Keely Kolmes, PsyD
CA License: PSY21284
220 Montgomery Street, Suite 400 [MAP]
(between Pine and Bush)
San Francisco, CA 94104
Phone:
(415) 501-9098
Fax:
Email: drkkolmes@hushmail.com
Twitter: drkkolmes
My Mindful Musings about mental health issues and other therapy-related things. Due to legal and ethical concerns, I’ve chosen not to allow comments on this blog. However, I always welcome direct email if you wish discuss any blog topic with me.
I also invite you to email me directly with any questions or topics that you’d like to see me blog about.
Thanks for reading!
Please note that I will be out of the office from Thursday, March 11th until Monday, March 22nd.
I will still be checking and returning phone messages and emails, but my response time may be delayed.
If you are experiencing a crisis, you should call 911 or go to your nearest Emergency Room.
At a couple of recent trainings, and in consultations with other mental health professionals, the question has come up about whether is is okay to check in on sites like Foursquare, Loopt, brightkite, and Gowalla when one is involved in the provision of clinical services. I have met with a few clinicians in training who use these sites socially and who are eager to rack up points by checking in when they go to work at their practicum or internship sites to see clients. My predictably conservative take on this is that it is probably not the best idea.
It’s one thing for clients to decide on their own to add your clinic or private practice to these sites and, subsequently choose to check in when they attend therapy. But adding your own psychotherapy office or clinic to location-based social networking sites could be a walk down a slippery slope. It could be perceived as your encouraging clients to publicly check-in on these sites which raises a number of sticky issues.
When sites like foursquare encourage business owners to put their sites up to connect with their customers, they are usually thinking of bars, restaurants, or other non-confidential services. But when you put your own business on a site like this when you are involved in the provision of confidential services it’s a bit more dicey whether it’s simply strategic marketing and business promotion or an invitation for people to check-in. Given that ethics codes for psychologists, social workers, and marriage and family therapists all strictly prohibit the solicitation of client testimonials, might putting your psychotherapy practice on sites like this be perceived as a passive request for endorsement by clients? A trickier question is whether a “check-in” is the same thing as a testimonial. Maybe not, but it does seem to be some sort of indicator of patronage. We may not be realizing it, but our presence on these sites may be perceived as a veiled invitation for clients to disclose that they are in treatment with us.
I find myself wondering if particular populations or individuals are more likely to be lured by points and badges at the expense of their privacy. I can certainly imagine some adolescent clients going for the check-in before thinking twice. And if you work in outpatient treatment or see people multiple times a week, do you want them to become the Mayor of your clinic? We may hope that distressed clients have more on their minds than checking in when they go to therapy, but one never knows.
Some might point out that putting your practice up on a site does not mean that you have identified who you have seen in your office. This is correct, of course. A client still gets to choose whether or not to check in when they attend therapy and the disclosure is theirs to make. But the question remains whether the invitation alone could be perceived as subtly influencing some clients to do so.
These are questions about the gray areas of overlap between social networking and marketing of services. They stir up issues related to boundaries, ethics, confidentiality, and multiple roles. The APA Ethics Code applies only to activities that are a “part of (our) scientific, educational, or professional roles as psychologists.” The Internet has been already making it harder to distinguish the separation between our personal and professional lives. And certainly, once we have created a listing on sites to advertise our practices, we have brought our professional lives and the duties and responsibilities that come with it into another realm. It’s worth it to be mindful about which risks you want to take in your own professional practice.
Last Wednesday, I logged into Gmail to discover that I had a new little Buzz icon. When I clicked on it, I discovered what everyone was tweeting about: I was auto-following a number of people. Some I knew and some I didn’t really know at all. We just happened to be active participants on shared email lists, but we’d never met. I’d heard the murmurs about Google Buzz, so I knew something was brewing. But what arrived wasn’t what I expected. I certainly wasn’t prepared for the invasive experience of having Google decide for me who I should be following based upon the frequency of our email exchanges. And this was just on my personal email account.
As I slowly woke up, it occurred to me that I should check my professional practice email account. Here is where the horror hit. I discovered that a handful of friends and family were following me, and so were a couple of clients. I also saw that I was also auto-following a client. As I looked through my list of followers, Gmail asked, did I want to follow them back? No! No! NO! NO! I did not. I did not want us linked at all. And why hadn’t I been asked or alerted before this morning, by the way?
At this point, it hadn’t even occurred to me that my public profile on Google which advertises my practice was also showing the lists of who was following me and who I was following back. Yes, this had already become public information on my profile.
2. I deserve some privacy too. I don’t necessarily want clients or business contacts to know who else I regularly exchange email with, whether those people are clients, friends, or colleagues.
3. It was unclear whether people had chosen to manually add and follow me or whether Google had decided for them that they should be auto-following me. This bit of information can be of particular importance in the therapy relationship. Some may have assumed I followed them and were politely following me back. Some may have added me and felt rejected when I blocked them. Some may not have even known we were following one another in the first place. But since it was done automatically, without any prior notification, both parties in the relationship were left wondering but I still felt I had to act immediately to clean up the potential privacy mess.
I wasn’t the only person who was upset about this. I got emails from several other therapists who were distressed to find themselves following clients. Over the next couple of days, articles started to emerge that were addressing the privacy flaws.
I turned Buzz off immediately. But I then discovered that I had to go back in and manually block the folks I’d been following as well and remove the links to our names if I did not want them showing up on my public profile.
But this was a wake up call for me.
My email signature for my private practice has always included a warning about the limitations of email in regard to privacy. Generally, clients do not send me emails about anything more than appointment confirmations or requests to reschedule. But sometimes, people choose email as the first point of contact in reaching out to me for my services. In these cases, I have found that they often share a lot more personal information. I had been well aware that gmail was not the most secure service, but I figured with the limited amount of emailing that I do with patients, it was a low risk endeavor. That was before Google decided to turn email into a social network. Obviously, the time has come for me to address this security problem in my professional practice.
My response has been to completely move my email to hushmail for all interactions with anyone with whom I have a confidential relationship. I have been pleased to discover that I can set up hushmail to forward new mail notifications to other email addresses without including the name of the sender in the alert. I have this setting selected so that client names are not being forwarded to other email accounts.Please note that as of this writing, there has been an apology from Google and a number of privacy updates to correct the Google Buzz problems. Here is Google’s official reply.
Still, if you are a therapist who has been unaware of the privacy issues related to Google Buzz, here are some steps you should consider taking:
1. Go into your Gmail settings and select “Disable Buzz.” You can also directly access this setting by selecting “Turn Off Buzz,” at the very bottom of your Gmail Inbox. (Click on photo for larger version.)
2. Let me be a warning to you. Now is the time to move your private practice email to a more secure service. Hushmail was my choice. But other options include ciphersend. Both sites also offer the option to put secure forms on your website, if you choose to do so. I recommend doing this for anyone who uses email as a way of communicating with clients, even if you’re not on gmail.
7. Of course, if you use PayPal or have a presence on other sites like Psychology Today on which clients may contact you, switch the email address to your new secure email.
Last week, I spoke at a singles event for women. There is such a high emphasis in our culture on finding a partner that it can be hard to recognize what a rich opportunity being single can offer us. It is a chance to learn more about who you are and your wants and needs as you discover how you experience different dates and potential partners.
I thought I would share with my blog readers my Five Dating Tips for Singles that I shared at the event last weekend:
Dating can often feel like one part clarity to two parts confusion. Learning more about your wants and needs can help turn that ratio around. Spend some time allowing yourself to dream and let go of previously held assumptions or the pictures other people have painted for you of what is ideal.
Do you want to date women, men, transfolk, any-or-all, or just whomever makes you feel happiest? Do you enjoy dating? Or would you prefer to focus on finding a serious relationship? Is dating even what you want to do right now? Don’t assume you should date just because you are single.
Do you like being monogamous or are you open to having multiple partners or romances? Are you seeking a traditional relationship or are you open to something less “standard,” such as living separately?
Allow yourself to think of what has worked for you in the past and what hasn’t worked so much. This will help you develop a clear picture of what you want now, and when that picture gets clear, it will be easier to communicate that vision to others who may want to be in it. You may be surprised to find that if you take some space and really think about it, the script you’ve followed before may not be the right dating script for you today.
Getting clear on who you are and what you want is one thing. It’s another thing to take an honest look at whether you are allowing room in your life to find what you want. This can be a good thing to check in with your friends about. Are there things that keep you from connecting to others?
Some things that came up in my talk last week that can frequently get in the way of dating included kids, work, hobbies, exes or other relationships, and other passions which take up time and space. All of these things are good, but is there balance? You may want to see if you need to clear out some space to allow a new sexual intimacy or romance to bloom in your life. Re-evaluate periodically to be sure you’re dividing up your time the way you like. This could even mean noticing that you’re spending more time and energy on dates than you want to be, and you may need to adjust so that it feels more like pleasure than a mission.
Some people love using personal ads to meet people. Others prefer getting out to events and organized activities in order to meet new folks. Some people like physical activities like sports, dancing, or excursions while others like events focused on talking and conversation. Others may like just getting out in the world in less organized ways or going to bars or clubs. These preferences can depend a lot on such attributes such as shyness, introversion, or extraversion.
Think about how you have met friends and dates in the past. Now may be a time to shake up your routine and try something new or to fully embrace your style and recognize your preferences. Think about how you like to plan dates: do you prefer to take the lead or do you like another person to suggest activities or surprise you? Do you like to stay in your comfort zone on first dates or do something new to you?
This is also a good time to figure out how many dates a week you have the stamina for. One? Two? More? With how many different people? Do you need to make a decision about the potential of a new person quickly or does it take time for you to figure out if something can be more than a friendship? Are you comfortable with your pace and can you allow yourself to respect it? These are all important things to know about yourself before venturing into the dating waters.
Sit down and think about which qualities matter to you most in a date or a life partner. Make a list of things that you know you can’t do without. Make a similar list of things that are deal-breakers that would send you running in the other direction. There may also be things that you are more flexible about. What are they?
In your first drafts of these lists, allow yourself to be impulsive. You can re-evaluate later and some yes or no items may later move to the maybe zone. Think about whether chemistry or emotion ever leads you to ignore what you know you need or want. This may be a good question to ask some of your closest friends about too. They may have observations about your dating choices or style that are useful to hear. Friends can also help you keep your head and think about whether you discount people for superficial (or more “maybe” reasons) when they have a lot of the qualities on your “must have” list.
Are you finding that you are responding strongly to rejection or missed connections? Do you get disappointed often in dating? Are you having any fun? If you find that you are frequently in conflict with others on dates or that it feels like work or a bad time overall, it may be time to put things on pause and take more time to reflect on what’s blocking you. Remember that primal issues and emotions and even past traumas can get strongly tapped in in dating and relationships. If this seems to be a theme, you may want to consider therapy to help clarify what is in your way and help you get on track.
And remember that new relationships can also benefit from therapy! People do not need to wait until a relationship is in trouble to learn to develop healthy ways of communicating and handling conflict. New couples sometimes go to therapy to learn how to plant the seeds for a more fulfilling relationship. So if you find someone in your dating adventures who is worth hanging onto, be open to putting some work into the relationship in the beginning. I will offer Tips for New Couples in a future blog post!
Please note that the ThirtySomethings and Connexions event that I’ll be speaking at and facilitating this Saturday, February 6th has a new location.
It will now be taking place at Aquarium of the Bay @ Pier 39 – in the Farallon Room.
This event offers a fun, relaxed way for single women to connect and get to know one another. You may even learn a bit about yourself in dating and relationships. I’ll be offering dating tips for singles and facilitating small group activities.
Please come!
Saturday, February 6th, 2010
5:00 PM – 5:15 PM – Arrival
5:15 PM – 6:00 PM – Mingle Walk Through the Aquarium
6:00 PM – 6:30 PM – Welcome Activity with Roke Noir
6:30 PM – 8:30 PM – Interactive Discussion and break out groups with Keely Kolmes, Psy.D. and Roke Noir
8:30 PM – Break
9:00 PM – Singles Party & Dance with Finding Stella Band
Hard Rock Café @ Pier 39
You can find out more details and still get tickets on Betty’s page.
I hope to see you there.
