Ethics in Telehealth: Competence and Care
Telehealth has become a permanent part of psychological practice, but with new opportunities come new responsibilities. Ethical practice requires us to go beyond simply using video platforms. It means addressing privacy, competence, professionalism, and emerging issues like artificial intelligence in care. By pairing the APA telepsychology guidelines with ethics CEUs from an APA-Approved Sponsor, we strengthen both our clinical effectiveness and our ethical integrity. Continuing education in this area not only fulfills licensure requirements but also equips us to respond to the evolving landscape of digital practice.
It’s easy to underestimate just how different online care can feel to clients. For some, meeting in a virtual space provides relief from stigma, greater flexibility, or freedom from transportation barriers. For others, it can introduce distractions, technological frustrations, or heightened fears about confidentiality. These reactions can shift depending on client identity, access to resources, or cultural context. That’s why ethics in telehealth is not just about technical compliance — it’s about anticipating these differences and showing up as clinicians who are flexible, transparent, and proactive.
Competence as the Bridge Between Evidence and Client Trust
The APA’s Ethics Code identifies competence as a cornerstone of professional practice. Without it, psychologists cannot provide safe, effective, or ethical care. In telehealth, competence extends beyond clinical knowledge to include technical fluency and cultural responsiveness. Each domain plays a vital role in ensuring that online therapy is not only effective but also equitable and trustworthy.
Clinical competence means being able to adapt evidence-based interventions to an online format without losing their effectiveness. Techniques may need modification to fit the limits of a screen, and clinicians must consider how rapport, assessment, and intervention strategies translate virtually.
Technical competence involves more than just knowing how to log on. It requires mastery of secure platforms, the ability to troubleshoot technology alongside clients, and familiarity with accessibility features that make care usable for individuals with diverse needs. A session is only as safe as the system supporting it.
Cultural competence reminds us that access to telehealth is not equal. Psychologists must account for disparities in digital literacy, language barriers, and structural inequities that affect how clients experience online care. Competence here means intentionally working to reduce those barriers so that telehealth expands — rather than limits — access.
What’s important to remember is that competence is not a one-time achievement. As technology evolves, so do the expectations for psychologists. For instance, when secure messaging, asynchronous therapy tools, or AI-assisted features are introduced, clinicians must be confident not only in their clinical application but also in their ethical and security implications. Pursuing ethics CEUs from an APA-Approved Sponsor ensures that our knowledge evolves alongside technology, keeping us aligned with best practices rather than relying on outdated habits.
Privacy Concerns in Online Therapy
One of the most frequent client questions about telehealth is: “Will my therapy really be private?” Addressing privacy concerns in online therapy means more than choosing a HIPAA-compliant platform. It includes:
Reviewing risks in informed consent.
Clarifying where data is stored and how it’s used.
Staying current with HHS and OCR guidance on online tracking technologies.
In reality, clients’ privacy concerns are often very practical. They may worry about roommates overhearing sessions, whether their data could be shared by the platform, or if recordings are being stored. Taking time to validate these concerns — and explicitly addressing them in intake paperwork — not only fulfills ethical obligations but also reassures clients that you are mindful of their vulnerability.
Professionalism and Emerging Ethical Issues
Professionalism doesn’t disappear online. Therapists must maintain boundaries, avoid dual relationships, and set clear expectations for communication. Beyond these fundamentals, emerging issues — such as the use of AI tools in telehealth — demand careful ethical reflection.
AI is already entering therapy spaces through chatbots, scheduling tools, and even clinical note-generation. While these tools can increase efficiency, they raise questions about data security, clinical judgment, and informed consent. Should clients know if an AI is transcribing their sessions? Absolutely. The APA telepsychology guidelines and APA ethics CE requirements remind us that transparency is not optional — it’s a cornerstone of ethical practice. Completing self-paced online CEUs (APA-Approved Sponsor) gives psychologists space to think critically about these issues before they arise in real-world care.
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Bringing it all together
Ethical telehealth practice is about more than compliance — it’s about competence, privacy, and professionalism in a rapidly evolving field. The APA telepsychology guidelines provide a strong framework, but ongoing learning is what allows us to apply them effectively in real-world clinical situations. New technologies, shifting regulations, and diverse client needs demand that we continually refine our skills. By completing ethics CEUs from an APA-Approved Sponsor, psychologists not only meet their APA requirements but also develop a telehealth practice that is safe, ethical, and future-ready.
In the end, ethics in telehealth isn’t just about avoiding mistakes — it’s about cultivating a mindset of responsibility and growth. Staying open to feedback, updating our knowledge as the field evolves, and engaging in continuing education allow us to keep pace with change while holding steady to psychology’s core values. This commitment reassures our clients — and ourselves — that the profession’s ethical foundation remains strong, no matter the platform or modality. Ethical practice in telehealth is therefore not a destination, but an ongoing process that strengthens both public trust and the therapeutic alliance.
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APA Approved Sponsor Ethics CE Hub for Psychologists
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Enroll in our ethics CE course onlineRead first in the series: Telehealth Efficacy Evidence 2025: What Clinicians Should Know
References
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. Author.
American Psychological Association. (2024). Proposed revision of guidelines for the practice of telepsychology. APA Task Force on Telepsychology. https://www.apa.org/practice/guidelines/telepsychology-revisions.pdf
U.S. Department of Health and Human Services, Office for Civil Rights. (2024, June 20). Use of online tracking technologies by HIPAA covered entities and business associates. U.S. Department of Health & Human Services. https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html
