By Crystal Raypole
Technology can make life easier in myriad ways. But it can also present challenges, especially for therapists and counselors trying to uphold a nuanced code of ethics and maintain boundaries between their personal and professional digital presences.
In a world that’s rapidly gone digital, it’s almost impossible to succeed as a business without some sort of social media use. Whether you use social media to market your practice, keep in touch with other professionals, pursue continuing education opportunities, or reach out to people who may be searching for your services, you may be concerned about certain ethical issues that could arise as a result of social media use.
Here, we’ll discuss a few common concerns mental health care providers might have about using social media ethically.
Setting Boundaries in a Digital World
As you begin to market your private therapy practice (or clinic), you’ll likely turn to all available channels in order to achieve the greatest visibility. Today, most of these marketing opportunities are found online on social media platforms such as Facebook and Twitter.
It’s very common to have a Facebook account. More than 2 billion people worldwide, and 68% of Americans, use Facebook each month. Twitter has more than 300 million monthly users, and many professionals also use Twitter to market their practice. If you do use these or other social media channels, it’s generally recommended to make a business or professional page and clearly indicate it as such. Then use privacy tools to make your personal Facebook profile (the one you share with friends and family) as private as you can make it. This may not prevent your clients from seeking you out online, but it can limit the information they’re able to access. You can use privacy tools to set everything you post to “Friends Only,” or you can tailor your settings to each new post.
Using professional language can help your business account flourish. While your personal communication style could involve multiple exclamation points, smiley faces and other emoticons, or curse words, keeping the language on your professional page clean and free of internet-speak is recommended. In your private practice you may choose to be yourself with your clients, in order to encourage them to bring their true selves to therapy. Many therapists believe swearing or otherwise sticking to their usual language in session can help promote this goal and develop the therapeutic relationship. Even so, it may be better to let clients know your philosophy in session, where you can give them an explanation, rather than on the social media account serving as their first introduction to you.
Keep your posts business-appropriate. Sharing quote cards and other motivational graphics is usually fine, but it’s generally recommended to keep personal photos, even positive or cheerful ones (like your new kittens), for your private page. Remember people struggling with different issues may view your page at any time. Before you make a post, consider whether it could negatively impact someone in distress. If there’s a reasonable chance of this, avoid posting it on your professional page.
When a Person in Therapy Sends a Friend Request
At some point, a person you’re working may send you a friend request through Facebook. There’s no ethics code that explicitly forbids accepting such a request, but guidelines from the American Psychological Association and experts in mental health ethics recommend against having clients as Facebook friends.
People often use social media accounts to share very revealing information about themselves. Having a client as a Facebook friend will give you the opportunity to see details about their life they may not share with you in therapy, which they may not have considered when sending you the friend request. They might also see details about your life you wouldn’t share within the therapeutic relationship. Having access to this level of detailed personal information can significantly affect the bond you have with your client—on both sides. This is also important if you’re considering looking up your client online. This may be necessary if you have a real concern for someone’s safety, but in most other cases it’s not advised or appropriate.
You might worry that rejecting the friend request could hurt your client’s feelings or make them feel you don’t care about them. A particularly vulnerable client may have even more of a negative reaction. Developing a social media policy and sharing it with individuals during their first session can help you avoid alienating clients and may help prevent friend requests from becoming an issue. In your policy, let clients know you never accept friend requests in order to protect their confidentiality and maintain an effective therapeutic relationship.
Some clients may not entirely understand the therapeutic relationship, so it could help to remind them that while many therapists and clients do develop a strong bond, the bond differs from that of a personal relationship or friendship.
Marketing Your Practice on Social Media
When setting up your business Facebook page or Twitter profile, think of it as a business card or ad you’ve taken out. In other words, you’re introducing yourself to potential clients with your social media page. Consider the following four tips on social media business etiquette for therapists as you begin to market your practice online:
1. Remember your likes and comments are often public.
Not everyone uses privacy settings. If you like a public post or leave a comment, anyone can see this activity. The best practice here may be only liking or commenting on other professional posts that directly relate to therapy services or mental health treatment. Caution is still recommended. Even if you aren’t divulging any client information, consider whether there’s any possibility your words could help someone identify a person in therapy. If there’s any chance of this, reconsider your comment. In short, use care when liking posts, even those from other private practices or therapists, and consider how your likes and comments might reflect on you and your practice.
2. Interact with other therapists carefully.
Building a social network of other mental health care providers can be a great way to use social media professionally, but it’s essential to cultivate awareness of potential ethical concerns. If another therapist shares client information that could violate confidentiality, for example, avoid replying publicly. You might consider, however, reaching out to that therapist through private message to express your concerns.
3. Avoid interacting with posts that could be unprofessional.
If another therapist or private practice page shares information you feel is more personal than professional, ignoring the post is probably the best course of action. As stated above, a better option might be sending a private message to that professional letting them know why their post could seem inappropriate—if you feel comfortable doing so.
4. Consider preventing incoming messages.
On Facebook, you can set your business page settings to allow incoming messages, but you can also prevent this. Because Facebook correspondence isn’t private, you may want to prevent potential clients from sending you Facebook messages that might contain sensitive information about their mental health. Instead, post your contact information clearly on the business page. Include your phone number and email address, if you accept email correspondence, and encourage clients to reach out to you with these methods.
When You Make a Post You Regret
Therapists are human, and all humans make mistakes. One common internet mistake is making a social media post you later regret. You can take it down, of course, but often not before many, perhaps hundreds, of people have viewed it. Maybe you got involved in a public discussion with another therapist and some of the exchange veered toward the unprofessional. Perhaps the language on one of the quote cards you shared, or your accompanying remark, gave someone a bad impression or implied a lack of sensitivity. Or possibly a comment you left on a page indicated your political leanings and offended a person you’re working with in therapy.
No matter the situation, it’s important to take a step back before reacting emotionally. First, ask yourself if you’re truly in the wrong or if someone has taken offense unnecessarily or is trolling you. For example, expressing your frustration that people with mental health issues struggle to access affordable care under the current political administration may not have been an ideal public post, but it’s not inherently inappropriate or harmful. Quietly removing the post and letting the issue fade away may be enough.
Other kinds of posts may require an apology. Posts that use non-affirming language for transgender or gender-variant people or imply blame toward survivors of sexual assault, for example, should not simply be removed. Make a new post letting your followers know you weren’t aware your language or post was harmful. Apologize sincerely, acknowledging that you made a mistake.
Moving forward, be mindful to use greater caution in your social media posts. If you want to share something on a topic you aren’t well-versed in, consider asking someone with more experience for their input. Remember to exercise self-compassion. No one is perfect. You made a mistake, but you didn’t intend to cause harm. Learn from the experience and let what happened help you grow as a therapist and a person.
Navigating the internet and learning how to make the best choices for your private practice is challenging for many, but it doesn’t need to be difficult. If you hesitate to use social media for your therapy business, consider taking a continuing education course on the subject. These can help you learn to use social media tools like Twitter and Facebook ethically and effectively.
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- Chamberlin, J. (2010). Is it ever OK for a therapist to snoop on clients online? American Psychological Association. Retrieved from https://www.apa.org/gradpsych/features/2010/client-searches
- Cooper, P. (2018, November 13). 41 Facebook stats that matter to marketers in 2019. Hootsuite. Retrieved from https://blog.hootsuite.com/facebook-statistics
- Cooper, P. (2019, January 16). 28 Twitter statistics all marketers need to know in 2019. Hootsuite. Retrieved from https://blog.hootsuite.com/twitter-statistics
- Lannin, D. G., & Scott, N. A. (2013). Social networking ethics: Developing best practices for the new small world. Professional Psychology Research and Practice, 44(3), 135-141. Retrieved from https://www.researchgate.net/publication/255721188_Social_Networking_Ethics_Developing_Best_Practices_for_the_New_Small_World
- Lannin, D. G., & Scott, N. A. (2014). Best practices for an online world. CE Corner, 45(2), 56. Retrieved from https://www.apa.org/monitor/2014/02/ce-corner
- Martin, S. (2010). The Internet’s ethical challenges. Monitor on Psychology, 41(7), 32. Retrieved from https://www.apa.org/monitor/2010/07-08/internet
- Natwick, J. (2017). Boon or bother? Social media marketing and ethics. American Counseling Association. Retrieved from https://www.counseling.org/docs/default-source/ethics/ethics-columns/ethics_february-2017--social-media-marketing.pdf?sfvrsn=1225522c_6
- Zur, O., & Walker, A. (n.d.). To accept or not to accept? How to respond when clients send “friend request” to their psychotherapists or counselors on Facebook, LinkedIn, Twitter or other social networking sites. Zur Institute. Retrieved from https://www.zurinstitute.com/socialnetworking