Social Media and Ethics – A Therapist’s Online Presence

In my recent blog on Googling therapists, I touched on the subject of the therapist’s responsibility to manage their own online activity. In this blog post I would like to expand on that and highlight some ways in which therapists can ensure their online activity does not negatively impact on clients.

I was heartened and inspired by Cathy Knibbs’s recent blog post raising the issue of therapists posting about clients online. It is something I have witnessed on a number of occasions, mostly in Facebook groups and on Twitter. As Cathy Knibbs points out, even that which seems anonymous can be narrowed down, and can even become identifiable information, especially when combined with the poster’s Facebook page details, in the many instances that the therapist’s workplace is listed on their profile. Supervision exists to ethically discuss client work, and posting about it on social media, for whatever reason is very difficult to justify in my opinion.

I think a large part of the problem is that therapists are not always as aware as they perhaps should be of how their online presence can impact on clients. As a relatively tame example, I was once searching for a supervisor, and as part of my process of narrowing down potential supervisors I looked to see if any of my shortlist had social media profiles. One supervisor did, and had written in a public post about how glad they were that it was the weekend because being at work was such a bore! I thought about how their therapeutic clients in particular might have felt if they had read this. I imagine it could be quite hurtful and potentially damaging to the therapeutic alliance. In addition, due to the feelings of shame which can emerge for clients around searching online for their therapists, this hurt may never be brought into the room and never be addressed in the relationship. All of this potential risk of harm to client relationships could have been avoided if the therapist had simply altered their Facebook privacy settings more appropriately, and/or anonymised their personal Facebook account. (This supervisor was promptly crossed off my shortlist).

I feel that any therapist using social media needs to feel confident that they are able to manage their content ethically and safely. If not, there are many resources to help. From online tutorials to help with managing Facebook privacy, to ethical blogging workshops and social media coaching, help is out there and we are each responsible for any gaps in our understanding.

I was recently at an event where online conduct and ethics were debated. It seems to me that dilemmas such as “What do I do if a client sends a friend request?” are easily resolved by the presence of a social media policy, which can be made available to the client at the contracting stage outlining what the therapist’s boundaries are around online activity. Hazel Hill has an excellent example of this on her website. Like any boundary consideration, clarity, consistency and dialogue are crucial for avoiding harm. Think ahead and remove the need for reactionary social media policy, which could be received as shaming by any client involved in its creation.

As I have written before, I am aware that by engaging with social media, I am allowing my clients access to thoughts, opinions and areas of my experience which would not be presented in the therapy room. I am self-disclosing with every tweet and blog post. I am mindful of how my words could be received by clients, and I have brought this part of my professional activity to my supervision in order to ensure I am properly reflecting on it.

To me, social media is a valuable platform, both on a personal and a professional level. I love to blog, and to read blogs; I find engagement with other therapists enriching and I feel the knowledge I gain from other bloggers and social media users (including therapists, other professionals and therapy-users too) contributes to my awareness in counselling practice and also in research and professional issues.

The ethics of social media use is a subject gaining traction, I think, and I am hopeful that our awareness will continue to grow. The latest BACP ethical framework requires that “reasonable care is taken to separate and maintain a distinction between our personal and professional presence on social media where this could result in harmful dual relationships with clients”. I feel a significant expansion on this area of ethical conduct would be beneficial for its members and their clients going forward.