Virtual Service Delivery in Response to COVID-19 Disruptions

Many communities are experiencing school closures (with no instruction provided) or suspension of school attendance with efforts to provide instruction through alternative formats. As schools take these steps for extended periods in order to protect community health, school psychologists may be asked to engage in virtual service delivery on a short-term basis. For those who plan to deliver services remotely, NASP has a guidance document on telehealth that should be helpful (https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-psychology). This document outlines considerations with respect to technology, record keeping, privacy, and validity of measures.

However, the current situation presents some additional challenges because professionals may be asked to engage in virtual service delivery in an emergency context, not a planful one. There will not be a “one size fits all” response to the various situations practitioners face. There is a great deal of uncertainty and anxiety regarding what is best practice in these circumstances.

As you receive directives from your supervisors, it may be helpful to examine requests for providing services remotely through an ethical lens.

  • Consider your competence and the best interests of students. Clearly, individual practitioners need to consider the limits of their own competence in deciding whether they can ethically provide services remotely and the nature of the services they can provide in this format (Standard II: Professional Competence and Responsibility). Practitioners must also consider the best interests of the children they serve (Principle IV.1: Promoting Healthy School, Family, and Community Environments), which includes not abandoning clients in times of need. There are many considerations in assuring that students’ best interests are served when working remotely. For example:
  • If evaluations are to be conducted remotely, they should be conducted through platforms specifically designed for that purpose.
  • Consider that even assessment measures that are designed to be delivered using technology most often also involve human support for the student’s use of technology. Practitioners must consider their own training needs and the need to develop clear procedures for service delivery in this manner. Training will also be needed for the adult who is assisting the student at home. It is unlikely that appropriate supports can be developed quickly.
  • Potential validity issues must be addressed when assessments are taking place in a time of anxiety for youth, their families and caregivers, and school personnel.
  • Practitioners may need to renegotiate confidentiality agreements to manage the limited privacy students may have at home.
  • Practitioners need to set clear limits on when they are and are not available for consultation or counseling. Arrangements must be made for back-up communication when individual providers are unavailable. Emergency response plans need to be in place if students threaten harm to self or others.
  • Ensure all students have equitable access to mental health and other school psychological services provided remotely. When plans are being made or directives are received, it is important to ask how all students will receive services. For example, students with disabilities, students who are from low-income economically marginalized communities, students in rural areas, and students in unstable home environments may have different needs and different opportunities to access services. School psychologists should work with school and district administrators to ensure that continued service delivery is available to all students who need it. This may require creative problem solving to ensure that students who do not have access to a computer, other technology-related devices, and/or internet are able to access telehealth services in the event of a prolonged school closure (Principle 1.3, 1.3.1., Fairness and Justice).
  • Consider the relationship between ethics and law. School psychologists will need to know and understand the regulatory and legal limits placed on their practice by their credentialing bodies (Principle IV.2. Respect for Law and the Relationship of Law and Ethics). Consult with your state department of education and, perhaps, your state psychology board to ensure that you are practicing within the limits of your credentials.
  • Continue to monitor guidance from your district, state, and the U.S. Department of Education related to service delivery requirements during extended school closings. NASP cannot provide legal guidance related to IDEA compliance and ensuring the implementation of students’ IEPs during COVID-19 related school closures. School psychologists should monitor and follow guidance from the U.S. Department of Education, as well as state educational agencies (SEAs) and local educational agencies (LEAs). Direct questions about specific cases to your supervisor or the appropriate district-level administrator.
  • Engage in a problem-solving process to determine the best course of action in individual cases. Consider the problem-solving model presented in Armistead, Williams, and Jacob (2011) as a model. It includes seven steps:
  1. Describe the problem situation.
  2. Define the potential ethical–legal issues involved.
  3. Consult available ethical and legal guidelines.
  4. Confer with supervisors and colleagues.
  5. Evaluate the rights, responsibilities, and welfare of all affected parties.
  6. Consider alternative solutions and the likely consequences of each.
  7. Elect a course of action and assume responsibility for this decision.

Our guidance is limited at this point while we await additional information from the U.S. Department of Education regarding service delivery, timelines, and other special education related issues during extended school closings. We will disseminate this information when it is received. In addition, we have created a companion document to this one (Telehealth: Virtual Service Delivery Updated Recommendations) that expands on some of the points made here.

In the meantime, please keep in close touch with your state department of education and your LEAs for additional guidance. Coordination between the local school district, other service providers, and available technology will be critical. In addition, some practitioners may find the following documents of use (although none are directed specifically at school psychology practice). 

From the Department of Health and Human Services

From the Department of Education

From the American Psychological Association

From the American School Counselors Association

From the American Public Health Association

From the National Register of Health Service Psychologists

Reference

Armistead, L., Williams, B. B., & Jacob, S. (2011). Professional ethics for school psychologists: A problem-solving model casebook (2nd ed.). National Association of School Psychologists.

 

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COVID-19: Virtual Service Delivery

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