The Google Question: Should Therapists Google Their Clients?

This article is part of an online course: Digital and Social Media Ethics for Psychotherapists for 8 CE credits

DeeAnna Merz Nagel posted an entry today on the American Counseling Association’s blog entitled Is it okay to “Google” your client?. This is a great question, and a timely one, as it seems to be coming up with more frequency in both my professional circles and in my conversations with others who are using social media. In fact, just a couple of weeks ago, I was interviewed by a journalist who was writing a piece on the issue of therapists Googling their clients.

I’m reposting my comments from the ACA blog below.

These questions have been coming up frequently with trainees and colleagues with whom I consult. I believe that if you are a therapist who is using Google to obtain additional information about your clients, then this needs to be formally integrated into informed consent and become an explicit part of your treatment agreement.

Googling clients or reading their blogs without their awareness is a subtle way of entering into a multiple role with them. The APA Ethics Code cautions us against entering into multiple relationships which can impair our objectivity, competence, and effectiveness in our primary role as psychologists. While it may not seem obvious on the surface, consider how doing these things invites us to be voyeurs, investigators, or audiences to our clients outside of their sessions with us.

In my work with clients, I obtain consent when I’m going to share (or collect) information from a third party. As I recently shared in a Twitter conversation on this topic, I think that the internet is now becoming a sort of third party, with additional client data becoming so easily accessible.

I like Kate Anthony’s comment above about Googling clients being like following them home. The example I often give is that of donning a disguise and following them to a bar where you can secretly observe their behavior. It is one matter if a client invites you to view their online content and it becomes integrated into the clinical conversation in some way. But it is an entirely different matter if we do this on our own, without the client’s awareness. I expect that these types of boundary issues on the internet will soon be addressed by ethics codes.

To add to my comment, I appreciate Nagel’s recognition that there may be some circumstances in which it makes sense to use Google in your work with your client perhaps as part of helping her understand her online presence. This, of course, would be a consensual and negotiated clinical application of an internet search in the therapy relationship. I also agree with her that collecting this information without explicitly making it part of the clinical conversation potentially places the clinician in a quandary about what to do with the information. Will it get used in the therapy? Will the clinician keep it to herself but use it to inform clinical impressions and diagnoses?

Today on Twitter, Dr. David Ballard asked if anyone had questions for Dr. Stephen Behnke, American Psychological Association’s Ethics Director about psychologists’ use of social media. My question was whether new ethical guidelines are being developed for integrating social media into practice of psychology? I imagine the answer is yes, and I’m hoping that Google searches are one of the issues that will be addressed in social media policies and future drafts of our APA Ethics Code.

References

Chamberlain, J. (2010, May) Is it ever OK for a therapist to snoop on clients online? Retrieved June 14, 2009 from http://www.apa.org/gradpsych/features/2010/client-searches.aspx

Nagel, D.M. (2009, June 25) Is it Okay to “Google” Your Client? Retrieved June 25, 2009 from http://my.counseling.org/2009/06/25/is-it-okay-to-%E2%80%9Cgoogle%E2%80%9D-your-client/

Scarton, D. (2010, March 30) Google and Facebook raise new issues for therapists and their clients. [Electronic version]. Washington Post. Retrieved March 30, 2010 from http://www.washingtonpost.com/wp-dyn/content/article/2010/03/29/AR2010032902942.html?hpid=moreheadlines

Zur, O. (2010, April 27) To Google or Not to Google…Our Clients? Retrieved May 11, 2010 from http://www.zurinstitute.com/blogs/index.php?blogid=15

© 2009 Keely Kolmes, Psy.D.

To cite this page: Kolmes, K. (2009) The Google question: Should therapists Google their clients? Retrieved month/day/year from http://drkkolmes.com/2009/06/26/the-google-question-should-therapists-google-their-clients/.

3 Responses to “The Google Question: Should Therapists Google Their Clients?”

  1. Megan

    I want to add my two cents to the discussion of therapists looking at client’s profiles.

    On more than one occasion, I’ve heard from individuals who have suffered greatly from therapists snooping on client’s social media.

    With the vast availability of information online about any particular person, it becomes easy, and often unavoidable in most situations.

    Yet there is a problem that is cropping up more and more.

    If you google “clients that stalk therapist,” you will find a wealth of information relating to how clients overstep boundaries in the therapeutic relationship.

    Accusation include: looking up therapist online to get information, trying to add a therapist as a friend on facebook, twitter, google, etc, writing negative reviews online about the therapist, or becoming romantically attached to them and stalking them online.

    If you turn around and google, “therapists who stalk clients online,” you see how this subject hasn’t been as extensively broached.

    The possibility for a therapist (who after all, is human) to overstep the therapeutic relationship by snooping on clients online is a huge concern for many people I talk to. Yet the focus is always on how patients are unhealthy and how therapist only use it as a tool in therapy.

    There is an inherent power inequality in therapy. This can be used in healthy ways. On the flipside: this can be used in unhealthy ways-but a problem still exists.

    Therapist, because they know a considerable amount about psychology due to education and training, are often able to camouflage their unhealthy behavior when dealing with clients.

    I am not saying all therapists do this, or that all therapists are bad. There are many professional and helpful therapists who do have the clients best interest at heart. The world is not black and white.

    What I am saying is, what I am finding out more and more is that therapists have the ability to snoop or stalk clients online under the pretense of being helpful ( or having the clients best interest at heart) all the while engaging in unhealthy collection of information online…without the client’s knowledge…and knowing exactly how to document this in the notes to not be held accountable.

    It would be foolish to assume that client’s stalk therapist online, yet believe that it’s not possible for therapist to do the same to a client’s online.

    it is because of this power inequality, and dilemma…that I strongly encourage a set of strict and explicit rules regarding the use of online information about client’s. I agree, that there may be situations that warrant snooping without client knowledge. I also agree, that abuse of this ability may be happening as we speak, and is hurting vulnerable clients.

    Therapist who are asked by clients to read online information for help is appropriate.

    Therapists who first obtain (explicit) permission from a client to look at information online to help a client is appropriate. Explicit meaning-that it was verbally brought up in therapy in the form of a question, and was agreed upon by the client ahead of time.

    Notice-this does not include implicit agreement through legal contract that involves client signature before starting therapy.

    Snooping on clients online, without explicitly informing them, and without having a darn good reason for doing so (that includes loss of life or abuse) is EXTREMELY unethical. This should be addressed appropriately.

    Like I’ve said, I’ve heard some disturbing stories, and have experienced it first hand. As professionals, it is a duty to look into how those behaviors could be undermining the therapy relationship.

    Reply
    • drkkolmes

      Dear Megan,

      You may find, of interest, my recent paper with Dan Taube, Ph.D., J.D. on psychotherapist’s viewing the online information of their clients. It also references a number of studies that have been done on clinicians who view their patient’s information. You can find a copy, for free, at this link: http://www.drkkolmes.com/docs/kolmestaubepprp2012.pdf

      You’ll also be happy to know that we are about to attempt to publish our paper on psychotherapy patients who have sought out their psychotherapist’s information online. It was extremely rare that this was a case of stalking or that it came from anything other than curiosity, although clients expressed a range of feelings about having looked, and some did experience discomfort.

      I agree with you that the power imbalance is an extremely important distinction and that most clients are genuinely seeking professional information and may be surprised by personal information they find. Clinicians who are using this to supplement their assessment or diagnosis absolutely (in my opinion) should be informing clients they are doing this, and it would be best done as a collaborative process.

      Thank you for your comments!

  2. Megan

    Thank you so much for the paper, and your work. I found it very interesting, and comforting to some extent… in the fact that for years I thought I was the only person who had experienced this.

    Reply

Leave a Reply