Using technology-assisted clinical tools

“Implement technology-assisted clinical tools (e.g., online therapy platform, AI note takers, virtual reality tools, calming apps, wearable devices to monitor heart rate and breathing)” (NBCC, 2027 task 6.11)

Counselors now use many technologies alongside sessions: online platforms, AI note takers, virtual reality, calming and tracking apps, and wearables that monitor heart rate or breathing. These tools can extend care, but they raise questions of evidence, privacy, consent and competence. The exam tests responsible adoption.

Key points

Choose tools with a clear clinical purpose and, where available, evidence of effectiveness; for example, virtual reality is used to deliver some exposure therapies.
Obtain informed consent that explains what the tool does, what data it collects, where data go and the risks.
Many consumer apps and wearables are not covered by HIPAA; data shared with them may be used or sold under the company's terms. Help clients understand this.
Tools that handle protected health information on the counselor's behalf need HIPAA safeguards, including a business associate agreement.
Gain competence in the tool before using it with clients (ACA Section H addresses technology competence).
Consider accessibility and equity: not every client has a smartphone, broadband or comfort with technology.
Technology supports clinical judgment; it does not replace assessment or the therapeutic relationship.

In practice

A counselor suggests a client with panic disorder try a breathing app between sessions. She reviews the app's privacy policy first, tells the client that the app company is not bound by HIPAA, and lets him choose whether to use it.

A clinic adds virtual reality exposure for clients with fear of flying. Counselors complete training, add a VR consent section explaining side effects such as motion sickness, and track outcomes.

Check yourself

Are consumer wellness apps generally covered by HIPAA?

Often not, because HIPAA applies to covered entities and their business associates rather than most consumer app companies.

What should a counselor do before using a new technology tool with clients?

Gain competence in it, review its privacy and evidence, and obtain the client's informed consent.

Why consider equity when recommending technology tools?

Not all clients have access to devices, internet or technology skills, so tools may widen gaps.

NBCC's knowledge and skills for Domain 6

Knowledge of: State laws (state licensure law, supervision requirements, abuse reporting, license renewal, CAQH); Federal laws (e.g., HIPAA, FERPA, immigration policy, HI-TECH, ADA, NPI); Codes of ethics; Third-party reimbursement, insurance and billing (e.g., CPT codes); Counseling Compact; Emerging technologies in Counseling; Crisis policies and procedures; Recording keeping and reporting requirements and procedures; Appropriate logistics for telemental health services; Scope of practice (e.g., letters of support, working with special populations); Alternative medical-assisted/pharmacological interventions; Accessing state licensure board; Executing voluntary and involuntary commitments.

Skill in: Maintaining confidentiality; Discerning reputable training providers and programs; Troubleshooting technological difficulties during telemental health session (e.g., session disconnects, video not working); Billing and third-party reimbursement.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.