Group Telehealth

Telehealth is the utilization of electronic information and communication technologies by a mental health clinician to deliver services to clients when they are located at a different site than the clinician. For group treatment services, clients will be utilizing technology to engage in a group treatment setting with lead clinicians, as well as other group members. The principles of confidentiality that are abided by for in-person group are maintained for telehealth. There are additional considerations to adequately maintain confidentiality over group telehealth. Group members are expected to sign this agreement indicating that they will take the following steps to ensure confidentiality.

Confidentiality Agreement

Caregiver(s) and child agree to maintain confidentiality of group members and group content by taking the following steps. Group leaders will assist caregivers in developing a plan to follow these steps.

1. Continue to follow and maintain confidentiality of group members and group content as outlined in the group rules and caregiver group contract.
2. Identify a private location in the home for each the child and caregiver, separately, with door that shuts.
3. Utilize headphones and a sound machine when engaged in telehealth sessions to maintain confidentiality of group content. Both the caregiver and the adolescent should have their own pair. Notify KPCAC if you do not have access to this equipment and arrangements will be made to provide this equipment.
4. During telehealth sessions, the caregiver and child are positioned with the screen facing a wall and away from the door entrance.
5. The child and caregiver will not take screenshots or pictures of the screen during the entire duration of the telehealth session.
6. The caregiver and child will keep all other cameras and smart devices put away during the entire duration of telehealth sessions,with the exception of the caregiver having a phone available to be contacted in case of emergency.
7. Chat features and shared screen capabilities shall not be used by any group member and will be disabled by group leaders.
8. If it is necessary for the child or caregiver to leave the private location during a session, the child or caregiver will notify the group leaders and disconnect from the session. Group leaders will contact the caregiver to assist with reconnecting to the session.
9. The device shall remain in the private location for the entire duration of the telehealth session.
10. The caregiver will develop a plan to avoid interruption of the session by another member of the household, including organizing adequate supervision for other children and providing clear rules regarding not entering the private locations during the session.
11. The caregiver and child will notify lead clinicians if there is a break in confidentiality or if at any point confidentiality can no longer be followed or maintained.

By Signing, I am indicating that I have read this document and understand my responsibility in maintaining confidentiality and will follow the steps outlined. I will ensure that my child understands and follows the steps as well. This form has been explained to me and my questions have been answered. If I have additional questions, I will call (843) 729-1190.