In 2009, I began teaching and offering consultation to psychotherapists using the Internet. I was frequently recommending that clinicians establish clear written policies for their practices regarding interactions with clients online. Last February, I decided it was time for me to follow my own advice and create a social media policy of my own.
This was a great opportunity for me to review the decisions I’d made regarding my online conduct with clients on the Internet. It also offered me an opportunity to explain to my clients how and why I’d come to these decisions in clear and accessible language.
I blogged about my policy on my professional website, acknowledging that it was simply a first draft. It should be noted that the policies themselves were clear and fixed at this point, but I was revising and seeking feedback about the document’s language.
I do not know whether my clients read my blog, as this does not regularly come up during my clinical work. I also do not allow comments on my own blog. However, I welcomed feedback via direct e-mail and I also used Twitter to notify other professionals that I had a draft of the policy on my website. I received constructive feedback from other professionals who read my blog posts. None of my clients ever referred to the drafts of the policy on my blog.
By April, I had finalized my policy and I began notifying all new and current clients of the update. Again, none of what I included in my policy represented an actual change in how I operate. It simply made my procedures easy to understand for those who might not have known what they were.
In order to set up a social media policy of your own, the first step is to take a look at how you are currently using technology. Have you added activities such as e-mail or text messaging to your practice?
Have you set up professional profiles on social networking sites? If you have done any of these things, have you formally addressed with your clients how you integrate these activities into your work? Do clients know where best to contact you? Do they have a sense of what content is appropriate to send via e-mail or text message? Do they know how long it may take you to respond to messages? Do they know that these exchanges become a part of their legal record?
Therapists who create a web presence should think about how clients may perceive these profiles and how they plan to interact with clients when using various sites.
Bear in mind that a mere presence on some sites can inevitably lead to such accidental interactions as your profile being suggested to your client as someone he or she should link to, or vice-versa. This occurs if you have exchanged e-mail with a client or if you have other friends or contacts in common.
Other things may happen such as accidentally inviting everyone in your address book to connect to you – a common mishap that can happen to both therapists and clients.
Some psychotherapists may wish to use their social media policies to discuss whether they accept clients as friends, contacts or followers on sites. Other issues to address include whether you will look at a client’s web content out-of-session if they ask you to. Do you ever utilize web searches to collect information about your clients? If so, do your clients know this is one of your procedures?
Do you do this routinely or only in particular situations? If you engage in such searches, do you document them and discuss it with clients? All of this information is as relevant to treatment as other information we routinely share about confidentiality and releases of information. Clients are entitled to have a full understanding of these practices and this should be a part of the informed consent process.
In my practice, I updated my site when my forms were finalized and made the updated forms available for download on my site. I notified all my clients in-session of the update to my policies and I had them sign a form acknowledging that they have been notified of the update and that they had access to the policy. I requested that they read the policy and bring questions or concerns to therapy.
All new clients have access to my policy on my website and all are instructed to read all of my policies before coming in. I also allow clinicians to adapt or modify my policy for their own practices. It can be found on my website which is located at: www.drkkolmes.com/docs/socmed.pdf (PDF).
Keely Kolmes, Psy.D., is a psychologist in private practice in San Francisco and writes, teaches, does research and provides consultation to other mental health professionals on working with sexually diverse populations and managing technical, clinical and ethical issues related to the Internet and social media. Her website is www.drkkolmes.com and she may be reached by e-mail at firstname.lastname@example.org.
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