Navigating the Intersection of Work and Mental Health
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Working Better and Stressing Less

Ideas on work and mental health

Can I connect with my therapist on social media?

For a long time, most therapists answered this with a pretty quick "no," reasoning that such connections were bad for therapists and clients. However, social media has become such an integral part of existing in modern society, that it's difficult for therapists to run businesses, spread positive messages about mental health, and generally function without social media.  So how do we navigate this huge grey zone?

First, let's talk about the issues that caused the therapy community to initially reject social media. Confidentiality is on the top of that list as it is an issue that all counselors care about deeply. Although the stigma of counseling and of mental illness is fading, most clients and certainly all of our ethics boards, are VERY concerned about us protecting our client's confidentiality to the greatest extent the law allows. Counselors and clients connecting on social media opens the door for accidental breaches of confidentiality or client-disclosure that a client may consent to today and later regret. 

The counselor-client relationship is another important counseling issue that can be impacted by social media connections. Certain limits and boundaries are very important to providing effective therapy, regardless of the type of therapy a counselor provides. Social media can provide a sense of false intimacy in which either party, the counselor or the client, may neglect certain boundaries that make counseling work. It's also possible for clients to know too much about their counselor. What if, via your connection on social media, you found out that your counselor has polar-opposite political or religious viewpoints from you? Clients often won't open up in the same way if they know too much about their counselor's personal viewpoints on issues. Also consider that you may not want your counselor to know about everything you do all week long for fear of judgment. 

Counselors also shied away from social media due to concerns about their own physical and emotional safety. Some counselors work with clients whose conditions cause them to be potentially intrusive to the counselor's personal life in either benign or dangerous ways.  Imagine a counselor is working with an individual who is trying hard to establish healthy boundaries in their life and the client (still struggling with establishing good boundaries) decides to show up to an event they know the counselor will be at, via their connection on social media. Not only might this be discombobulating to the counselor, it could also be very counterproductive to the therapy process for the client. 

Healthy social media use - emerging and dynamic 

In recent years, most counselors and counseling associations have backed off their initial positions and have taken a slightly softer stance on the use of social media by counselors and clients (and electronic communication, in general). The reality is that in order for us to help our clients navigate the emerging and dynamic world of "life online," we actually have to have our own "life online." This article does a nice job summarizing the issues counselors consider when writing social media policies. Below, I outlined how I thought about my own position on social media and the policies I have in my practice. 

The Process of Policy Development 

First, we're all required to comply with the laws of the state we practice in, the ethical codes that govern regional practice, and the ethical code of the American Counseling Association or American Psychological Association. So checking that my social media policy was ok by those standards was the first step. I did have to include limits on electronic communication in my practice policies to satisfy these standards. 

Second, I had to define my own needs for privacy.  Healthcare professionals have to be comfortable and secure themselves in order to be effective at helping others. I had a career in consulting prior to becoming a counselor so my own comfort level with social media and electronic communication is VERY high. My need for privacy is fairly low. So I am not likely to be personally uncomfortable having electronic communication with my clients. I did not have to establish any policies to satisfy my personal comfort. 

Third, I had to identify my level of professional comfort with client electronic connections. I believe that social media, sharing blogs, using secured email communication, and sharing other online resources can be beneficial to clients and I can also imagine how they might be harmful. Since clients and their concerns vary, I had to establish not only a general policy for electronic communication but also procedures to tailor those guidelines to the needs of diverse clients with different needs.  

Here is a summary of my social media policies:

As a veteran of the tech industry, I welcome electronic connections with my clients. That said, we should discuss the pros and cons of electronic connections and choose together, what types of connections are appropriate, given each of our values, goals, and challenges. I also must comply with generally accepted standards within the counseling profession. Below you will find a summary of my thoughts on various types of connections common today and together, we can determine what, if any connections, we can make in an ethical, professional, way to help facilitate your therapy. 

Correspondence

Email can be a wonderful way of scheduling visits, collaborating on homework, and staying in touch between therapy appointments. I use an electronic medical record site called Counsol.com to help facilitate secure email communication with my clients. I ask that anytime you need to communicate protected health information (PHI), you use only the Counsol system and not my katie@playfairconsulting.com email address. If we are working on career-specific goals and you wish to send me a professional document, such as a resume, via katie@playfairconsulting.com, that is perfectly ok with me. It is also ok to set appointments using regular email. If you send me a document or email to katie@playfairconsulting.com, I cannot guarantee the confidentiality of the correspondence.  

Facebook

I have both personal and professional Facebook pages. I do not accept friend requests from current or former clients because doing so would compromise your confidentiality and the professional nature of our relationship. I do allow current or former clients to "fan" my Playfair Consulting page but request that you think carefully before doing so. I also suggest strongly that you not write reviews on our work together or "check in" saying that you were at my office, as both can compromise the confidential nature of our relationship. 

If we discover, during the course of our work together, that we have mutual friends or acquaintances, (perhaps identified by Facebook), we should discuss those directly in therapy and arrive at a mutually comfortable and ethically-sound way of navigating those relationships.   

Blog

I write a blog on my website so that clients, potential clients, other counselors, and anyone interested in therapy issues, can hear my views on issues in counseling. I do not stop anyone from commenting on my page but note that if you have an easily recognizable screen name, you may be compromising your confidentiality by posting comments on my blog. If I feel that you posting comments to my blog might be counter productive to your therapy goals, I may choose to take down your comment. It is probably best for us to discuss your reactions to anything I write in my blog, during session.

LinkedIn

I maintain a LinkedIn profile to connect with other professionals and to maintain my "resume" online. This information is public and I welcome my clients to review my LinkedIn profile at any time. If we are working together on career counseling issues, I may also review your LinkedIn profile to see what prospective employers might see if they look for you on social media. In general, I cannot accept LinkedIn invitations from clients but am open to discussing the issue if you feel that such a connection would be highly beneficial to your therapy. LinkedIn is one grey area in terms of counselor-client electronic connections.  

Google, Google+, Angie's List, other review sites, etc. 

Social media sites like those listed above can be really helpful to others looking for professionals of different types and you may very well feel like writing a review of our work together on one of those. In general, I like to discourage clients (and anybody really) from writing reviews about therapy experiences because although you may feel open about having sought therapy today, you may change your mind at a later date. Anything you say on the internet is permanent.

If you feel motivated to say something positive about your experience working with me, thank you and we should talk about it in session! If you feel very negative about our work together, I would very much like to get your feedback so I can improve my practice. Of course, if you are very concerned about something that happened in therapy, I also invite you to tell the Oregon Board of Licensed Professional Counselors and Therapists as they are my licensing agency and have the power to discipline me if I am not meeting the standards of my profession. 

Remember that counseling is about helping you and you should always feel comfortable asking me about connections you would like to have with me. Even if I cannot accept your electronic connection, talking about it can be a very powerful tool in therapy!

Katie Playfair