls outside of the guidance developed for the provision of clinical services remotely using technology. As a result, concerns may be raised by ethics boards about delivering psychotherapeutic interventions to individuals living in multiple jurisdictions. For example, the Institutional Review Board that evaluated the Web-MAP study raised initial concerns that theresearch team was practicing clinical psychology outside of local jurisdictions where the researchers were licensed to practice (study participants reside throughout the United States and Canada). The distinction between using e-health technology to evaluate a psychological intervention in the context of research versus performing a clinical service within the health care professional atient relationship, was at stake. Because e-health and telehealth do not have universally agreed on definitions, the Aprotinin site stakeholder defines them (e.g., insurers define based on the services they are willing to reimburse). Telepsychology or telepsychiatry involves real-time interaction between providers and patients via videoconferencing, and this is the situation considered most frequently in US state laws and guidelines, such as those summarized recently by the American Psychological Association (APA). Although the APA does not have established guidelines on telehealth at this time, they presented a 50-state review of telehealth laws and rules (published in summer 2010 by the APA Practice Organization). Very few states were found to have established telehealth laws. There are state laws on practicing across state lines that would be applicable in the scenario in which a clinical psychologist wants to enter into a contractual arrangement to provide clinical services to a patient in another state using telehealth services. The APA recommends that psychologists approach each state licensing board for guidance in such situations. This is de.D not exist (Sharkey et al., 2011). The Let’s Chat Pain study took a conservative approach and developed critical incident procedures in consultation with the University ethics committee, an e-health researcher from the host institution who had experience with online adolescent research and the head of adolescent services in the local pain clinic. In response to disclosure of harmful health behaviors, such as underage drinking and illicit drug use, participants would be provided with a number of pre-identified help lines and local sources of support. However, more serious safety concerns (e.g., abuse, neglect, self-harm) were to be addressed by suspension of the message board followed by a meeting of the research team to discuss the incident and determine further action (e.g., alerting caregivers, filing a report with child protection services, etc.). Such incidences did not arise during the study, but considerations are critical to contemplate in advance of implementing study procedures so that decision rules can be built that allow for adequate protection of child participants.Delivering Psychological Interventions OnlineAn important ethical issue for licensed psychologists is the consideration of licensure rules in the particular state, province, or territory where the psychologist resides pertaining to the delivery of psychotherapeutic interventions using the Internet. The practice of technology in medicine broadly, and psychology specifically, is beginning to be defined and regulated by professional licensure boards (e.g., APA, 2010). However, e-health research falls outside of the guidance developed for the provision of clinical services remotely using technology. As a result, concerns may be raised by ethics boards about delivering psychotherapeutic interventions to individuals living in multiple jurisdictions. For example, the Institutional Review Board that evaluated the Web-MAP study raised initial concerns that theresearch team was practicing clinical psychology outside of local jurisdictions where the researchers were licensed to practice (study participants reside throughout the United States and Canada). The distinction between using e-health technology to evaluate a psychological intervention in the context of research versus performing a clinical service within the health care professional atient relationship, was at stake. Because e-health and telehealth do not have universally agreed on definitions, the stakeholder defines them (e.g., insurers define based on the services they are willing to reimburse). Telepsychology or telepsychiatry involves real-time interaction between providers and patients via videoconferencing, and this is the situation considered most frequently in US state laws and guidelines, such as those summarized recently by the American Psychological Association (APA). Although the APA does not have established guidelines on telehealth at this time, they presented a 50-state review of telehealth laws and rules (published in summer 2010 by the APA Practice Organization). Very few states were found to have established telehealth laws. There are state laws on practicing across state lines that would be applicable in the scenario in which a clinical psychologist wants to enter into a contractual arrangement to provide clinical services to a patient in another state using telehealth services. The APA recommends that psychologists approach each state licensing board for guidance in such situations. This is de.
