LinkedIn for Mental Health Professionals

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

Recently, when teaching a training for clinicians working in college mental health, I was discussing some of the multiple role conflicts that can come up when clinicians accept friend requests from clients. One clinician asked me to share more about how accepting requests on LinkedIn could become complicated and I thought I’d blog about that, since I haven’t yet discussed it.

So let’s think this through. First, on the surface, it can seem that LinkedIn might be a reasonable space on which to accept requests from clients. Afterall, it is a professional context, so it’s not as potentially confusing as adding a client on a network that is used primarily for sharing personal photos or tidbits. We are in our professional role on this site. On the other hand, it can blur the boundaries of the clinical relationship. It also creates a visible and public connection to someone with whom we are supposed to be in a confidential relationship. Two of our primary commitments to clients are providing confidentiality and avoiding multiple relationships that could cause harm (APA, 2002).

Some would say that simply listing someone as your contact doesn’t compromise confidentiality in and of itself or create multiple roles.

But consider the following scenario:

Your former client, Linda, sends you a request to connect on LinkedIn which you decide to accept. You rarely go onto the site, so you don’t really think about it much until four months later, when Linda sends you a message requesting that you make an Introduction to your friend, Tom, who she sees in her LinkedIn network. Linda is looking for a job at Company X and she sees that Tom, your 1st degree contact, works there.

What should you do? Ignore Linda’s request? Make the introduction? What if Tom wants to know how you know Linda? Even if Linda says it’s okay, this does not mean it’s okay to reveal that she was in treatment with you.

What if you refuse Linda’s request? Do you want to call her and discuss this? Reply via email?

What if Linda asks you to write a recommendation for her on the site? What if instead of Linda making the request, one of your other business contacts asks you to make an introduction to Linda? What if his interest is more personal and he just wants to ask her out? What if his interest is specifically about business? Would you do that? Would you be comfortable asking Linda to help your friend get a job at her company?

 

While a scenario like this may seem unlikely, it’s easy to see how quickly an innocent click of the mouse can turn what was once a therapy relationship into something more complex. It’s trickier too, when requests are made by former clients, since we are not typically in the position of being able to explain to them why we decline a request, if we do so. And, obviously, our commitment of confidentiality extends beyond the termination of the therapy relationship.

It’s good to remember that the purpose of LinkedIn is to engage in business networking. Most therapists do not include making job introductions as part of their practice with clients. If you are someone who would not typically do this in your offline practice, then adding a client on this site is unwise. Some clinicians, however, feel strongly that having across-the-board policies is at odds with how they work. Some may feel more comfortable deciding who to add on a case-by-case basis, and there may be scenarios in which it could be argued that making the connection serves the clinical work in some way.

What do I recommend? While I appreciate the thoughtfulness and care that can go into making decisions on a case-by-case basis, doing this also opens the door to risk in terms of professional liability and the possibility of damaging therapeutic relationships. Suppose a former client experiences feelings of rejection when you decline her contact request, but she then discovers that you went ahead and accepted her friend’s request? This is why having a clear policy about how you handle contact requests and communicating this to your clients (via Social Media Policies and Consent to Treatment forms) is important. My own policy is not to add current or former clients as contacts on any social media site.

Some last considerations for psychotherapists using LinkedIn are issues related to your privacy. There are a number of settings that you can adjust on the site, including whether you wish make your list of contacts available to all connections who are browsing your profile or to no one. If this is information you’d like to keep private, you go to the Settings on your profile, go to Privacy Settings, and select Connections Browse. Here you have the option of hiding or showing your connections list.

Another privacy setting that you may adjust is whether people can see if you’ve browsed their profiles. You change this setting under Privacy Settings > Profile Views, where you may choose whether to show your name, just your industry and title, or to remain completely anonymous. Lastly, under Profile > Profile Settings, you can to go Public Profile to choose whether or not to let your profile show up on search engines. Be aware that many aggregator sites can link your business profile to your social profiles on other social networking sites, merging your online identities, based upon matching the people in your friend network. If you maintain a pseudonym for your personal life, you might prefer to keep these identities dissociated by keeping your business network off of search engines.

References

American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073.

© 2009 Keely Kolmes, Psy.D.

To cite this page: Kolmes, K. (2009) LinkedIn for mental health professionals. Retrieved month/day/year from http://drkkolmes.com/2009/11/16/linkedin-for-mental-health-professionals/.

4 Responses to “LinkedIn for Mental Health Professionals”

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  3. Kellin

    I was struck by your comment that you do not disclose that a person was a client even if that person wants you to and so, gives you permission. As a career counselor (also bound by counseling ethics rules), I have once connected a client to a former colleague of mine for an informational interview. The client did not know anyone in the field in which she was interested and was having difficulty getting started on informational interviewing. The connection was very valuable to her in her career research.

    Of course, I asked the client if I could give her name and the fact that she was a former client and interested In the specific profession. That is all I revealed and, again, completely with the client’s permission. I do not believe this is wrong and that it is consistent with APA guidelines. Would love to learn your take on this.

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    • drkkolmes

      Hi there. For me, the two ethical principles that could potentially be breached here are confidentiality and dual or multiple roles.

      Perhaps this is different for your role or your ethics code. Generally speaking, as a clinical psychologist, I will get a signed release of information to speak to people with whom I am coordinating care for a client. Assisting a client in a job search would be, for me, outside of the clinical care and stepping into a multiple role with a client. I would not consider it part of their clinical care since it is not part of my clinical work to make job introductions to my clients and assist them with making new connections for any endeavour. In my practice, I would see that as a blurring of roles. I would, on the other hand, help them psychologically prepare for interviews and help them brainstorm how to make connections in their field, but I would stop short of making introductions.

      Ethical standards provide a structure for thinking through issues but not everything is black or white. In rural ethics, many boundaries get blurred, but we do have to think about the impact and possibility of exploitation or loss of objectivity.

      Your story reminds me of when I was applying for graduate school in psychology. At the time, I asked a former therapist (not a psychologist, but she had her masters in education) if she would write me a letter of recommendation. She said yes and I later found out from the admissions department that they took points off of an applicant if a former or current therapist wrote a letter of recommendation because they saw it as a sign of poor boundaries.

      Since I had never taken a psychology class, I was stunned. I figured the person who is supposed to hold the boundary is the clinician and I was surprised that I, as an applicant, would lose points because the clinician had (what someone else might consider) poor boundaries. I didn’t yet know the rules of the profession. I still believe applicants shouldn’t suffer because of such a choice, but I can see how a school might assume there was poor modeling for the student that might take a lot or work to unlearn.

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