The Community Counseling Clinic has undergone substantial changes in adjusting to the needs of our clients and counselors since the COVID-19 pandemic. It is vital that all practicum and intern counselors become familiar with both in-person and virtual procedures.
If you have any questions after reviewing this website, please reach out to the Peer Supervisor, Faculty Instructor, and/or Clinic Director (in that order).
Your patience, flexibility, and understanding are greatly appreciated, as we continue to navigate the needs of our clients and counselors as well as adhere to university policies, and state mandates.
Communication with the Clinic
It is absolutely vital that you keep the clinic informed of any client issues or policy-related challenges you are having. The Clinic Director must be informed when your client is struggling with payments, has decided to terminate services, is not attending sessions consistently, or is upset with a clinic-related issue (among other things).
The best way to communicate with the Clinic Director is through email (clinic@pdx.edu). When in doubt, COMMUNICATE!
Communication with Clients
While providing virtual services, you will be utilizing your PSU email address to communicate with clients for scheduling purposes only. Email is not a secure form of communication, therefore you must not send an email with any clinical information or reference to "Counseling" in it, as this would risk the clients' privacy and confidentiality.
If you need to communicate with the client urgently (to follow up on a no-show, regarding technology failure, university-wide emergency, etc.) then you may use your own cell phone while DIALING *67 FIRST to restrict your phone number.
Note: *67 has been known to fail and we have learned clients are prone to skip 'Unknown' callers.
All contact with your client outside of session must be discussed with your peer supervisor first. All contact with clients should be documented in Titanium using Ancillary Notes.
Confidentiality & Telehealth
You are responsible for setting up a space for your telehealth sessions. Consider the following in consultation with your Peer Supervisor & Faculty Supervisor:
Soundproofing: If you live with others or have neighbors, consider how you can prevent sounds from transmitting outside the room you are in. Close any open windows, turn on a fan or low music outside your door, use headphones with microphone connection, put up wall hangings or thick blankets, etc.
Demonstrating Privacy: Try to eliminate any doors or windows from your background. The visibility of windows and/or doors for sighted clients can create anxiety over someone walking in on the session or walking past the window. When it's not possible to avoid background door and/or window, ensure all curtains or blinds are closed and doors are locked (when possible).
Past practicum counselors have had success indicating when a door is a closet door by hanging a piece of art on the door or concealing the door/window with a piece of tapestry. Counselors have also informed clients at first session when the door is a closet or their window is not on the first floor.
Professional Backgrounds: Visual cues are self-disclosure. It is recommended that you carefully cultivate what your client may be exposed to in your space. Artwork, plants, and lamps could convey personality and warmth but viewing your bed, religious/spiritual icons, or clutter may disclose more about you than is appropriate or professional.
Past practicum counselors have had success using virtual backgrounds. Check if your version of Zoom is background enabled and if your computer supports them with enough time to curate the background before your first session.
The Client's Space: You likely will know more about the importance of confidentiality and privacy than your clients. When beginning each session, check in with your client that they are in a private space and nobody else is in the room. In the first session, it is recommended that you discuss the space and sound limitations of your client's space and troubleshoot any privacy concerns. Encourage clients to hold their sessions indoors or in their car if possible, discuss using headphones, using a private room or bathroom, turning on fans or music near the door to drown out their voice, etc.
Zoom Requirements
The Clinic Director will email you and your Faculty Supervisor when a new client is referred to one of your available sessions. You are responsible for emailing the client a link to their Zoom meeting no later than one business day in advance of their scheduled first session. The following are required of Zoom sessions:
A recurring Zoom appointment for the remainder of the current Academic Term
A unique Zoom Meeting ID (NOT your Personal Meeting Room)
A password
You must enable the "Waiting Room" feature to control who enters the session
You must make your Peer Supervisor & Faculty Supervisor alternative hosts, so that they can enter the session without needing permission.
Paperwork & Documentation
You are still expected to complete all Clinical Case Notes and Ancillary Notes on the day of your Practicum. You must sign and forward these to your Faculty Instructor for review and signature. We strongly encourage you to check your Task List in Titanium before the end of your Practicum day to ensure that you address any edits or feedback from your Faculty instructor before logging off Zoom for the day/night.
The following are specific documents, who is responsible for them, and how they are shared with clients in typical order of appearance:
Informed Consent - sent to clients upon scheduling by Clinic Director through Adobe Sign. You are still expected to review the Informed Consent at the beginning of your first session, after discussing privacy/confidentiality. The Clinic Director will upload the signed Informed Consent to the client chart before the second session.
Clients must have a signed Informed Consent on file by the second session OR COUNSELING MAY NOT PROCEED.
If a client's Informed Consent is not in the client's file by the time of the second session and the counselor has not heard from the Clinic Director with further details, the counselor should assume the client has not returned the Informed Consent to the CCC. Counselors should not seek out the Clinic Director for confirmation that an Informed Consent is missing.
Service Plans & Service Plan Reviews - shared with clients by you in session via "Screen Share" tool in Zoom. Signed by the counselor with client endorsement. If in person, review it on your laptop together and then you sign and indicate client endorsement.
Termination Summary and Client Disposition - This process is completed by counselor after approval by the Faculty Instructor to proceed with its completion. The Clinic Director will send out the disposition form for you to complete with clients prior to termination.
Authorization for a Release of Information - sent to counselor via email by Clinic Director upon client's and/or counselor's request. Processed by the Clinic Director. Clinic Director will return ROIs to counselor and faculty instructor when completed incorrectly.
At this time we recommend you limit the use of worksheets and paper-based interventions for telehealth clients. Should you choose to use these, we suggest you use the "Screen share" option on Zoom and allow the client to screen-shot the item. DO NOT send forms to clients by email due to the unsecured nature of email. If you do use a worksheet or paper-based intervention, a copy of the completed document will need to be provided to the Clinic Director. The document(s) will then be uploaded and attached to a client's chart via Ancillary Notes.
Ethics and Safety Precautions
TeleHealth presents unique challenges to mandates of ethics and safety. Remember your ethical decision-making model from Ethics class and remember to CONSULT, CONSULT, CONSULT!
The Clinic Team is here to help.
In case of medical emergency or imminent danger emerging in one of your sessions, you must collect the following at the start of counseling:
The address where the client is that day (If they are at home, confirm their home address from Titanium the first session - afterward you can ask "are you at home today?" if you do not recognize the space).
Anytime backgrounds change, counselors should be prepared to reconfirm the address on the day of session.
The phone number of your Faculty Supervisor (and make sure your Peer Supervisor and Faculty Instructor have yours).
The emergency contact for the client (these are located at the end of the "Intake Interview").
To continue safeguarding the client's privacy and prevent abrupt abandonment in the case of technological failure, you must also confirm that the client is in a private room and if they prefer to be contacted by email or phone should the Zoom session get interrupted.