Social media for therapists
Social media for therapists is more difficult than ever. While social media may have considerable personal and professional benefits for a therapist, it introduces several ethical pitfalls around maintaining confidentiality and strong boundaries in therapy. Here is what every therapist needs to think about when creating a social media policy.
Summary
- Therapists should carefully consider whether maintaining a social media presence is necessary, as it presents ethical challenges related to confidentiality and professional boundaries.
- Regularly reviewing privacy settings, maintaining separate personal and professional accounts, and implementing a clear social media policy help therapists manage potential risks.
- Engaging with clients on social media, including friending, tagging, or messaging, can breach confidentiality and should be explicitly discouraged in a social media policy.
- While clients may leave online reviews, therapists should not request or respond to them, as doing so could violate ethical guidelines and potentially compromise client confidentiality.
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Do I need social media?
Due to the various privacy issues involved with social media use, the first question every therapist needs to ask is if they really need to have a social media presence. Social media for therapists can be used primarily as a marketing and educational tool.
For example, they can promote their services and disseminate relevant mental health information to clients and the public. Of course, they may also have personal accounts they use for social interaction with friends and family. Whether personal or professional, these accounts can lead to ethical issues with clients.
Every therapist needs to think long and hard about whether it is worth it to possess a social media account.
Educate yourself about social media for therapists
Therapists must spend some time learning about social media. Although it might be second nature to younger generations, therapists who are 35 or older were not brought up within these internet communities.
Even if you are more social media savvy, the intricacies might escape you. Sites like TikTok and Facebook have complicated privacy settings, and it is alarmingly easy to share unintended information with the public. It is well worth your time to understand social media for therapists, especially how these sites work, what information is being seen, and by whom.
Tip: If you decide to use social media, it makes sense to have two accounts, one personal and one professional, to reduce confusion. Blending personal and professional interests will likely lead to more problems.
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Regularly review privacy settings
Maybe it is unintended, but it seems like social media sites change their policies all the time and somehow your privacy is affected. Therapists must review their privacy settings regularly to make sure they are up to date and reflect their desires. Remember, the default settings tend to share your information with everyone.
Do not reveal client personal health information
The therapist must go to great lengths to not include clients’ personal health information in anything they post. This may seem like a no-brainer but it might be more difficult than it sounds.
For example, say you want to post a case study to illustrate some of your work on a specific topic. How can you do that without mentioning any client-identifying information? Can you describe the client’s problems without anyone in the public figuring out who you are talking about? It is always better to err on the side of caution if it is a gray area when it comes to social media for therapists.
Creating a social media for therapists policy
The following considerations must be part of your social media policy and discussed during intake:
No client interaction on social media
Therapists should state upfront that they won’t engage with clients on social media in order to maintain proper confidentiality and professional boundaries. These are not secure communication platforms and are not appropriate for therapeutic discussions.
This includes “liking”, posts, commenting, and direct messaging. Instead, make sure your client has appropriate ways to contact you, such as a phone number or e-mail. Some therapists may allow clients to text them but should not allow it through social media platforms. Acceptable emergency contact information must also be provided.
Friending
Let your clients know that you will not accept friend requests. This is not personal, it is an ethical decision and an essential component of social media for therapists. You can inform them that “friending” is inappropriate for a professional relationship and may expose both of you to breaches in privacy and confidentiality.
Tagging
Did you know that someone may be able to “tag” you on social media sites even if they are not your friend? You can usually prevent this in privacy settings. But you should still tell your clients not to tag you in posts or photos to maintain their confidentiality and yours.
Sharing therapist content
When therapists post content on social media they want their clients and other people to read it. Ideally, you want your clients to share it with others. This is how you disseminate information and extend your reach as a therapist.
However, if a client shares your content, that can jeopardize their confidentiality because people can see where they got the information and may figure out they are in therapy. Encourage clients to share content only if they feel comfortable with the potential privacy implications.
Location tracking
Many social media sites allow location tracking through phone apps. If they are enabled, people can follow the client’s location wherever they go, including therapy. While this won’t make much of an issue for people who engage in virtual therapy, it can affect confidentiality and safety for those that attend in person sessions.
Protecting client confidentiality as part of social media for therapists
Although it may seem like some of these regulations are taken to protect the therapist’s privacy, they also safeguard client confidentiality. This should be made clear to clients during intake. People don’t always consider how participation in social media can sacrifice their privacy and security. It is the job of the therapist to help make them aware of the possibilities.
Business reviews and testimonials
You can review anything today online, including therapists. Fair or not, commenting on a clinician’s work is something every therapist will encounter. Here are some suggestions for managing reviews and testimonials:
Responding to reviews
Clients can post reviews of your work online (e.g., Google, Yelp) for the public to digest and, regrettably, some of them might be less than flattering. Although you might want to defend yourself from a poor review, it can backfire spectacularly, mostly because you will need to explain to the public why it is unfair.
To do so, you will need to present some of the facts of the case, which may break the bonds of confidentiality and lead to bigger problems. For example, an agency in New Jersey recently lost a lawsuit because they defended themselves online using a client’s protected health information.
No soliciting reviews
It is tempting to want to solicit positive reviews from clients. Who wouldn’t want to be seen as a five-star therapist? However, ethical guidelines prohibit therapists from doing so. Because you are wielding your influence, soliciting reviews from clients can make them feel uncomfortable and negatively affect the therapeutic relationship.
Testimonials
You might believe posting client testimonials will be good for business but you have to be very careful not to present any identifying information. This means no names or other data that could help someone in the public identify your client. You also have to consider if a client testimonial holds any value if it is anonymous.
Streamline your practice with One EHR
- Scheduling
- Flexible notes
- Template library
- Billing & payments
- Insurance claims
- Client portal
- Telehealth
- E-fax
Resources
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More resources
- Therapy resources and worksheets
- Therapy private practice courses
- Ultimate teletherapy ebook
- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
- Mental health credentialing
- Insurance billing 101
- Practice management tools
- Behavioral Health tools
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- Free mini video lessons to enhance your private practice
- 9 Admin tasks to automate in your private practice
References
APA Committee on Professional Practice and Standards. (2021, October). APA Guidelines for the Optimal Use of Social Media in Professional Psychological Practice. https://www.apa.org/about/policy/guidelines-optimal-use-social-media.pdf
United States Department of Health and Human Services. (2023, June 5). HHS office for civil rights reaches agreement with health care provider in new jersey that disclosed patient information in response to negative online reviews.
