Transitioning to Teleservice Toolkit

Module 3: Maximize Safety by Minimizing Risks

Utilizing/Adapting Safety Best Practices for the Teleservice Environment

1. Understand your agency’s teleservice policies and procedures for crisis situations and/or victim safety and security.

Teleservice policies and procedures around crises situations often depend on your local circumstances, community capacity, and available resources. However, some information you will want to know includes:

  • How does your agency define a virtual “emergency” or “crisis” and who is responsible for responding to it in a teleservice format?
  • How are VSP’s at your agency trained to assist with de-escalation techniques or safety planning through teleservice?
  • Does a supervisor need to observe or participate in the interaction? Are there mechanisms to include supervisors in the interaction (e.g., multi-user function of a platform)?
  • Does your agency have a phone tree for supervisors in the event of an emergency?
  • Does the agency have partnerships or collaborations with local providers to assist in emergencies or crisis situations? Do these partners serve victims in the jurisdiction that you work in?
  • Are there any restrictions on information that can be shared with other agencies or resources in the event of an emergency?

Taking time to answer these questions with a supervisor or agency lead can help you feel more prepared to protect victims’ safety with the knowledge of your agency’s expected procedures when providing services remotely.

If your agency has not yet established policies or procedures for teleservice delivery and crisis management, please refer to Module 4 of this Toolkit for examples of related policies.

2. Know the range of potential responses to emergencies in the local jurisdiction where your victim is located , which may be different from your physical location.

When delivering services to victims remotely, VSP’s can rely on both local and national resources to ensure their safety. It is important to be aware of potential resources before interacting with victims through teleservice, so these resources can be discussed and shared when needed. Examples of these resources include:

  1. 988 Suicide and Crisis Lifeline: This service is available to all 50 US States and Puerto Rico, 24 hours a day, 7 days a week, 365 days a year. It can be used by both victims and VSP’s to assess safety by calling or texting 988 or using their chat feature at 988lifeline.org. This resource is currently available in English, Spanish, and includes options for Deaf and Hard of Hearing (HOH)
  2. Law enforcement social work or behavioral health teams: Some areas may have social work or behavioral health teams embedded within law enforcement. Work with your local law enforcement teams to assess victim safety and behavioral health needs. These teams can help secure locations and provide additional supports for victims that may be fearful or distrusting of uniformed law enforcement personnel.
  3. Community-based victim or survivor advocates: Non-profit and community organizations may also employ advocates that can assist in urgent situations. Often, these advocates are a part of the community they serve and are trusted individuals. Advocates can leverage this to ensure victim safety during crisis situations.
  4. State Coalitions – DV, SA, general CV resources

3. Have a clear agenda for the initial meeting that will allow you to discuss victim’s personal safety and security during future sessions.

It is important to assess early on, and often, victim’s personal safety and security when using virtual platforms. For example, victims that live with or in close proximity to their abuser could pose a dangerous situation. In other situations, sexual assault survivors may try to safeguard their privacy, not wanting others, even those closest to them, to know they were assaulted. In both instances, having a clear agenda and collaborative discussions can help understand a victim’s personal safety and security risks during teleservices.

Try using our downloadable template ("Pre-session Checklist") to help prepare for your initial meeting.

4. Discussing & documenting informed consent for Teleservice:

  • Informed consent is an important process for any type of services provided to victims. This allows for the VSP and the victim to be on the same page about what services will be provided, how confidentiality will be established, and to set a clear understanding of the agency and victim responsibilities in this relationship.
  • It is also important to highlight the areas of consent that may be different for services provided remotely. Some of these areas include:
    • At times, other individuals may be present to operate or troubleshoot teleservice equipment (e.g., IT Consultants); however, VSP will take reasonable steps to continue to maintain confidentiality.
    • There may be risks or challenges associated with technology, including (but not limited):
      • Video connection may stop working during the encounter
      • The video connection or information transmitted may not be clear enough to be useful for the encounter
      • I may be asked to switch to in-person services, as possible, if issues persist.
      • Services may result in data usage or other charges to clients depending on their coverage.
      • Privacy of patient location cannot be guaranteed by the agency.
  • Informed Consent for teleservices: Signing electronically (Demo)
  • Informed Consent for teleservices: Reviewing verbally and sending via mail (Demo)

Review the difference between privacy and confidentiality

  • VSPs should discuss the difference between privacy and confidentiality with victims, including what the limits are for confidentiality at that agency.
  • Common limits to confidentiality:
    • Suspicion of child abuse or abuse of a vulnerable adult (each state may have specific statutes related to this)
    • A credible threat to harm oneself
    • A credible threat to harm someone else
  • VSPs should also describe whether their agency has a systems-based approach to confidentiality
    • If the agency works within a law enforcement system, will other advocates and law enforcement personnel have access to victim’ information?
    • Does the agency have a supervision model that allows for more than one supervisor or team member to have access to victim information?
    • Does the agency use a tracking system that can be accessed by multiple people (e.g. VAMS, EHR)
  • As VSPs, there is a code of ethics that provides guidance on privacy and confidentiality in practice from the National Advocacy Credentialing Program (NACP) Code of Ethics.
  • (Demo) Modeling conversation about privacy vs. confidentiality

Privacy is the control over the extent, timing, and circumstances of sharing oneself with others.
Privacy is:
  • About people
  • A sense of being in control of access that others have to ourselves
  • A right to be protected
  • Is in the eye of the participant

Confidentiality pertains to the treatment of information that an individual has disclosed in a relationship of trust and with the expectation that it will not be divulged to others without permission in ways that are inconsistent with the original disclosure.
Confidentiality is:
  • About identifiable data
  • Is an extension of privacy
  • Is an agreement about maintenance and who has access to identifiable data
  • In regard to HIPAA, protects patients from inappropriate disclosures of “Protected Health Information” (PHI)

5. Factors to include as part of overall safety plan

  • Client’s cell phone, home phone, email address, physical location (if not already obtained)
  • Client’s personal safety and security concerns/issues: (Demo)
    • Medical/physical
    • Psychological (distress, known diagnosis, substance use disorders)
    • Social/legal (location of perpetrator, unsupportive family members, lack of social support system, hostile people in the living situation)
  • Patient Support Person (PSP), if possible (Demo)
    • Family member, friend, neighbor, co-worker, acquaintance who can assist during emergencies or crises
  • Discuss circumstances under which the PSP would be contacted (Demo)
    • There may be circumstances where a VSP is concerned about a victim and determines they need to speak with their PSP. Common reasons to initiate this process are:
    • VSP is worried about safety
    • Victims activates a “danger protocol”
  • Session safety - Location should be kept consistent if possible (private, stable tech, clearly identifiable surroundings, how to handle unexpected location shifts, e.g. clients calling in from car, grocery store); Creation of “safe” words for sessions (agreed upon phrases to assess safety without directly asking in future sessions); identify alternate safe, physical location. (Demo)
  • Discuss tech issues; identify person who can troubleshoot?
  • Emergency service numbers in client’s area
  • Record all this information on Teleservice Safety Sheet for client (Download)
  • Be aware of unique needs and accommodations clients may need: In order to create a safe, supportive, and accessible environment, VSPs should thoroughly assess potential barriers to communication prior to or during the initial contact:
    • Physical or Intellectual Disabilities
    • Auditory Challenges including being Hard of Hearing or Deaf
      • Example accommodation: Engage an ASL sign language interpreter. Be prepared to identify other versions of sign language dependent on victim’s country of origin. Include closed captioning
    • Visual Impairment
      • Example accommodation: Include larger text or magnifier applications
    • Language Access
      • Example accommodation: Include interpreter servicers and translated written materials

Downloadables: