Providing Services During the Coronavirus Pandemic

The global coronavirus (COVID-19) pandemic has MFTs questioning whether they can provide their services through the use of telehealth technology, especially given the recommendations from the Centers for Disease Control and the World Health Organization to practice social distancing. While telehealth seems like the easiest solution to best protect yourself as the mental health provider, as well as your clients, it’s important to understand the complexities of providing telehealth services before making the decision to offer teletherapy to your clients.

Top Items to Consider Before Offering Teletherapy During the COVID-19 Pandemic

Does your state allow MFTs to practice teletherapy?

MFTs are legally able to provide teletherapy within a state if they are a licensed MFT or other licensed mental health provider in that state. However, some states do have requirements that licensees must meet before providing teletherapy, such as a certain number of hours of CEs on the subject. Therefore, please check with your licensure board for any state requirements pertaining to teletherapy before proceeding
Some state licensing boards may have special notices or alerts regarding this very issue. It will be crucial to periodically check in with your licensing board because this situation is very fluid, and teletherapy policy may change at any time.
Some state governments have issued emergency declarations that could impact whether or not MFTs can practice telehealth. Please contact your state’s licensing board or agency to find out more information on how an emergency declaration impacts your scope of practice.

Can MFTs provide teletherapy to clients who now reside in another state?

Some members are encountering situations due to the pandemic where their clients moved away to another state where the member is not licensed, or the clients can no longer travel from their home state to the member’s office in another state. In most states, you must be licensed in the state where the client is currently residing in order to provide therapy online to that client. Unless the government in the state where the client resides waives this requirement under an emergency declaration by the governor, or emergency rulemaking by a licensure board/agency, then this restriction would still apply.

Have licensure laws, or sections within these laws, been waived for the duration of the epidemic?

The short answer is “no” so far. The current statutes and regulations still apply and remain in effect for the duration of this pandemic. Federal or state law still applies and is still enforceable. The only exceptions would be if the government waives a statute or rule under either an emergency declaration by the president or governor or other executive authority, or emergency rulemaking by a licensure board, or a court order.
In some cases, the executive branch, whether the federal government or state governments, might not have the legal ability to waive certain requirements during an emergency. Congress and state legislatures also can push legislation that waives or amends certain requirements.
Please be sure to contact your licensure board should your state government make any emergency changes to confirm how the changes may impact your scope of practice or your ability to utilize teletherapy options.

Will the insurance companies reimburse me for a virtual visit during this time?

It’s important to check with each insurance company you are paneled with. Some insurance companies will only reimburse mental health providers for virtual visits after the provider has had an in-person visit with the client. Some insurance companies may change their telehealth policies in order to address the current crisis.

Will my malpractice insurance cover telehealth services?

If you are insured by CPH and Associates through AAMFT, they have released a notice stating that the policy will cover telehealth as long as the services are being provided legally within the scope of your license.
If you are covered by a different malpractice insurance company, you will need to contact them to find out if telehealth services are covered under your policy.

What teletherapy platform should I use?

Normally, members should use a teletherapy platform that is HIPAA-compliant.
UPDATE: Effective March 17, 2020, the Office for Civil Rights at the U.S Department of Health and Human Services (HHS) announced that it will waive potential penalties for HIPAA violations against health care providers that serve clients through everyday communications technologies, such as Skype or FaceTime, during the COVID-19 nationwide emergency. See the HHS website for the announcement and notification on this waiver. Members should read this information before proceeding with using everyday communications technologies. Public facing apps, such as Facebook Live and TikTok, still cannot be used for telehealth. Note that this waiver does not apply to any enforcement by states of any similar state laws.
Regarding supervision, AAMFT’s affiliate partner, Motivo, is offering all members a free, HIPAA-compliant platform for virtual supervision during COVID-19.

What ethical issues apply to teletherapy?

All AAMFT members are bound to comply with the AAMFT Code of Ethics. Standard VI of the AAMFT Code of Ethics addresses the provision of online therapy or supervision. In particular, Standard 6.1 outlines the steps MFTs should take before commencing therapy or supervision services through electronic means. In addition Standard VI, the remaining provisions of the AAMFT Code of Ethics also apply to online therapy or supervision.
Besides the AAMFT Code of Ethics, your state’s licensure law might have additional provisions that apply when conducting teletherapy or supervision online. Many states have requirements that are the same as or similar to the AAMFT Code of Ethics. However, some states have additional requirements that apply to therapy or supervision through electronic means. Members should check their state’s licensure law or contact their state licensure board. For information regarding your state’s licensure law and licensure board, please visit our State Resource Pages.

I am a student in an MFT program attempting to complete my practicum this semester. Our university is now closed, and I have gone back home, which is in different state. Can I continue providing therapy to clients virtually in the state where the program is located?

Regarding the ability of students to continue providing services online, this will depend upon several factors. One factor is whether the MFT program or university will allow the practicum to continue during the disruption. Some programs might not allow it, particularly if they are formally closed during this period. Another factor is whether this therapy is allowable under the laws of the state where the clients live, as well as under the laws of the state where the student is residing. You or your program will need to check with the licensure boards in these states. In addition, you will want to contact your liability carrier to see if providing therapy virtually from another state as a student would be covered under your liability policy.

What about for associate MFTs? Will my hours earned during this pandemic count towards licensure?

As an MFT in training, the COVID-19 pandemic may have you worried about completing your hours of supervised experience in order to become licensed. Supervisors may also be worried about providing supervision while adhering to the recommended social distancing preventative measure. Some states already have a certain number of supervision hours allowed to be completed virtually. Again, given the fluid nature of this pandemic, it could be possible to see some of these virtual supervision policies change. Please contact your state’s licensing board/agency to determine if virtual supervision hours will be counted towards licensure.

AAMFT Resources

AAMFT has several resources regarding the practice of teletherapy. Those resources, along with other resources that may be helpful during this time of uncertainty, have been compiled for your convenience here.
For information regarding your state’s licensure and supervision policies, please visit our State Resource Pages. Please note: These pages were not created with a global pandemic in mind! Please utilize the links on your state’s page to access information directly from your state’s MFT licensing board/agency, because policies may temporarily change due to this crisis. Each State Resource Page features links to the MFT licensing board/agency.