Informed Consent - Understanding the Benefits, Risks, and Alternatives to On-Line Mental Health Services

You are requesting on-line mental health services. It is important that you understand the potential risks and benefits of these services, safeguards against risks, and alternatives to these services.

The On-Line Counseling and Advice Process

1. Possible Misunderstandings

   You should be aware that misunderstandings are possible with text-only email. The typical nonverbal cues that are part of face-to-face communication are mostly lacking. This makes misunderstandings possible. Should you feel that a misunderstanding has occurred, please contact Dr. Chance via Feedback.

2. Turnaround time

   Emails will be answered within 48 hours, often sooner. Should this change, due to vacations, etc., Dr. Chance will post the change clearly and explicitly on the site.

3. Privacy of the counselor

   Dr. Chance requests that if you disseminate the information she provides, that you make the appropriate attribution. For example, if you post a message on a newsgroup and refer to something that Dr. Chance has stated, please use the format: "Dr. Chance (www.psychadvisor.com) says that...."

The Counselor

The Center for Psychological Advice uses the services of Dr. Cathy A. Chance, Ph.D. She is a licensed psychologist in the state of California (PSY 12827). She holds a Ph.D. from Auburn University in Clinical Psychology. Please refer to the section "About Dr. Chance." Her credentials can be verified with: Board of Psychology, 1422 Howe Ave, Suite 22, Sacramento, CA 95825-3200, http://www.psychboard.ca.gov, phone: (916) 263-2699.

Potential Benefits of On-Line Counseling and Mental Health Advice

As noted on the homepage, there are several potential benefits to on-line advice. These include:

1. You may send and receive mail at any time of the day or night.
2. You never have to leave messages with intermediaries such as receptionists or secretaries. "Phone tag" is also eliminated.
3. You can take as long as you need to compose a message when using email counseling. This also provides the opportunity to reflect on you message and edit as you feel necessary.
4. You have a printable record of the communications from Dr. Chance when using email counseling.
5. You may feel less inhibited on-line than you would with face-to-face counseling.

Potential Risks of Dealing With Mental Health Problems On-Line

There are always risks involved when dealing with mental health problems. When using telecommunications, these risks are compounded.

1. Your email may not be received.

   This may be due to improper addressing or a failure of the server.

2. Confidentiality may be breached.

   Hacking does occur. At the present time, Dr. Chance is not using either DSL or cable modem technology which increase the possibility of being "hacked." Still, it is possible that someone may intercept either your email or Dr. Chance's response. At the point when Dr. Chance changes to either DSL or cable modem technology, this will be posted on the web site. She will also then utilize protection software to decrease the possibility of being "hacked." The use of encryption at this time is not practical.

   Dr Chance accesses the Internet using cable modem. This increases the risk of hacking compared to dial-up connections. For that reason, Dr. Chance is utilizing a firewall program to prevent hackers from accessing her computer. It is still possible that someone may intercept either your email or Dr. Chance�s response. At present we are researching encryption technology for our emails. When such encryption is instituted, we will advise you on this site.

   Storage of transcripts of email messages will be maintained on floppy disk (not hard drive) that can be removed from Dr. Chance's system and stored securely in a locked filing box.

Safeguards

1. Dr. Chance recommends that you request a "return receipt" whenever you send email to her.
2. Dr. Chance further recommends that you password-protect you email account, and possibly your internet access account.
3. If you share a computer with others, it is a good idea to have separate email accounts.

Alternatives to On-line Mental Health Services

There are various alternatives to on-line mental health services. These include:

1. Face-to-face counseling.
2. Talking to a trusted family member or friend or clergy.
3. Attend self-help groups.
4. Using various techniques such as relaxation, meditation or exercise.
5. Do nothing.

Proxies

Dr. Chance does not accept email from individuals who cannot consent to treatment for themselves. This would include minor children and those mentally impaired and requiring a legal guardian or conservator. However, should a competent adult request advice regarding coping with a child or with an adult who has been deemed incompetent, Dr. Chance will answer the question.

Standard Operating Procedure

Dr. Chance deals primarily with adults. She can offer only limited advice regarding children and their problems.

As a psychologist, and not a medical doctor, Dr. Chance can only give general information regarding medications or medical conditions.

While there is every expectation that the services provided will be of benefit to the client, Dr. Chance cannot guarantee that the client will benefit.

Structure of Our On-line Mental Health Services

You may email Dr. Chance at any time and as often as you wish for the agreed-upon price of services. The fee is US$15 per email counseling session with a 33% discount for every third email. Billing is done via credit card. When you wish to submit a counseling request to Dr. Chance, you will be transferred to AuthorizeNet's web site and asked to supply you credit card information. AuthorizeNet will then verify the credit card through its payment processing network and you will then be returned to the counseling request section on the psychadvisor.com web site. You will be sent a "receipt" for the transaction by email.

The overall cost to a particular client will vary depending on the number of counseling sessions with Dr. Chance.

Evaluation of Your Mental Health Situation

You will be asked to fill out a brief questionnaire before submitting your counseling request. This will help Dr. Chance evaluate your situation and provide the best advice she can. Since Dr. Chance is not able to see a client via email, there are limitations to the evaluation. In particular, evaluation of a client's situation is based on the answers to the questionnaire and to the email provided. It is in your best interest to be as complete and accurate as you can be. If Dr. Chance requires answers to some questions so that she can properly evaluate the situation, your response to her questions will be free of charge.

Records

Dr. Chance will maintain records of all correspondence for a minimum of 15 years. These records will be maintained on floppy disks which will be stored in a lockable file box. Only Dr. Chance will have access to these disks.

Confidentiality

The limits of confidentiality are fully explained under the Terms of Agreement. Essentially, no information regarding clients will be shared with a third party except in special circumstances. Clients should be aware, however, that it is possible for web sites and software to track the sites that users have visited. Commercial software is available to detect and delete these traces of on-line activity.

Dr. Chance has entered into an agreement with Amazon.com to help clients find books. When a client leaves the Center for Psychological Advice web site and goes to Amazon.com, a code is imbedded in the link so that Amazon.com knows that they are ordering based on having been on this web site. Amazon.com, however, does not link this information with personal information of any individual.

For further details regarding privacy and confidentiality, please see the Terms of Agreement and our Privacy Policy.

Emergencies

Dr. Chance is not able in this format to deal with emergencies. While she checks her email daily, this may not be timely enough in the case of an emergency. Clients are strongly urged to contact a local mental health facility or provider or local hotline.

Dr. Chance will, in the case of a life-threatening emergency, make every effort to contact the client and/or local emergency responders such as fire department or police. She will also contact local authorities in the cases of child abuse.

To continue, please click on the button below to acknowledge that you have read and understood the above Informed Consent.

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