With more and more therapists embracing social networking sites like Facebook and Twitter, the question arises — where do you draw the line in terms of boundaries with your patients? Where does a patient’s and therapist’s privacy end or begin on such sites? How do patients and therapists navigate this brave new world of connectedness and “friending”?
Dana Scarton over at The Washington Post has the insightful article addressing this issue by talking to a number of therapists across the country. These therapists have had to deal with their own challenges with social networking sites and “researching” people online once it was brought into psychotherapy by a client or a client’s actions.
Professional associations haven’t addressed this kind of technology in their ethical guidelines, but common sense rules the day. As I just gave a presentation to therapists on this very topic, here’s the upshot of what I had to say about this from a professional’s point of view …
- Feel free to be on social network like Facebook or Twitter. But do not “friend” your clients and do not allow your clients to “friend” you. Become intimately familiar with the privacy controls on these networks and ensure that the general public cannot see personal details of your life you would prefer to share only with your immediate friends and family.
- Develop a social media policy. Years ago, I was recommending that therapists develop and share with their patients an email policy. But now you need a more inclusive policy that covers social networking, emails, and even doctor rating sites. Dr. Keely Kolmes has an excellent one here. Share it with your patients and ensure they understand its highlights in session.
- Anything that is publicly available online is food for thought. While I don’t encourage therapists to investigate and research their clients, if a client has a public blog or journal, the client should be aware that their therapist may be reading it. If a client wants the therapist to read it, I think that’s fine, but clients should know that therapists generally don’t have so much spare time that they spend all of it looking for and reading patients’ blogs, tweets or what-not.
- Setting and maintaining clear boundaries is always the hallmark of a professional therapeutic relationship. Let such boundaries always guide your decision making with any new online tool or technology.
- Share your decisions with your patients up-front. Nothing causes more trouble that having to make up policy after something unintentional has happened. Setting clear policy, sharing that policy, and ensuring your patients understand your policies is always the way to go. Even if you don’t use or intend to use any of these tools, you should nonetheless have a social media policy that states as much.
And here’s why you need to do it sooner rather than later, especially if you work with younger, more technologically-engaged clients:
[Psychologist Stephanie] Smith also has a Facebook account for her personal life. After teenage patients discovered that account and sent her “friend” requests, Smith enacted a policy forbidding past or current clients from engaging her online. She informs new clients of the policy and obligates them to comply.
This is the type of problem that UMass’s Benjamin wants to avoid. “To me, it’s a much bigger issue than bumping into a patient in a restaurant,” he says. “You’re putting out there, ‘Hey, these are my contacts.’ And someone then wants to enter your social circle. It puts you in a position where you must take a stand.”
Here’s the reason I have no problem with therapists being on Facebook or what-not, as long as they understand and set their privacy settings appropriately. Therapists are human beings too, and we’ve long since come from the psychoanalysis days of psychotherapy when therapists were supposed to be these blank slates that had no personal life, no personality, and could share zero details of their lives. While it’s not appropriate for therapists to go to the other extreme, it’s a therapist’s humanity that makes the therapeutic relationship work. (If we didn’t need human therapists, a computer could well be programmed to do all the work of a therapist.)
The key is that when clients and therapists interact online, it’s done in a manner that doesn’t create new boundary issues or problems with the therapeutic relationship itself. This is done by therapists understanding the options they have available to them, thinking about them mindfully and with some deliberation about the choices they are making, drawing up a social media policy, and then ensuring their clients read and understand the policy in the next session.
Read the full article: Google and Facebook raise new issues for therapists and their clients.