(a)Licensees who provide marriage and family therapy
to clients or supervision to supervisees outside the State of Texas
must comply with the laws and rules of Texas and of the out-of-state
authority which govern the practice of marriage and family therapy.
(b)Licensees who provide treatment, consultation,
and supervision using technology-assisted services must meet the same
standards of appropriate practice as licensees who practice in traditional
(i.e., in-person) settings.
(c)In accordance with Texas Occupations Code, §502.251
(relating to License Required), a person may not practice as a marriage
and family therapist unless the person holds a license under this
chapter or is exempt under Texas Occupations Code, §502.004 (relating
to Application of Chapter).
(d)A licensee may provide technology-assisted services.
To ensure the competent delivery of services by technology-assisted
means, a licensee must maintain an appropriate level of education,
training, or experience in using relevant technology.
(e)A licensee may not render therapy using technology-assisted
services without complying with the following at the onset of each
(1)fully verifying the location and identity of the
client, to the most reasonable extent possible; and
(2)disclosing the identity of the licensee.
(f)Before providing technology-assisted services,
a licensee must determine whether a client is a minor. Upon determining
that a client is a minor, and before providing technology-assisted
services, a licensee must obtain required consent from a parent or
guardian and must verify the identity of the parent, guardian, or
other person consenting to the minor's treatment.
(g)The licensee must determine if technology-assisted
service is an appropriate delivery of treatment or supervision, considering
the professional, intellectual, or emotional needs of the client or
(h)Informed consent must include, at a minimum, information
that defines electronic service delivery as practiced by the licensee
and the potential risks and ethical considerations. The licensee must
obtain and maintain written or electronic evidence documenting appropriate
client informed consent for the use of technology-assisted services.
The licensee must ensure that the informed consent complies with other
informed consent requirements in this chapter and must include the
(1)identification of the client, the therapist, and
the therapist's credentials;
(2)list of services provided by the licensee using
(3)client agreement that the therapist determines
on an on-going basis whether the condition being assessed or treated
is appropriate for technology-assisted services;
(4)details on security measures taken with the use
of technology-assisted services, as well as potential risks to privacy
notwithstanding such measures;
(5)information regarding secure protocols and back-up
plans in case of technical failure;
(6)the licensee's credentials or training to engage
in technology-assisted services, and contact information;
(7)risks and benefits of engaging in the use of technology;
(8)emergency procedures to follow when the therapist
is not available;
(9)information collected and any passive tracking
(10)third-party websites or services used by the licensee
to facilitate technology-assisted services; and
(11)an explanation of how records are maintained electronically,
including encryption type and record security, and the archival storage
period for transaction records.
(i)Therapists who use technology-assisted services
must meet or exceed applicable federal and state legal requirements
of health information privacy, including compliance with the Health
Insurance Portability and Accountability Act of 1996 (HIPAA), Public
Law 104-191; The Health Information Technology for Economic and Clinical
Health (HITECH) Act, 42 U.S.C. Chapter 156, Subchapter III; Texas
Health and Safety Code, Chapter 181 (relating to Medical Records Privacy);
and state privacy, confidentiality, and security rules.
certifies that legal counsel has reviewed
the adoption and found it to be a valid exercise of the agency's legal
Filed with the Office
of the Secretary of State on September 1, 2022
Darrel D. Spinks
Texas State Board of Examiners of Marriage and Family Therapists
Effective date: September 21, 2022
Proposal publication date: April 22, 2022
For further information, please call: (512) 305-7706