Calif. But when they were asked to list what kind of diagnoses were being made, most were fairly serious. As of yet, very few complaints about online providers have been made with state attorneys general and none has resulted in convictions or enforcement actions, said Gerry Koocher, an associate professor at Harvard University's Medical School. In a survey of 42 state attorneys general due to be published in the APA journal in October, Koocher found only seven states have received complaints against therapists using electronic means to carry out counseling. The only conviction involved telephone counseling, not the Internet. Every state has different standards for what therapists are legally obligated to tell the authorities.
Most states require that child and elder abuse be reported, but beyond that, standards vary.
In California, for instance, therapists must tell the police when a client threatens any third party. The Florida Supreme Court has ruled the opposite. If an online therapist is sued for malpractice, it's unclear if professional liability insurers will pay up. Professional liability policies usually exclude coverage for illegal acts committed by the practitioner. Some say the only way to address legal problems is to license therapists nationally.