Since March 2020, COVID-19 has spread throughout the world, causing an ongoing global health pandemic. In-person healthcare services, including mental health, have been limited, leading to the rise in popularity for telehealth services. The American Psychological Association (APA, 2013, Definition of Telepsychology para 1) defines telehealth as the “preparation, transmission, communication or related processing of information by electrical, electromagnetic, electromechanical, electro-optical or electronic means. As the initial impact of COVID-19 begins to dissipate and in-person services resume, psychologists must determine the impact of in-person services versus telehealth, with regard to mental health recourse and the quality of services (i.e., information gathering; Carroll, 2020). This decision is perhaps even more critical when working with special populations, as is the case for clients seeking forensic assessment services, due to the complexity of alleged offenses of their clientele and the scrutiny psychologists face when justifying their findings (Carroll, 2020).

When considering administration of assessments via telehealth, there are several provisions in the Ethical Principles of Psychologists and Code of Conduct (APA, 2017) that are pertinent to the process. General principles address the following: do no harm (Principle A: Beneficence and Nonmaleficence), professional responsibilities (Principle B: Fidelity and Responsibility), promoting accuracy and honest practices (Principle C: Integrity), fairness and justice in access and benefits (Principle D: Justice), and respecting the dignity and worth of all people (Principle E: Respect for People’s Rights and Dignity). Given that “forensic evaluation reports are heavily contested or subjected to intense cross-examinations” (Adjorlolo & Chan, 2015, p. 4), it is imperative that psychologists prioritize beneficence, fidelity, integrity, justice, and respect for people’s rights and dignity when choosing to conduct virtual forensic assessments.

With these principles in mind, we continue to explore ethical guidelines and literature particular to assessments. The first standard (9.01, Bases for Assessment) states that psychologists should “base the opinions, contained in their recommendations, reports and diagnostic or evaluative statements including forensic testimony, on information and techniques sufficient to substantiate their findings.” The standard continues by stating that, if a psychologist is unable to substantiate their findings, they should “document the efforts they made and the results of those efforts, clarify the probable impact of their limited information…and appropriately limit the nature and extent of their conclusions or recommendations.” According to Adjorlolo and Chan (2015, p.14), “the report should explicitly state whether, in the opinion of the evaluator, the use of the virtual conference medium negatively influenced the result obtained, especially the reports produced for court utility.” Further, psychologists should have a clear rationale for the selection of telehealth services and the chosen assessments they administer based on “established scientific and professional knowledge of the discipline” (Standard 2.04: Bases for Scientific and Professional Judgements). Because of the lack of research examining the effectiveness of virtual assessment for forensic purposes (Adjorlolo & Chan, 2015), psychologists must consider all relevant ethical codes when determining their forensic assessment modality.

The second standard (9.02, Use of Assessments) states that psychologists should “administer, adapt, score, interpret, or use assessment techniques, interviews, tests or instruments in a manner and for purposes that are appropriate.” In addition, the standard continues by stating that “psychologists describe the strengths and limitations of test results and interpretation.” For example, psychologists should be mindful of the differences that in-person versus telehealth-based assessments provide (i.e., cost, convenience, comfort, privacy and confidentiality; Adjorlolo & Chan, 2015; Carroll, 2020). Telehealth assessments may improve access to services; however, the quality of nonverbal assessment regarding eye contact, use of senses, motor movement, and micro-expressions may be compromised or removed entirely (Carroll, 2020).

Finally, Standard 9.06, Interpreting Assessment Results states that a psychologist should “take into account the purpose of the assessment as well as the various test factors, test-taking abilities, and other characteristics…such as situational, personal, linguistic and cultural differences.” For example, modifications a psychologist takes while conducting telehealth services should be addressed in any documentation or results. This includes the topics of accuracy, validity and the reliability of the assessments used (Adjorlolo & Chan, 2015).

In conclusion, it is important that forensic psychologists consider the assessments they provide, the setting in which assessments are administered, and the ability of the psychologist to interpret the assessment data in response to the referral question. Forensic psychologists should be mindful of the population with whom they are working and the cost and access to resources for both in-person and telehealth-based assessment. In addition, psychologists should not only maintain competence for the assessments being used but also for the modality in which assessments are being given. Maintaining these areas of competence is the “best practice standard required for assessments” when complicated and complex challenges may arise with the use of telehealth (Adjorlolo, 2015, p. 185). 

References

Adjorlolo, S., & Chan, H. C. (2015). Forensic assessment via videoconferencing: Issues and practice considerations. Journal of Forensic Psychology Practice, 15(3), 185-204. https://doi.org/10.1080/15228932.2015.1015363