Accessible Communication for Online Counseling Services

Accessible Communication for Online Counseling Services

As we consider online counseling for persons who are blind or visually impaired, we must first ask: Shall we consider online mental health counseling a business service or a medical service? Since mental health counseling coverage typically falls under the individual’s health policy, I maintain that mental health counseling can be considered a medical service and will most likely be governed by future policies that pertain to health and medical practices.

Here, I examine the current status of the law as it pertains to communication with persons with disabilities and medical services. The ADA requires that Title II entities (State and local governments) and Title III entities (businesses and nonprofit organizations that serve the public) communicate effectively with people who have communication disabilities. The goal is to ensure that communication with people with these disabilities is equally as effective as communication with people without disabilities.

In implementing communication solutions, the business or public accommodation should first consider the person’s preferred method of communication. Such as speech electronic text or large print.

• For people who are blind, have vision loss, or are deaf-blind, this includes providing a qualified reader; information in large print, Braille, or electronically for use with a computer screen-reading program.

• The key provision of the communication rules is that the person with the disability should be able to fully communicate to the covered entity and to fully understand the information conveyed by the covered entity resulting in a free exchange of information with both parties.

What do the courts require with regard to access to medical care? Under the Barrier Free Healthcare Initiative, the courts have recently targeted the enforcement of the law for communication with persons who are deaf or have hearing loss, physical barriers for persons with mobility impairments and discrimination towards persons with HIV/AIDS. The most recent rulings on these matters can be found at

Here we see the courts repeatedly find in favor of the plaintiffs who were denied communication and physical access to medical care. Examples include Brookside Rehabilitation and Nursing Center Settlement agreement which is a case where the medical facility was required to provide an interpreter for the person who was deaf or hearing impaired. The North Ft. Mitchell Settlement agreement required the defendant to provide proper auxiliary aids and services to the person with a sensory disability. Additionally, there are many legal cases that found that physical barriers must be eliminated for persons with physical disabilities. Thus, the courts currently are focusing on accessibility for these populations. Accessibility for the blind and visually impaired, such as online mental health and virtual medical treatments, has not yet been addressed. However, one can assume that the courts will eventually find that accessibility online is equally important to make certain persons who are blind and visually impaired have equal access to online mental health and medical care especially considering the difficulty that exists for these individuals getting out of the house and accessing medical offices .

Are you looking for accessibility guidance? Kimberly can be contacted for networking, conversation and consultation on the topic of accessibility. To contact Kimberly go to:

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Overcomers Counseling, LLC has current openings for target populations of Christian counseling, disability and chronic illness, and military and their family members. Visit the following web site to contact Kimberly with any questions or referral information:

Welcome to my February 2022 accessibility newsletter.

This month I want to highlight why making your private practice web site or online platform accessible is simply the right thing to do even if you haven’t been given a legal challenge at this point. I want to give credit to disability rights attorney Lainie Feingold. Much of this current content comes from her webinar from 12/10/2021. You can learn more about her practice and the current state of the law with regard to accessibility by going to her web site at

How should we view the concept of access and accessibility? First, therapists should recognize that accessibility is a civil right of the person with a disability. Digital accessibility means that the person who is blind or visually impaired can utilize the digital information independently without asking for help. This right of the individual grants them privacy, independence, and security. A web site that cannot be accessed independently creates a barrier for the person, thereby breaking the person’s right to privacy, independence, and security. Privacy is broken when I need to ask a sighted person to assist me with completing a task. Of course, this means I am not able to be independent when I must ask for this assistance. Security is broken because I must typically give the person access to user names or passwords in this process.

We know that the law solidifies these civil rights through Title II and Title III of the ADA. Title II mandates that federal, state, and local governments make their web sites accessible to the public. Private practices that accept federal funds through Medicaid, Medicare, or other federal or state programs are expected to make their online services accessible to the public.

Title III applies to the business that offers a service or a product to the public. Last month we highlighted how this act easily applies to the brick and mortar business and any architectural barriers. We recognized that the guidelines for the online business or practice may not be as clear-cut as technology and the law are rapidly evolving.

I agree with accessibility attorney Lainey Feingold who states that it’s better to be proactive rather than reactive in these circumstances. Therapists who practice online or who have a web site should make a good faith effort to promote accessibility to avoid future legal conflicts and to promote the dignity and civil rights of persons with disabilities. Therapists should recognize that accessibility is about people and about promoting an individual’s dignity and sense of independence. As therapists, we are bound by an ethical code that requires that we promote the ethical concepts of autonomy, beneficence, and non-malfeasance. Providing information in an accessible manner promotes these concepts as it enables the person who is blind to be independent and to be empowered to accomplish a task.

Are you looking for accessibility guidance? Kimberly can be contacted for networking, conversation and consultation on the topic of accessibility. To contact Kimberly go to:

It’s a New Year. Is your website accessible?

I often describe the conversation with my mom that occurred after the surgery that left me totally blind in which I asked her, “How can I do anything if I’m blind? How can I have a job or a family?” My mother’s response framed my future as she stated, “You can still do anything you wanted to do before; you’ll just have to do things differently now.”

My name is Kimberly Duff and I am a Licensed Professional Counselor and a Certified Rehabilitation Counselor (LPCCRC). These credentials mean that I am licensed to work as a counselor in Georgia and I have special education and certification in disability and chronic illness. Throughout my education and professional development I have paid particular attention to the advances in assistive technologies and also the changing laws and guidelines that have direct impact on my practice as a counselor and my life as a person with disabilities.

Did you know in 2020, 10,982 Title III ADA lawsuits were filed in federal courts. In 2019, a suit was filed by a visually impaired individual against Domino’s Pizza because he was unable to order a pizza through the company’s website in 2015. Domino’s was ordered to bring their website into compliance with industry standards for website accessibility and pay the plaintiff $4,000 in penalties.

Federal district courts have held that businesses are “places of public accommodation” and as such, must reasonably accommodate the disabled in accessing services. They violate ADA when they fail to make their websites and physical locations accessible for disabled customers.

Privately owned therapy offices are also considered “places of public accommodation” and are subject to Title III regulations as set forth in the ADA. This includes websites if the website provides the address or directions to the office, provides a phone number for the office, offers an online scheduling system for prospective clients, and provides a printable copy of an informed consent document or other intake paperwork.

The key provision of the communication rules is that the person with the disability should be able to fully communicate to the covered entity and to fully understand the information conveyed by the covered entity resulting in a free exchange of information with both parties.

So, what should a counselor or practice manager like you do? Where should you start? Just like my mother told me, you can still do anything you want to do, you just need to do things differently now.

This newsletter will bring these issues to the forefront and offer clear guidance on how you can comply with current best practices and legal standards and also better serve your clients with disabilities. I hope to encourage dialogue to foster understanding and change within the counseling community. If you are ready to implement accessibility in your online course, counseling platform, or electronic forms, contact me so we can get started. To see if my accessibility services are the right fit for your practice, please fill out the contact form on my website here


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