This could also mean that less time would be spent on trust issues and side-tracking, denial, deflection, and so on, resulting in further cost reductions for both patients and providers. State regulatory agencies and professional organizations are struggling to agree on standard ethical and practice guidelines. Nonetheless, progress has been made. The American Counseling Association, the American Psychological Association and the National Board of Certified Counsellors have each released codes of ethical conduct for e-therapy that emphasize various concerns. Internet communications are not secure unless additional provisions are made by the psychiatrist and patient.
Technical solutions are available to allay most confidentiality concerns, however.
Such Web sites utilize data security and encryption measures to protect confidentiality. Encryption of regular e-mail is also available through formats such as PGP software, provided that both patients and providers enable their computers. PGP and other encryption software are readily available to the public at a reasonable cost. Generally speaking, state licenses restrict providers to practice within a state, but patients on the Internet can reside anywhere. This is an unsettled area, so it is smart to take a conservative approach until further guidelines are developed.