Risks accompany benefits of telecommunications

By James Bradshaw
January 15, 2014

Risks accompany benefits of telecommunicationsThe Internet that so greatly expanded the spread of information is just as efficient at disseminating misinformation, listeners at the keynote address were told on the opening day of the Fall Conference of the Indiana Psychological Association.

Jana N. Martin, Ph.D., CEO of the American Psychological Association Insurance Trust (“The Trust”), also cautioned that while computer technology can help psychologists expand their practices, either simply as a tool to let potential consumers know of their services or through actual online communications with patients, it comes with new risks of ethics infractions.

“They’re manageable, but we’re in a new dimension,” Martin said, noting that licensing boards already are getting complaints about alleged inappropriate comments from psychologists on social media sites.

She illustrated misinformation dangers with a personal example. She said the person introducing her for a presentation at a conference of the Minnesota Psychological Association outlined Martin’s professional history and then commented that she also has “a flourishing avocation.”

The problem, Martin said, is that another “Jana Martin” has written dozens of steamy romance novels, which the person making the introduction had learned from a web search and mistakenly applied to her.

“It’s not me,” Martin said, adding that being considered an expert in sultry prose is not something she wants people to think when they consider her professional qualifications.

“Google yourself and see what comes up,” Martin advised. She said psychologists can be sure that some patients look them up on the web and it’s a good idea to know what’s there.

Participating in social media, such as establishing a Facebook page or creating a blog, can expand community awareness of a psychologist’s practice and offer a forum for public education, but great discretion is necessary, Martin said.

For example, if a psychologist maintains a Facebook page, how should a request from a patient seeking to become a “friend” be handled? Martin offered two possible answers.

One way is to include a note in the informed consent that the psychologist does not accept patients as “friends” to avoid any dual relationship that could subtract from the therapy relationship. Another would be to establish different limits for “friending” through privacy settings, such as a very restricted level for patients, a professional level for colleagues and a separate level for those who are actual social friends in the real world.

But, Martin said, no matter the precautions used there is always “a friend of a friend” danger since those viewing a Facebook site can see the names of other “friends” who post comments. The result could be an accidental revelation of a patient/therapist relationship or an overlap of friendships in which a patient friend is a social friend in either the real world or cyberspace with another of a psychologist’s friends and thereby learns personal information the psychologist would rather not share.

However much or little a psychologist uses social media it is wise to set firm boundaries, she said, especially in blogging. Unlike Facebook where information can be removed, material on blogs remains there forever, she warned. “I’m not saying you shouldn’t do it. They’re a wonderful way to educate the public on what you do … but you do want to be very careful.”

The best policy, Martin said, is to impose limits in the informed consent and avoid social networking with patients. When clinical information is exchanged with patients via the Internet patients should be warned ahead of any possible breach of confidentiality and safeguards such as encryption should be in place in case, for example, a laptop computer is stolen or lost.

The psychologist considering communicating with a patient through social media should first consider questions such as: Will this constitute a dual relationship and can it disrupt therapy? “For some reason, dual relationships are more clear to us when they’re face-to-face,” Martin said.

She said the emerging technology of online communications prompted an unprecedented coalition of the APA, The Trust and the Association of State and Provincial Psychology Boards to develop guidelines for telepsychology. Psychologists have an obligation to keep abreast of such guidelines, she said, recommending that practicing psychologists attend workshops on telecommunications to learn both the dangers and the potential rewards.

Change is certain, both in how we communicate and how psychologists practice, Martin said, conceding it is impossible to know in advance all the changes to expect, which she said brings to mind a quote from Yogi Berra: “Prediction is difficult, particularly about the future.”

About 170 attended the Nov.8-9 conference at the Lilly Conference Center.

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