Rehabilitation Counselors and Technology,Social Media,and Distance Counseling: Contemporary Considerations

Abstract

The use of technology in rehabilitation counseling including the delivery of rehabilitation services via virtual counseling is occurring at greater rates than ever before. At the same time, views about the utility of social media have evolved, necessitating increased consideration of social media benefits while at the same time highlighting a need for more detailed guidance regarding its usage and risks. As a standard of ethical practice, certified rehabilitation counselors (CRCs) are required to be aware of guidelines that govern the ethical use of technology in the provision of rehabilitation services, including revisions to the Code of Professional Ethics for CRCs. The 2023 revisions to the Technology, Social Media, and Virtual Counseling section of the Code of Professional Ethics for CRCs specify expanded guidance for CRCs integrating apps, relevant social media, and the provision of virtual counseling. To assist CRCs to meet their standard of ethical practice, this article reviews the historical evolution of technology within the Code, the changes and expansions to Section K of the Code and discusses ethical consideration and revised guidance in the critical technology areas of virtual counseling and social media.

Keywords

rehabilitation counseling technology social media virtual counseling ethics

Since the start of the 21st century, certified rehabilitation counselors (CRCs) have relied on technology to communicate with clients and colleagues (e.g., phone, email, and videoconferencing), store information (e.g., client records), and deliver quality support services with the most recent information. Advances in technology such as early word processing technology, facsimile technology, the advent of social media, and the smartphone have all impacted the delivery of counseling services. Public health concerns relative to the COVID-19 pandemic recently required a seismic shift for many counselors, and as such, teleconferencing technologies (e.g., Zoom) have significantly impacted the way we, as CRCs, carry out the work we do. The use of social media relative to career exploration, information dissemination, and community building has also created multiple paradigm shifts pertaining to rehabilitation counseling. For instance, educators and providers of training and technical assistance have needed to move from a “Just say no” to social media stance when following or referencing the 2010 Code of Professional Ethics to providing additional guidance considerations when referencing the 2017 Code. The need for providers to balance a much-needed digital footprint while adhering to the Code has led to several significant changes in the Code (Commission on Rehabilitation Counselor Certification [CRCC], 2023).

Literature pertaining to Codes of Professional Ethics for Rehabilitation Counselors dates back to the 1970s and earlier (Obermann, 1973). Historically, the 1987 Code of Professional Ethics for Rehabilitation Counselors made reference to technological applications in Cannon 6 (Confidentiality) and Cannon 7 (Assessment) pertaining to topics such as recording of sessions (R.6.7) and computerized assessments (R.7.7; CRCC, 1987). Since 2002, standards related to technology and its usage within the scope of vocational rehabilitation (VR) practices have been included in the Code of Professional Ethics (Barros-Bailey & Saunders, 2010). The 2002 revision (CRCC, 2001) included Computer Technology as a subheading within Section A—The Counseling Relationship. In addition to integrating the new subheading, the Code revision included topics such as the use of computers, explanation of limitations, and access to computer applications. Furthermore, the 2002 revision included the Electronic Communication and Emerging Applications section. The revisions leading to the 2010 code included the Technology and Distance Counseling Section (J), addressing distance counseling relationships, distance counseling security and business practices, distance group counseling and teaching, supervision, and training considerations at a distance (CRCC, 2009).

The 2017 Code further refined the application of technology to the practice of Rehabilitation Counseling, including enhanced guidance on the use of social media. The introduction to Section J reminds CRCs that service provision is not strictly limited to face-to-face interactions. Furthermore, CRCs should understand the technology they use and consider legal implications and best practices. Greater detail pertaining to the 2023 updates to the Technology section follows below in “Changes to Section J and Applying the Code Changes.”

Beyond this brief historical review, it is worth noting that technology directly relates to the CRCC Scope of Practice and the professional identity of CRCs. The scope of practice notes, “Regardless of the specific tasks, work settings, or technology used, rehabilitation counselors demonstrate adherence to ethical standards and make reasonable efforts to ensure the standards are vigorously enforced” (CRCC, 2017, p. 1).

Impact of COVID-19 Pandemic

The corona virus 2019 (COVID-19) pandemic illustrated how effective virtual counseling and distance communication (e.g., email, telephone calls, and text messaging) have been in ensuring that clients receive vocational support despite the health and safety guidelines established in response to the global pandemic (U.S. Department of Veterans Affairs, 2021). Individuals with disabilities experienced barriers to medical care as the rapid adoption of virtual counseling, or virtual medical appointments attempted to abide by the social distancing regulations, creating disruptions in service access (e.g., systems challenges, communication barriers, and legislative barriers; Annaswamy et al., 2020). Dallas et al. (2022) evaluated CRC interactions with VR clients during the pandemic. They reported that many experienced difficulties or a lack of engagement with current clients due to accessibility-related concerns (e.g., limited access to the Internet, unsupported software, and no access to technology devices; Dallas et al., 2022).

Exposure to social media and social interactions is widely accepted and associated with client-level strategies to combat COVID-19-related stress and trauma (Lund et al., 2020). Prior to the COVID-19 pandemic and stay-home orders, Americans’ social media usage averaged around 30 minutes per day; however, according to a survey collected in March 2020, users spent an additional 1 to 2 hours on social media per day after the start of the pandemic (Statista Research Department, 2021). The CRCC Code of Professional Ethics, frequently referred to as “the Code,” supports the use of technology and social media (CRCC, 2017, 2023); however, CRCs are urged to be aware of the guidelines that govern use to protect the confidentiality, ensure accessibility, and explain expectations for professional online behavior (CRCC, 2021).

Virtual Counseling in VR

To stay consistent with the Code of Professional Ethics for CRCs, any form of web-based counseling, telecounseling, telemedicine, or telerehabilitation will be henceforth referred to as virtual counseling. The history of virtual counseling services starts with “Ask Uncle Ezra,” the first documented web-based service to provide mental health support to college students (Zainudin & Yusop, 2018). Prior to web-based counseling services, software-based services were developed in the 1960s, starting with “ELIZA,” a program that enabled communication with a computer (Zainudin & Yusop, 2018). Following the ability to provide counseling services via an electronic platform, the implementation of legal standards occurred in the early 2000s (e.g., Health Insurance Portability and Accountability Act [HIPAA]; Health Information Technology for Economic and Clinical Health [HITECH]) to ensure the protection of client-related health information and ensure the security of delivered services (Holmes & Reid, 2018). As varying services started surfacing and prior to legal standards, in 1996, the National Board of Certified Counselors (NBCC) developed ethical standards of practice to serve as guidance for appropriate usage (Barros-Bailey & Saunders, 2010). The use of technology as an ethical consideration was first introduced to Rehabilitation Counseling in 2002; however, it was not until 2010 that additional research presented a need for additional considerations and the implementation of virtual counseling (Barros-Bailey & Saunders, 2010).

In VR Counseling, virtual counseling has emerged to reduce access barriers for persons with disabilities and increase engagement in service delivery methods to enhance employment outcomes (Castillo & Cartwright, 2018; Embree et al., 2018). Implementing virtual counseling strategies presents an opportunity to address challenges and barriers to rehabilitation services, such as budgetary constraints or geographical location (Castillo & Cartwright, 2018; Ipsen et al., 2012). Ipsen et al. (2012) note that client and counselor engagement through virtual counseling can occur synchronously and asynchronously, increasing accessibility and service delivery methods for many individuals. Holmes and Reid (2018) present in-depth information regarding the different methods available for virtual counseling and important considerations for CRCs using such methods within their scope of practice.

Considerations for Virtual Counseling

Before engaging in virtual counseling, CRCs need to consider not only the method by which they intend to deliver services but also the laws and regulations guiding service implementation. A CRC’s familiarity with HIPAA, Privacy Rule, and Security Rules protects an individual’s personal information. It is essential for CRC’s to understand legislation and regulations as they pertain to the use of electronic health systems to maintain and store information regarding clients and client progress. In a review of ethical violations, though not prominent, violations regarding the use of technology were noted to be of continued occurrence (Hartley & Cartwright, 2015, 2016; Hill et al., in press; Tarvydas & Barros-Bailey, 2010). As CRCs, it becomes crucial to obtain consumer permission before engaging in services that rely on virtual counseling methods. The counselor’s professional responsibility is to ensure that the consumer’s privacy is protected.

Privacy

Since the introduction of technology into the counseling realm, significant considerations for practice revolve around the transfer of information across different platforms. Virtual platforms such as Zoom provide different methods for communication, such as the chat function; however, it becomes crucial to consider the privacy of this option and the use of that information once the meeting has ended. When providing virtual counseling services, CRCs must ensure that the platform they use maintains client privacy through encryption; it is noteworthy to mention that Zoom client provides this level of encryption (Zoom, 2021). Telework options for vocational CRCs present an additional challenge in maintaining privacy when smart devices such as Alexa, or Google home, in addition to other Bluetooth devices (e.g., Cortana, Siri, air pods, and vehicles), are enabled. Some professionals face difficulty knowing how to speak with their clients due to privacy and confidentiality concerns because they do not know who else is listening or do not have sufficient space to engage in services privately (Hezel et al., in press). At the same time, significant research supports the use of virtual counseling and notes little difference in outcomes (Castillo & Cartwright, 2018; Embree et al., 2018; Holmes & Reid, 2018). Additional research notes that using platforms such as Zoom limits a clinician’s ability to engage with the whole person or fully interpret nonverbal communication (e.g., handwringing, foot-tapping, and skin picking; Hezel et al., in press).

Appropriateness

Just as it is essential for CRCs to obtain consent from the individual receiving services, ensuring the appropriateness of the services presented is equally necessary. In addition to ensuring the appropriateness or feasibility of services, CRCs must attend to necessary accommodations to support an individual and their engagement with virtual services. The use of synchronous virtual counseling options reduces the number of potential barriers that an individual with a disability may face when accessing face-to-face service delivery options (e.g., time, cost, transportation, stigma, and residence location; Lin et al., 2022); however, it is also essential for counselors to ensure that virtual platforms do not create additional barriers. Rawlings et al. (2021) note that the National Institute for Health and Care Excellence encourages providers to consider how an individual will need to engage with virtual services based on functional limitations and how new barriers impact the outcome of services.

Technology Ethical Dilemmas

Certified rehabilitation counselors continue to face ethical dilemmas. Some are unavoidable, while others stem from a flawed ethical decision-making process or poor counselor judgment. Based on a review of ethical complaints and violations from Hartley and Cartwright (2015), the Technology and Distance Counseling section noted violations relevant to documentation and record-keeping. In addition, Hartley and Cartwright (2016) completed a survey to determine sections of the Code most frequently referenced as an ethical dilemma or an ethical violation. This specific study replicated the 2010 study completed by Tarvydas and Barros-Bailey, which focused on the ethical dilemmas from the 2002 Code revision, examining ethical violations from the past 5 years to inform the 2010 Code revision. Notably, only one ethical dilemma regarding technology was reported based on the 5-year review of Code violations and dilemmas (Tarvydas & Barros-Bailey, 2010), and zero dilemmas were reported based on the 2010 Code (Hartley & Cartwright, 2016). Even though ethical dilemmas did not present themselves in the section specific to Technology, additional concerns lie in areas of relationships and confidentiality. Recently, CRCs were surveyed regarding ethical dilemmas according to the 2017 Code; it is noteworthy to mention that the Technology section (Section J) was reported as an ethical dilemma by 18 of the respondents (Hill et al., in press). Compared with previous Code revisions, this is a substantial increase. In addition, the most commonly reported ethical dilemma concerned confidentiality and privacy, a significant consideration when utilizing technology to engage with consumers.

Social Media as an Outlet for Communication

As the opportunities and advancements of the world wide web continue to evolve, so too has the breadth of knowledge surrounding the risks and benefits people find in staying connected and exchanging information online. Since the Internet’s inception and presentation in the early 1980s, people have benefited from the availability of numerous resources. Originally coined the “internet society” by Cerf et al. (1992), the Internet was seen to “function as a professional society to facilitate, support, and promote evolution. . . [as well as] a global research communications infrastructure” (para. 1). The byproduct of the Internet society birthed a catalyst to connect and exchange content both personally and professionally, known as social media. Social media generates opportunities for users to share content and establish social networks that may not have been fashioned due to limited reach and accessibility (Crtalic et al., 2015). The use of social media has proven to be enticing and beneficial, as evidenced by its astronomical expansion across the past several decades, but with this comes potential risks and pitfalls that cannot be understated.

Expansion of Social Media

Recent data describe social media use (individuals who have ever used the platform) across platforms such as YouTube (81%), Facebook (69%), Instagram (40%), Twitter (23%), and LinkedIn (28%) (Pew Research Center, 2021). For example, the Pew Research Center (2021) data further reveal that 7 in 10 Americans currently use social media, with a notable increase in adult usage from 5% in 2015 to 72% in 2021. In an exploratory survey of 128 mental health professionals, including social workers, psychologists, and counselors, researchers found that 90% of respondents reported using social media for personal and/or professional purposes (Wardi-Zonna et al., 2020). Evidence also highlights that the primary reasons for establishing social media accounts include the exchange of news content, employment benefits (Leonardi et al., 2013), advocacy (Hartley et al., 2015), and the everyday purpose of entertainment (Pew Research Center, 2021).

Strengths and Benefits of Social Media

Social media presence has many potential benefits for practicing CRCs. When used appropriately, social media tools can add convenience and accessibility to marketing one’s practice, maintaining valuable connections with other professionals in the field, accessing continuing education opportunities, reaching potential clients (Raypole, 2020), and providing or receiving clinical supervision (Reamer, 2018), scheduling appointments and exchanging and accessing data (Strom-Gottfried et al., 2014). Social media networks have also increased in popularity as a tool to support job seekers and employers. Since 2018, online job boards “have accounted for a fifth of job hires worldwide” (Statista Research Department, 2022, para. 1). Having a “digital footprint” is an essential method for marketing oneself in the current job market. Surveys conducted by the Society for Human Resource Management (SHRM) indicate that most human resource professionals prefer to hire candidates who have an online presence, most notably LinkedIn, the social media platform most aligned with professional networking. About two-thirds of organizations surveyed by SHRM reported that they found new employees through social media sites in the past year (Schramm, 2016).

In addition to the individualized benefits of utilizing social platforms, the CRCC has accepted the challenge to consider the impact of digital networks on service delivery. Social media-based recruitment increases community building and heightens awareness of the benefits provided by CRCs to both persons with disabilities and stakeholders (e.g., employers, policymakers, and investors; CRCC, 2017). Crtalic et al. (2015) provided justifications for the use of social media at the professional level, including (a) the ability to conduct contact-less service provision for clients who may feel anxious about self-disclosure or (b) the expansion of opportunities for information gathering about the needs of a client from a business perspective.

Similarly, Hartley et al. (2015) highlighted that social media served as an opportunity for clients to self-advocate. This article accentuated the three-phase advocate model by Brophy et al. (1974) to teach self-advocacy across digital networks. Hartley and colleagues (2015) explained the education phase as a way for clients to connect with others who may have similar concerns and who were able to succeed despite barriers and resistance. The facilitation phase encourages independence and autonomy, and the final stage of implementation promotes action through well-crafted written statements that foster dialogue with a larger audience (Guo & Saxton, 2014). Social media provides a free and accessible platform for clients to engage and grow.

Limitations and disadvantages of social media

This significant increase in adults who use social media indicates that users find worth in virtual forms of communication. Research suggests that a limitation in using social media is the negative impact it can have on a person’s well-being and potentially triggers adverse mental health concerns (e.g., depression, anxiety, and loneliness; Srivastava et al., 2019). Additional negative impacts of social media consist of invasion of privacy, identity theft, and for more vulnerable groups, the consumption of toxic content (Scott et al., 2017). The term developed to explain this phenomenon is infodemic and explains the overwhelming mass of information that promotes false and misleading material resulting in mistrust in a sweeping fashion throughout society (Hernandez et al., 2021). Research by the Pew Research Center (2021) projects that the future of digital spaces could potentially garner problems created by misinformation, disinformation, and toxic discourse. Furthermore, the increasing prevalence of social media results in a blurring of public and private personas, often leading to profoundly challenging ethical questions for counseling professionals. Even without direct engagement with clients, counseling professionals may struggle with concerns about social media usage, leading to increased concerns with boundary crossing and intentional or unintentional self-disclosure, potentially harming the counseling relationship (Wardi-Zonna et al., 2020).

A troubling phenomenon known as “online disinhibition” occurs when social media users are prone to more frequent and less restrained personal disclosure when using online platforms compared with face-to-face interactions (Casale et al., 2015). As CRCs, we are confronted with questions about defining our “private lives” and how events in our personal lives inevitably impact our work. Herein lies the risk that the sometimes-overwhelming availability and quantity of such information may place counseling professionals at greater risk of confusing personal value judgments with assessments of professional competence (Behnk, 2008). It is the responsibility of the CRC who has selected to infuse social media as a tool of communication to express to the client the potential implications through informed consent.

Evolution of Social Media Across CRCC Policies and Code of Professional Ethics

The social media policy developed by CRCC is a separate document from the Code of Professional Ethics and serves as a model of engagement that is legal and directive. The social media policy encourages professionals to abide by the conduct measures and the terms of any third-party site. The policy includes a preamble that strategically outlines the interaction of practices of rehabilitation professionals and provides a detailed code of conduct to enhance awareness of appropriate social media use in the profession (CRCC, 2021).

Social media as an ethical responsibility first made its explicit appearance in the 2017 version of the CRCC Code of Professional Ethics for Rehabilitation Counselors under Section J: Technology, Social Media, and Distance Counseling. Before considering social media across “the Code,” social media was not initially mentioned; however, CRCs were expected to self-reflect on ways digital interactions might impact the counseling relationships. For example, regarding privacy, counselors were expected to consider respect for client rights, confidentiality, and privacy across all facets of interactions regardless of the explicit mention of social media. Crtalic et al. (2015) suggested that future versions of the Code provide more perspicuous instructions on ethical social media usage by offering an example of how to frame the section of the Code focused on social media.

The inspiration to add more intentional dialogues led to the addition of social media in Section J.4 of the 2017 Code of Professional Ethics. Critical components of this new section included (a) professional electronic presence, (b) monitoring social media, (c) social media and informed consent, (d) privacy in informed consent, and (e) maintaining confidentiality in social media. As the intricacies of social media continue to advance, the guidance provided to CRCs must also advance in order to support their ethical practice. Hence, the new 2023 Code of Professional Ethics for CRCs will further illuminate guidelines for practice that are relevant and appropriate as social media tools emerge.

Recommended Use of Social Media

Reviewers of this section of the Code considered how the changes to social media introduced across new platforms, language, and threats might impact the counseling relationship. An overview of technological advancements led to the additional wording specific to appropriate boundaries, informed consent related to “friending” on social media, and confidentiality. In applying these guidelines to professional practices, CRCs should consider how social media might strengthen or hinder connections with clients and the community. Furthermore, counselors must consider social media’s advantages and disadvantages when serving clients with varying disabilities, cultural backgrounds, and needs.

Commission on Rehabilitation Counselor Certification recommends that CRCs who utilize social media clearly distinguish between their personal and professional pages (CRCC, 2023). A professional social media account can share helpful information about one’s practice, areas of expertise, and referral processes in clean and professional language while allowing a counselor to maintain a private, personal account for connecting with friends and family. It is a generally accepted best practice to keep strict privacy settings on personal social media pages to maintain appropriate boundaries (Raypole, 2020). CRCC recommends against accepting friend or follow requests from current or former clients. Such connections can result in sensitive personal information being inadvertently shared between counselor and client (or vice versa), negatively impacting the therapeutic relationship and causing ethical quandaries (CRCC, 2023). Developing and sharing a social media policy during an initial session with clients can help set expectations and establish boundaries regarding social media connections (Raypole, 2020).

Changes to Section J

The first change to note is that Section J has become Section K. The notable updates and changes to this section provide clarification and guidance for CRCs on the appropriate use of technology, virtual counseling, and social media in their rehabilitation counseling practice.

K.1. Competence and Legal Considerations

As stated in the 2017 version of the Code, CRCs are expected to be competent in the various technology used within the rehabilitation counseling practice. If CRCs lack skills or competence in using any technology, they should seek training and consultation to become competent in technology-assisted services. When using virtual counseling modalities such as videoconferencing for service delivery, CRCs need to consider if that modality is most appropriate for the client and their situation and adjust modalities as needed. Certified rehabilitation counselors should also be aware of federal, state, and local laws and limitations regarding rehabilitation counseling service provision across state lines and ensure they follow the appropriate regulations. Additional considerations for practicing CRCs include ensuring that clients are aware of the rules and regulations and the limitations of practice across state lines.

K.2. Accessibility

When using technology or technology-assisted services, CRCs are ethically obligated to ensure client accessibility regarding appropriate and needed technology. Certified rehabilitation counselors should educate clients on the appropriate use of the technology when needed and as appropriate. They also must ensure that the technology, applications, or technology-assisted services are accessible and appropriate for the client, given their unique needs, ability level, and experience with technology.

K.3. Confidentiality and Disclosure

Regarding transmitting or communicating confidential information to clients or other parties, it is necessary to inform clients about the risks and limitations of certain technologies. For example, confidentiality is not a guarantee when using communication methods such as text messaging or email, and clients should be cautious when communicating confidential information using these technologies. When storing or transmitting confidential information, CRCs should ensure the use of encryption and password-protection techniques to protect information. When using technology-assisted services such as video or telephone counseling, CRCs should discuss the limitations of voice-activated technologies (e.g., Siri, Alexa, and Google Assistant) in the client’s homes and how these devices can impact the security and confidentiality of sessions.

K.4. Social Media

The use of social media as a source of information has increased in recent years. Many people also use social media to connect with others. For CRCs choosing to use social media both personally and professionally, the Code directs the use of separate profiles to distinguish between professional and personal virtual presence. Information provided by a professional account should be accurate, honest, and relevant to the profession. When using a professional account or page, CRCs should include a disclaimer about the purposes and limitations of the page. Certified rehabilitation counselors should not accept either a friend or a follow request from current clients and should include a statement regarding the nonacceptance of these requests on personal social media accounts as part of the informed consent process. After termination of a rehabilitation counseling relationship, CRCs must determine for themselves if they will or will not accept a friend or a follow request from former clients. When using social media or websites to advertise services or provide information about rehabilitation counseling, images and personal information about clients should not be shared without written consent from the client or the parent/guardian of a client.

K.5. Virtual Counseling

During the COVID-19 pandemic, many agencies and CRCs increased their use of virtual counseling services, and many are still providing these types of services postpandemic. To ensure ethical virtual counseling practices, CRCs need an increased awareness of the legal rights and limitations governing virtual counseling services within their state and across state lines. When providing distance counseling or virtual rehabilitation services, CRCs understand they may be subject to laws and regulations of both the counselor’s practicing location and the client’s place of residence. When using teleconferencing platforms, CRCs ensure such platforms are appropriately HIPAA compliant and meet agency/organization, local, state, and federal regulations. At the beginning of a course of virtual counseling, CRCs develop a procedure to follow in the event of an emergency, which includes acquiring contact information for local emergency services and a personal emergency contact in the client’s physical location.

Applying the Code Changes

Due to the ever-changing landscape of technology and social media, it can feel overwhelming to become competent in the various platforms and uses. However, CRCs have a duty and an ethical obligation to obtain and maintain competency in technology, social media, and distance counseling. There are both risks and benefits to using these modalities and platforms, and guidance for their appropriate use can be found in the most recent Section titled “Resolving Ethical Issues” of the revised Code (CRCC, 2023).

Certain technologies, such as virtual counseling platforms, can make access to rehabilitation counseling services more manageable for consumers with specific disabilities that may make travel to an office more difficult. They can also allow consumers that live in rural areas to avoid long travel times to get to an office. However, consumers must have access to a smartphone or a computer with a webcam and reliable Internet access to access virtual counseling platforms, which may not be possible for all consumers. Benefits and risks such as these are examples of why the guidance from the revised Code recommends that CRCs weigh the pros and cons of using virtual counseling methods with clients, use HIPAA compliant technology, and ensure that consumers are capable of using the technology required.

The use of social media also has benefits and risks regarding its use in rehabilitation counseling practice. Certified rehabilitation counselors could consider using social media to advertise the benefits of rehabilitation counseling services and inform the public about options available for people with disabilities who are seeking employment. When using social media for professional purposes, posts should be related only to providing information in a general sense and not to answer specific questions related to an individual consumer. The Code states that CRCs should not accept friend or connection requests from current clients on the counselor’s personal page or account. It may be beneficial to provide this information to clients as part of the informed consent process with clients. Certified rehabilitation counselors should use reasonable judgment when accepting friend or connection requests from former clients.

Conclusion

The new 2023 revisions to the Code of Ethics, specifically the revisions made to the section on Technology, aim to ensure that CRCs are informed of proper practices when supporting clients through the use of technology. Using virtual platforms or technology to communicate with clients or other service providers is not a new feat; however, it becomes crucial for CRCs to remain vigilant to ensure the safety and privacy of their clients and their clients’ information. The COVID-19 pandemic heightened awareness for the field of rehabilitation counseling regarding the use of technology and technology services (e.g., videoconferencing) as an effective method to deliver services and communicate with clients. Certified rehabilitation counselors demonstrated flexibility throughout the COVID-19 pandemic as many offices shifted from in-person services to virtual ones. Overall, changes in the 2023 Code address concerns related to the use of social media, security and privacy concerns when using technology, and issues related to virtual counseling as a mechanism to support CRCs and their provision of ethical and technological services to clients.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Julie C. Hill

References

Annaswamy

T. M.

Verduzco-Gutierrez

Frieden

(2020). Telemedicine barriers and challenges for persons with disabilities: COVID-19 and beyond. Disability and Health Journal, 13, 100973. https://doi.org/10.1016/j.dhjo.2020.100973

Barros-Bailey

Saunders

J. L.

(2010). Ethics and the use of technology in rehabilitation counseling. The Rehabilitation Counseling Bulletin, 53(4), 255–259. https://doi.org/10.1177/0034355210368867

Behnk

(2008). Ethics in the age of the Internet. https://www.apa.org/monitor/2008/07-08/ethics

Brophy

M. C.

Chan

Mar

B. M.

(1974). The advocate counseling model. In Samore

(Ed.), Progress in urban librarianship (pp. 40–48). Schools of Library.

Casale

Fiovaranti

Caplan

(2015). Online disinhibition: Precursors and outcomes. Journal of Media Psychology, 27(4), 170–177. https://doi.org/10.1027/1864-1105/a000136

Castillo

Y. A.

Cartwright

(2018). Telerehabilitation in rural areas: A qualitative investigation of pre-service rehabilitation professionals’ perspectives. Journal of Applied Rehabilitation Counseling, 49(2), 6–13. https://doi.org/10.1891/0047-2220.49.2.6

Cerf

Kahn

Chapin

(1992). Announcing the internet society. Internet Society. https://www.internetsociety.org/internet/history-of-the-internet/announcing-internet-society/

Commission on Rehabilitation Counselor Certification. (1987). Code of ethics for professional rehabilitation counselors. Author.

Commission on Rehabilitation Counselor Certification. (2001). Code of professional ethics for rehabilitation counselors. Author.

10.

Commission on Rehabilitation Counselor Certification. (2009). Code of professional ethics for rehabilitation counselors. Author.

11.

Commission on Rehabilitation Counselor Certification. (2017). Code of professional ethics for rehabilitation counselors. https://crccertification.com/wp-content/uploads/2021/03/CRC_CodeEthics_Eff2017-FinaLnewdiesign.pdf

12.

Commission on Rehabilitation Counselor Certification. (2021). Social media policy. https://crccertification.com/social-media-policy/

13.

Commission on Rehabilitation Counselor Certification. (2023). Code of professional ethics for rehabilitation counselors. Author.

14.

Crtalic

A. K.

Gibbs

R. L.

Sprong

M. E.

Dell

T. F.

(2015). Boundaries with social media: Ethical considerations for rehabilitation professionals. Journal of Applied Rehabilitation Counseling, 46(3), 44–50. https://doi.org/10.1891/0047-2220.46.3.44

15.

Dallas

Aquino

Scott

(2022). Vocational rehabilitation counselor’s perceptions on the impact of COVID-19: Transition to remote services and support needs of VR clients. Journal of Rehabilitation, 88(2), 4–10.

16.

Embree

J. A.

Huber

J. M.

Kapp

V. A.

Wilson

J. F.

(2018). Utilizing telerehabilitation to deliver rehabilitation services remotely as an alternative to traditional counseling. Journal of Applied Rehabilitation Counseling, 49(2), 40–47.

17.

Guo

Saxton

G. D.

(2014). Tweeting social change: How social media are changing nonprofit advocacy. Nonprofit and Voluntary Sector Quarterly, 43(1), 57–79. https://doi.org/10.1177/0899764012471585

18.

Hartley

M. T.

Cartwright

B. Y.

(2015). Analysis of the reported ethical complaints and violations to the commission on rehabilitation counselor certification, 2006-2013. Rehabilitation Counseling Bulletin, 58(3), 154–164. https://doi.org/10.1177/0034355214543565

19.

Hartley

M. T.

Cartwright

B. Y.

(2016). A survey of current and projected ethical dilemmas of rehabilitation counselors. Rehabilitation Research, Policy, and Education, 30(1), 32–47. https://doi.org/10.1891/2168-6653.30.1.32

20.

Hartley

M. T.

Tarvydas

V. M.

Johnston

S. P.

(2015). The ethics and practice of social media advocacy in rehabilitation counseling. The Journal of Rehabilitation, 81(1), 42–51.

21.

Hernandez

R. G.

Hagen

Walker

O’Leary

Lengacher

(2021). The COVID-19 vaccine social media infodemic: Healthcare providers’ missed dose in addressing misinformation and vaccine hesitancy. Human Vaccines & Immunotherapeutics, 17(9), 2962–2964. https://doi.org/10.1080/21645515.2021.1912551

22.

Hezel

D. M.

Rapp

A. M.

Glasgow

Cridland

Simpson

H. B.

(in press). Year of zoom in a year of doom: Lessons learned delivering ERP remotely during the COVID-19 pandemic. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2021.12.005

23.

Hill

J. C.

Harrell

L. S.

Froehlich

R. J.

Emmanuel

Hicks

(in press). Ethical dilemmas: Current and projected concerns reported by certified rehabilitation counselors. Rehabilitation Counseling Bulletin.

24.

Holmes

C. M.

Reid

C. A.

(2018). Ethics in telerehabilitation: Looking ahead. Journal of Applied Rehabilitation Counseling, 49(2), 14–23.

25.

Ipsen

Rigles

Arnold

Seekins

(2012). Access to, use of, and attitudes toward telecommunication among rural VR clients. Rehabilitation Counseling Bulletin, 55(3), 172–181. https://doi.org/10.1177/0034355212466270

26.

Leonardi

P. M.

Huysman

Steinfield

(2013). Enterprise social media: Definition, history, and prospects for the study of social technologies in organizations. Journal of Computer-Mediated Communication, Volume, 19(1), 1–19. https://doi.org/10.1111/jcc4.12029

27.

Lin

Heckman

T. G.

Anderson

(2022). The efficacy of synchronous teletherapy versus in-person therapy: A meta-analysis of randomized clinical trials. Clinical Psychology: Science and Practice, 29(2), 167–178. https://doi.org/10.1037/cps0000056

28.

Lund

E. M.

Forber-Pratt

Wilson

Mona

L. R.

(2020). The COVID-19 pandemic, stress, and trauma in the disability community: A call to action. Rehabilitation Psychology, 65(4), 313–322. https://doi.org.ezaccess.libraries.psu.edu/10.1037/rep0000368

29.

Obermann

C. E.

(1973). A code of ethics for rehabilitation counselors. Journal of Applied Rehabilitation Counseling, 3(4), 213–217.

30.

Pew Research Center. (2021). Social media fact sheet. https://www.pewresearch.org/internet/fact-sheet/social-media/?menuItem=81867c91-92ad-45b8-a964-a2a894f873ef

31.

Rawlings

G. H.

Gaskell

Rolling

Beail

(2021). Exploring how to deliver videoconference-mediated psychological therapy to adults with an intellectual disability during the coronavirus pandemic. Advances in Mental Health and Intellectual Disabilities, 15(1), 20–32. https://doi.org/10.1108/amhid-06-2020-0014

32.

Raypole

(2020). A therapist’s guide to ethical social media use. https://www.goodtherapy.org/for-professionals/marketing/digital-marketing/article/therapists-guide-ethical-social-media-use

33.

Reamer

F. G.

(2018). Ethical standards for social workers’ use of technology: Emerging consensus. Journal of Social Work Values & Ethics, 15(2), 71–80.

34.

Schramm

(2016). Job seekers need to be on social media. https://www.shrm.org/hr-today/news/hr-magazine/pages/0116-hr-social-media.aspx

35.

Scott

D. A.

Valley

Simecka

B. A.

(2017). Mental health concerns in the digital age. International Journal of Mental Health Addiction, 15, 604–613. https://doi.org/10.1007/s11469-016-9684-0

36.

Srivastava

Chaudhury

Prakash

Dhamija

(2019). Social media and mental health challenges. Industrial Psychiatry Journal, 28(2), 155–159. https://doi.org/10.4103/ipj.ipj_154_20

37.

Statista Research Department. (2021). Increased time spent on social media by U.S. users during COVID-19 pandemic 2020. https://www.statista.com/statistics/1116148/more-time-spent-social-media-platforms-users-usa-coronavirus/#statisticContainer

38.

Statista Research Department. (2022). Online and social media recruiting —statistics and facts. https://www.statista.com/topics/2727/online-recruiting/#topicHeader__wrapper

39.

Strom-Gottfried

Thomas

M. S.

Anderson

(2014). Social work and social media: Reconciling ethical standards and emerging technologies. Journal of Social Work Values & Ethics, 11(1), 54–66.

40.

Tarvydas

V. M.

Barros-Bailey

(2010). Ethical dilemmas of rehabilitation counselors. Rehabilitation Counseling Bulletin, 53, 204–212. https://dx-doi-org.web.bisu.edu.cn/10.1177/0034355210368566

41.

U.S. Department of Veterans Affairs. (2021, September). VA tele-counseling fact sheet-veterans affairs, veterans administration benefits. https://benefits.va.gov/BENEFITS/factsheets/vocrehab/VRE_Telecounseling.pdf

42.

Wardi-Zonna

Hardy

J. L.

Sanders

E. M.

Hardy

R. M.

(2020). Mental health professionals and the use of social media: Navigating ethical challenges. Journal of Social Work Values and Ethics, 17(2), 68–77.

43.

Zainudin

Z. N.

Yusop

Y. M.

(2018). Cyber-counseling: Is it really new? International Research Journal of Education and Sciences, 2(2), 19–24.

44.

Zoom. (2021). Zoom encryption. https://explore.zoom.us/docs/doc/Zoom%20Encryption%20Whitepaper.pdf