Navigating the Changing Landscape of Telehealth for Counselors

In a post-pandemic world, telehealth has become more than a backup plan—it’s a cornerstone of modern mental health care. For many clients, virtual sessions offer improved access, convenience, and continuity of care. For clinicians, however, the landscape is still shifting, with evolving regulations, technology demands, and ethical concerns.

So what do Rhode Island counselors need to know to stay current, compliant, and clinically effective?

1. Stay Updated on Licensing & Interstate Practice

During the COVID-19 pandemic, emergency licensure expansions allowed many clinicians to practice across state lines. While those have ended, new frameworks—like the proposed Counseling Compact—are being introduced to formalize interstate practice. Rhode Island is not yet a member, but the trend is clear: mobility is increasing.

Action Step: Visit the Rhode Island Department of Health and the AMHCA or ACA legislative update pages regularly. Keep a list of the states you serve clients in, and verify licensure requirements for each.

2. Understand HIPAA-Compliant Platforms

HIPAA flexibilities are winding down, and counselors are again expected to use fully compliant platforms for video and recordkeeping. Not all video conferencing tools meet those standards (e.g., standard Zoom or FaceTime may no longer be acceptable without a Business Associate Agreement).

Recommended platforms: SimplePractice, Doxy.me, TherapyNotes, Zoom for Healthcare.

3. Maintain Therapeutic Presence Online

Engaging clients virtually can be tricky. Eye contact, body language, and emotional attunement may be harder to communicate. But with intention and small adjustments—camera placement, tone of voice, presence—therapeutic rapport can thrive online.

Tip: Consider opening each telehealth session with a mindful check-in to ground both you and the client in the virtual space.

4. Ethics Still Apply

Boundary management, confidentiality, and informed consent are just as essential online. In fact, telehealth raises new ethical considerations, such as:

• What if a client logs in from a public place?

• How do you ensure privacy during a crisis?

• What’s your plan if the call drops mid-session?

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Update your informed consent to include telehealth-specific language. Consult ACA and AMHCA ethics codes for guidance.

Final Thought

Telehealth is here to stay—and it’s evolving quickly. By staying informed and adaptive, you can offer high-quality, ethical, and effective care no matter the setting.