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	<title>SF Bay Area Couples Counseling &#38; Psychotherapy for Anxiety, Depression, Relationships &#38; Sexual Problems &#187; privacy</title>
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		<title>Goodtherapy.org Responds Thoughtfully to Complaints About Contest</title>
		<link>http://drkkolmes.com/2011/07/09/goodtherapy-org-responds-thoughtfully-to-complaints-about-contest/</link>
		<comments>http://drkkolmes.com/2011/07/09/goodtherapy-org-responds-thoughtfully-to-complaints-about-contest/#comments</comments>
		<pubDate>Sat, 09 Jul 2011 18:00:51 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[blogging]]></category>
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		<category><![CDATA[mental health]]></category>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=2854</guid>
		<description><![CDATA[Earlier this week, a colleague brought my attention to a contest that was being run on Goodtherapy.org. The contest invited participants to compete for six months of free weekly therapy sessions with the therapist of their choice. Participants entered the contest by posting a public comment sharing the following information: What are the obstacles currently preventing [...]]]></description>
			<content:encoded><![CDATA[<p>Earlier this week, a colleague brought my attention to a <a href="http://www.goodtherapy.org/blog/therapy-award-contest/" target="_blank">contest</a> that was being run on Goodtherapy.org. The contest invited participants to compete for six months of free weekly therapy sessions with the therapist of their choice. Participants entered the contest by posting a public comment sharing the following information:</p>
<ul>
<li>What are the obstacles currently preventing you from being able to receive or afford therapy?</li>
<li>Why do you want to go to therapy and what issues are you facing or problems are you experiencing?</li>
<li>How would you like to benefit from therapy and what are you hoping to achieve?</li>
</ul>
<p>Top entries were going to be chosen and then the winners would be selected by having readers vote on the one most deserving of the prize of free therapy. While I appreciate that many people find it empowering to use Internet forums to write about the issues they struggle with, having such comments used as a way vie for the prize of &#8220;most worthy&#8221; of psychological care, as voted by readers, was objectionable in a number of ways.</p>
<p>A number of mental health professionals, including <a href="http://www.deeannamerznagel.com/index.html" target="_blank">DeeAnna Merz Nagel</a> and others who focus on clinical ethics,  posted comments expressing concern that this contest was exploitative of vulnerable populations and would violate many clinical ethics codes. The initial response from the website was to say that as a referral service, they were exempt from having to adhere to ethics codes. They also noted that names and emails were anonymous in the blog comments, offering participants a layer of protection.</p>
<p>Nevertheless, a couple more comments were posted by concerned practitioners, including myself, stating that we thought the contest was not offering appropriate protection to vulnerable people and that having readers vote on who was worthy of the grand prize was, at the very least, in poor taste.</p>
<p>After just a few days of commentary, Goodtherapy.org responded by removing the public comments (entries) from the blog and deciding not to allow users to vote on stories to pick the winner. Winners will now be selected by GoodTherapy.org.</p>
<p>I am grateful to those who spoke up and left comments expressing opposition to the format of the contest. But I especially wish to commend GoodTherapy.org for their thoughtfulness and care in reflecting upon the objections raised. They demonstrated sensitivity and flexibility in revising the competition so that it does not expose people who are in great need.</p>]]></content:encoded>
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		<title>Without My Consent: Paths to justice for survivors of online harassment</title>
		<link>http://drkkolmes.com/2011/06/03/without-my-consent-paths-to-justice-for-survivors-of-online-harassment/</link>
		<comments>http://drkkolmes.com/2011/06/03/without-my-consent-paths-to-justice-for-survivors-of-online-harassment/#comments</comments>
		<pubDate>Fri, 03 Jun 2011 07:46:58 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[consent]]></category>
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		<category><![CDATA[cyberharassment]]></category>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=2799</guid>
		<description><![CDATA[I&#8217;m so very pleased and excited to announce the launch of Without My Consent, a project on which I sit on the Advisory Board with a fine group of Internet superheroes. This project was co-founded by Erica Johnstone and Colette Vogele. Without My Consent is intended to provide resources and information to victims of online [...]]]></description>
			<content:encoded><![CDATA[<p>I&#8217;m so very pleased and excited to announce the launch of <a href="http://www.withoutmyconsent.org/" target="_blank">Without My Consent</a>, a project on which I sit on the Advisory Board with a fine <a href="http://www.withoutmyconsent.org/about" target="_blank">group of Internet superheroes</a>. This project was co-founded by <a href="http://rcjlawgroup.net/attorneys/erica/" target="_blank">Erica Johnstone</a> and <a href="http://cyberlaw.stanford.edu/profile/colette-vogele">Colette Vogele</a>.</p>
<p>Without My Consent is intended to provide resources and information to victims of online harassment to help them find safety, seek justice, and stand up for their rights. We also hope to provide psychological resources for people who have been harmed.</p>
<p>It is also our hope that our site serves as a deterrent to those who may be thinking of doing harm to another individual. These individuals may wish to seek help to process the intense or disturbing feelings that might lead them to want to lash out against another person in such a way.</p>
<p>This project was recently mentioned on June 2, 2011 in The New York Times story <a href="http://www.nytimes.com/2011/04/24/magazine/mag-24lede-t.html?_r=4&amp;ref=technology" target="_blank">How to Unmask the Internet&#8217;s Vilest Characters</a>. This article discussed one of Without My Consent&#8217;s strategies: encouraging victims to file suit pseudonymously.</p>
<p>Keep your eye on us. There will be some interesting news and updates coming soon.</p>]]></content:encoded>
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		<title>Taking Control of Facebook&#8217;s New Location Feature: More Privacy Woes</title>
		<link>http://drkkolmes.com/2010/08/19/taking-control-of-facebooks-new-location-feature/</link>
		<comments>http://drkkolmes.com/2010/08/19/taking-control-of-facebooks-new-location-feature/#comments</comments>
		<pubDate>Thu, 19 Aug 2010 22:20:30 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[privacy]]></category>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=1936</guid>
		<description><![CDATA[Facebook has released a new Location feature that already has critics — including the ACLU — worried about privacy concerns. As someone with a Facebook account, I found myself once again wondering why it was that I was hearing of new features on Facebook from news sources, rather than being notified of them when logging [...]]]></description>
			<content:encoded><![CDATA[<p>Facebook has released a new Location feature that already has <a href="http://bits.blogs.nytimes.com/2010/08/18/new-facebook-location-feature-sparks-privacy-concerns/?th&amp;emc=th" target="_blank">critics</a> — including the ACLU — worried about privacy concerns. As someone with a Facebook account, I found myself once again wondering why it was that I was hearing of new features on Facebook from news sources, rather than being notified of them when logging into my account. If you care about your privacy or you work with co-workers or clinical populations who have privacy worries, you may want to be aware of the new information that may be shared.</p>
<p>Those who want control over Locations should take the following steps.</p>
<p>1. Log into your Facebook account and in the upper right hand corner where it shows <strong>Account</strong>, click on that and drag down to <strong>Privacy Settings</strong>.</p>
<p>2. Here you will see what you are sharing on Facebook. Check to see what is selected for <strong>Places I Check In</strong> which may be set up as &#8220;Everyone,&#8221; Friends of Friends,&#8221; or &#8220;Friends Only.&#8221;</p>
<p><em>(Clicking on all images will let you view them in large size.)</em></p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/08/Picture-2.png"><img class="aligncenter size-medium wp-image-1937" title="sharing" src="http://drkkolmes.com/wp-content/uploads/2010/08/Picture-2-300x141.png" alt="" width="300" height="141" /></a></p>
<p>3. If you want to modify the setting, click on <strong>Customize Settings</strong> at the bottom.</p>
<p>4. This will bring you to the following screen.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/08/Picture-3.png"><img class="aligncenter size-medium wp-image-1938" title="change settings" src="http://drkkolmes.com/wp-content/uploads/2010/08/Picture-3-300x191.png" alt="" width="300" height="191" /></a></p>
<p>5. If you want the greatest level of privacy, you would make sure three things are selected here:</p>
<p>First, make sure <strong>&#8220;Only Me&#8221; </strong>is selected for <strong>&#8220;Places I Check In.&#8221;</strong></p>
<p>Second, Disable <strong>&#8220;Include me in People Here Now&#8221;</strong> after I check in. <strong>Enabling</strong> this will allow others to see if you are at the venue (feel free to click the &#8220;See an example&#8221; link on Facebook to see what this will look like to anyone else checking in).</p>
<p>Third, at the bottom, make sure <strong>&#8220;Friends can check me into Places&#8221;</strong> is <strong>Disabled</strong>.</p>
<p>You can read more about the new feature and the concerns of others <a href="http://mashable.com/2010/08/18/aclu-privacy-facebook-places/" target="_blank">on mashable</a> and also on <a href="http://violetblue.posterous.com/videotranscript-rodbegbie-asks-facebooks-zuck" target="_blank">Violet Blue&#8217;s blog</a> in which she publicized the potential problem raised by @RodBegbie about what happens when someone adds your home address as a venue on Facebook. It sounds as though users will have to go through a tedious process of flagging a venue and then waiting for Facebook to respond in order to get their personal information removed.</p>]]></content:encoded>
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		<title>Psychology Today Introduces New Call Tracking: Raises Privacy Concerns</title>
		<link>http://drkkolmes.com/2010/08/05/psychology-today-introduces-new-call-tracking-raises-privacy-concerns/</link>
		<comments>http://drkkolmes.com/2010/08/05/psychology-today-introduces-new-call-tracking-raises-privacy-concerns/#comments</comments>
		<pubDate>Thu, 05 Aug 2010 08:06:08 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[advertising]]></category>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=1915</guid>
		<description><![CDATA[Last week, Psychology Today, the popular website that many psychotherapists use to advertise their practices, sent out an email to those with listings on the site to inform us that we had been opted-in to a new &#8220;security feature.&#8221; From the email: Psychology Today has recently introduced call tracking and call security for your profile. People [...]]]></description>
			<content:encoded><![CDATA[<p>Last week, <a href="http://www.psychologytoday.com/" target="_blank">Psychology Today</a>, the popular website that many psychotherapists use to advertise their practices, sent out an email to those with listings on the site to inform us that we had been opted-in to a new &#8220;security feature.&#8221;</p>
<p>From the email:</p>
<p style="padding-left: 30px;"><em>Psychology Today has recently introduced call tracking and call security<br />
for your profile. People who find you on Psychology Today see a unique<br />
local phone number for you that, when they call it, automatically<br />
connects to your private number.</em></p>
<p>The email went on to explain that clinicians benefit from this change because it offers us &#8220;a simple way to tell who found your profile  on the Therapy Directory.&#8221; Really? You want to know another really simple way to tell how your clients found you? <em>Try directly asking all new clients how they found your practice</em>. I don&#8217;t need the website itself to document patient first contacts in order for me to have this information.</p>
<p>There are a number of problems with this system. First, Psychology Today is used by many people to locate a therapist in their area. But now, clients will not find your actual office number listed. They will see an automatically generated number that Psychology Today has put in place of your office number (as if you would not want clients to know your actual office number!). Then, the site records and documents calls made to our practices without patients being made aware that they are using a third party to connect with us. The call then gets forwarded to our practice phone number and an email summary is sent to us. But the call information also winds up being documented by Psychology Today, including caller ID information and the length of the call. This information is also stored on the Psychology Today site when you log into your account.</p>
<p>This is a serious potential breach of privacy and I object to this service being something I was automatically signed up for, without my consent. On a recent listserv discussion, many therapists had not even received a notification that this change had been made.</p>
<p>In order to opt-out of the virtual phone number, you must log into your Psychology Today account account and click the option in &#8216;Contact History&#8217;. I did this and I recommend others do so if you care about who else retains records of who calls your office or if you want clients to be able to save your actual phone number from the site.</p>
<p>For what it&#8217;s worth, Psychology Today also records the information of those who choose to email you from their site. I much prefer that if clients want to make direct contact with me, they use <a href="https://forms.hush.com/drkkolmes" target="_blank">my secure form </a>or phone my office directly without an advertiser acting as the middle man and collecting data on those who wish to use my services.</p>
<h2>Update: 8/5/10</h2>
<p>For those who want to know more about what it looks like when Psychology Today sends these emails, I phoned my own virtual number. As a caller, it sounded just as if I was calling my regular office line. No information or announcement let me know that my call was being routed through a service. After the call, I received the following email:</p>
<p style="padding-left: 30px;"><em>Hi Keely Kolmes,</em></p>
<p style="padding-left: 30px;"><em>At 09:21 AM PDT you received a phone call. This  caller found you on PsychologyToday.com.</em></p>
<p style="padding-left: 30px;"><em>Call to (415) 501-9098<br />
Call  from Caller ID Blocked<br />
Date: August 5, 2010<br />
Call Duration:  00:00:06</em></p>
<p style="padding-left: 30px;"><em>To view a record of this call, please log into your  profile and click on the Contact History tab.</em></p>
<p style="padding-left: 30px;"><em>FAQs:-</em></p>
<p style="padding-left: 30px;"><em>WHY AM I  GETTING THIS CALL CONFIRMATION?</em></p>
<p style="padding-left: 30px;"><em>Psychology Today has recently  introduced call tracking and call security<br />
for your profile. People  who find you on Psychology Today see a unique<br />
local phone number for  you that, when they call it, automatically<br />
connects to your private  number.</em></p>
<p style="padding-left: 30px;"><em>WHY DO I BENEFIT?</em></p>
<p style="padding-left: 30px;"><em>1: It&#8217;s a simple way to tell who  found your profile on the Therapy<br />
Directory.</em></p>
<p style="padding-left: 30px;"><em>2: You get a  record of the people who have called you (Check &#8216;Contact<br />
History&#8217;  when you log in).</em></p>
<p style="padding-left: 30px;"><em>3: Spam phone calls from telemarketers are  filtered out &#8211; about 99% such<br />
calls can be screened.</em></p>
<p style="padding-left: 30px;"><em>To opt  out of receiving these call confirmation emails, log into your<br />
account  and click the option in &#8216;Contact History&#8217;.</em></p>
<p style="padding-left: 30px;"><em>&#8212;<br />
The folks  at PsychologyToday.com<br />
&#8212;</em></p>
<p style="padding-left: 30px;"><em>*Don&#8217;t reply to this email*</em></p>
<h5 style="text-align: center;">© 2010 Keely Kolmes,  Psy.D.</h5>
<h5 style="text-align: center;">To cite this page: Kolmes, K. (2010)  Additional comments on documentation for clinicians. Retrieved month/year  from http://drkkolmes.com/2010/08/05/psychology-today-introduces-new-call-tracking-raises-privacy-concerns/</h5>]]></content:encoded>
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		<title>People in Your Social Circle: Dr. Kathleen Young Chats with me About Social Networking Challenges for Clinicians</title>
		<link>http://drkkolmes.com/2010/06/07/people-in-your-social-circle-dr-kathleen-young-chats-with-me-about-social-networking-challenges-for-clinicians/</link>
		<comments>http://drkkolmes.com/2010/06/07/people-in-your-social-circle-dr-kathleen-young-chats-with-me-about-social-networking-challenges-for-clinicians/#comments</comments>
		<pubDate>Mon, 07 Jun 2010 07:47:05 +0000</pubDate>
		<dc:creator>admin</dc:creator>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=1786</guid>
		<description><![CDATA[Last February, the Google Buzz fiasco affected lots of people who did not want their email relationships exposed to the world. At the time, Dr. Kathleen Young and I shot a bunch of emails back and forth sharing our concerns over the situation. Dr. Young, who also maintains a professional Twitter account pointed out to [...]]]></description>
			<content:encoded><![CDATA[<p>Last February, the <a id="klv6" title="Google Buzz fiasco" href="../2010/02/18/google-buzz-alarms-therapists/" target="_blank">Google Buzz fiasco</a> affected lots of people who did not want their email  relationships exposed to the world. At the time, <a id="yj7_" title="Dr. Kathleen Young" href="http://drkathleenyoung.com/" target="_blank">Dr.  Kathleen Young</a> and I shot a bunch of emails back and forth sharing  our concerns over the situation. Dr. Young, who also maintains a <a id="kgb1" title="professional  Twitter account" href="http://twitter.com/drkathleenyoung" target="_blank">professional Twitter account</a> pointed out to me how  Google Searches were showing people&#8217;s other connections through Google,  Facebook, and Twitter. Google&#8217;s <a id="hdnc" title="Social Search" href="http://www.google.com/support/websearch/bin/answer.py?hl=en&amp;answer=165228" target="_blank">Social Search</a> is currently in Beta  and is a way that Google is creating a network of connections to  identify relevant social search results.</p>
<p>Dr. Young and I thought we  would share some of our musings about this with readers.<br />
<em> </em></p>
<p style="padding-left: 30px;"><em> </em><strong>Dr.  Young: </strong><em>After Dr. Kolmes and I exchanged information and thoughts  about Google Buzz, I decided to investigate further how my social  media boundaries might be affected. The lack of information from Google  about privacy settings and Buzz led me to consider whether I needed to  maintain a </em><em>Google Profile and what its value is.</em></p>
<p style="padding-left: 30px;"><em>So I  Googled myself!</em></p>
<p style="padding-left: 30px;"><em>I do this periodically and encourage anyone to  do the same to gain information about your online presence. I saw that  at the bottom of my search page Google was linking me to other people </em><em>&#8220;In  my Social Circle&#8221;, information apparently culled from other sites  like WordPress (where I blog) and Twitter. It was not immediately clear  whether this was information the general public has access to or only  for my benefit.</em></p>
<p style="padding-left: 30px;"><em>[You may click on all images below to see larger versions.]</em></p>
<p><strong><a href="http://drkkolmes.com/wp-content/uploads/2010/06/soccirc.png"><img class="aligncenter size-medium wp-image-1798" title="soccirc" src="http://drkkolmes.com/wp-content/uploads/2010/06/soccirc-300x90.png" alt="" width="300" height="90" /></a><br />
</strong></p>
<p><strong><a href="http://drkkolmes.com/wp-content/uploads/2010/06/who.png"><img class="aligncenter size-medium wp-image-1806" title="who" src="http://drkkolmes.com/wp-content/uploads/2010/06/who-300x182.png" alt="" width="300" height="182" /></a></strong></p>
<p><strong>Dr. Kolmes:</strong> The results from <em>People in  Your Social Circle</em> is similar to an issue I faced a year or so ago  when a site called Delver was combing my professional LinkedIn profile  and merging it with my non-professional accounts due to crossover of  friend networks. This was the primary reason I decided to make my  LinkedIn profile non-public. I don&#8217;t want search engines to put together  a picture of my identity based upon my connections, and it feels  invasive to me after the extensive work I&#8217;ve put into separating my  professional and personal lives on the Internet. Google does provide information on how to change and troubleshoot Your Social Circle, but it can be time-consuming to have to constantly manage this information.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/06/how.png"><img class="aligncenter size-medium wp-image-1805" title="how" src="http://drkkolmes.com/wp-content/uploads/2010/06/how-300x195.png" alt="" width="300" height="195" /></a></p>
<p style="padding-left: 30px;"><strong>Dr. Young:</strong> <em>Navigating social media as a psychologist, and a consumer, and  determining ways to do so ethically is a challenge! What the Google  Buzz debacle reminded me is that this is brand new and constantly  changing territory. It is not enough for us as clinicians (or really  anyone who needs to maintain a separate professional online presence) to  create good practices and think that will be enough. We have to stay on  our toes and educate ourselves about changes. It is crucial to have  information about what is available in advance versus responding after  the fact. I find it absolutely necessary to have other social media  savvy mental health professionals to consult with.</em></p>
<p><strong>Dr.  Kolmes:</strong> I completely agree with Dr. Young that it&#8217;s essential to  have other social media savvy professionals with whom to consult. It is  hard to find other professionals who are venturing forth into social  media with shared values and caution. I am very grateful for those with  whom I&#8217;ve made a connection. I see people on the extremes: those who are  highly critical and believe that any social media presence is de facto a  dangerous thing that compromises therapy relationships; or others who  are using social media in careless ways potentially compromising basic  ethical principles. It&#8217;s hard to find professionals who are visible on  social media but are applying a thoughtful, principled standard to such  usage.</p>
<p>Providers of confidential services may want to carefully  consider which <em> Social Content</em> they wish to merge in their <em>Google  Profiles</em>. I opted to remove Twitter from my <em>Google profile</em> for my business, as I did not want people looking at my Google profile  to see a list of my Twitter followers. You can do this by accessing the <em>Social Content</em> settings on your  profile and then you can de-select content that you do not want added to  your profile. I also disabled <em>Google Buzz</em> completely.</p>
<p><em><br />
</em></p>
<p><em><a href="http://drkkolmes.com/wp-content/uploads/2010/06/soccont.png"><img class="aligncenter size-medium wp-image-1804" title="soccont" src="http://drkkolmes.com/wp-content/uploads/2010/06/soccont-300x124.png" alt="" width="300" height="124" /></a><br />
</em></p>
<p style="padding-left: 30px;"><strong>Dr. Young:</strong> <em>Like Dr. Kolmes, this  experience has me reconsidering how I move through the social media  world and what sites I connect to each other. More recently Facebook is  encouraging users to link to other external websites. We need to think  before acting in such situations. We also need to continue to request  that social media sites provide clear privacy policy information and  settings.  I have also opted to switch from gmail.com to hushmail.com  (which provides free and encrypted email services) for sensitive  professional purposes.</em></p>
<p style="padding-left: 30px;">
<p>I want to thank Dr. Young for taking the time to participate in this exchange with me and for alerting me to the <em>People in Your Social Circle</em> issue in the first place.</p>
<p>More and more sites are expanding the scope of their services to include social networking and sharing that their users never anticipated when they first signed up for the services. The latest such move is happening on Yahoo, where Updates will soon be broadcast to your Contacts, <em>à la</em><tt></tt> Google Buzz. You can find out more about <a href="http://www.eff.org/deeplinks/2010/06/opt-out-required-prevent-your-yahoo-mail-contacts" target="_blank">how to opt-out of sharing on Yahoo</a>, thanks to Kurt Opsahl over at EFF.org.</p>
<h5 style="text-align: center;"><strong><strong>©    2010 Keely Kolmes,     Psy.D. </strong></strong></p>
<p style="text-align: center;"><strong><strong>To  cite this page:     Kolmes, K. (2010) </strong></strong>People in Your Social Circle: Dr. Kathleen Young Chats with me About Social Networking Challenges for Clinicians<strong><strong>.   Retrieved month/day/year  from </strong></strong>http://drkkolmes.com/2010/06/07/people-in-your-social-circle-dr-kathleen-young-chats-with-me-about-social-networking-challenges-for-clinicians/.</p>
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		<title>Email Tips for Clinicians</title>
		<link>http://drkkolmes.com/2010/04/28/email-tips-for-clinicians/</link>
		<comments>http://drkkolmes.com/2010/04/28/email-tips-for-clinicians/#comments</comments>
		<pubDate>Wed, 28 Apr 2010 08:20:35 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[ethics]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[privacy]]></category>
		<category><![CDATA[technology]]></category>
		<category><![CDATA[tools for mental health professionals]]></category>
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		<description><![CDATA[This article is part of an online course: Digital and Social Media Ethics for Psychotherapists for 8 CE credits Email Tips for Clinicians Nearly everyone uses email nowadays. I would guess anyone who is reading this right now has an email account. While many clinicians avoid social networking sites such as Twitter, Facebook, or LinkedIn [...]]]></description>
			<content:encoded><![CDATA[<p style="text-align: center;"><strong>This article is part of an online course: <a href="http://www.zurinstitute.com/digitalethicscourse.html" target="_blank">Digital and Social Media Ethics for Psychotherapists</a> for 8 CE credits</strong></p>
<h2>Email Tips for Clinicians</h2>
<p>Nearly everyone uses email nowadays. I would guess anyone who is reading this right now has an email account. While many clinicians avoid social networking sites such as Twitter, Facebook, or LinkedIn they may still use email to keep in touch with family or to access email lists and exchange notes with colleagues.</p>
<p>Those who publish their email addresses with their office information are likely to see more clients using email as the point of initial contact, even if it is their intention to dissuade clients from using email as part of treatment. Some others may be comfortable with ongoing use of email as a way to quickly convey appointment changes to clients or even to send files or documents that are related to treatment.</p>
<p>If email has been or will be a part of your clinical practice, there are some important factors to consider.</p>
<h3>Initial Contact</h3>
<p>A new challenge for clinicians who are visible in social media is that many clients are obtaining clinicians&#8217; email addresses and using them as a point of initial contact. Very often these emails may contain specific and extensive information along with requests for professional advice or information. Clinicians should be very careful in responding to such queries as their response can unintentionally initiate a therapist-client relationship. Giving any advice or offering diagnostic information can be perceived by a prospective client as beginning a treatment relationship. Sometimes the client sending such emails may reside in another state or another country and may not even be appropriate for our practice. I typically respond to such queries with a simple note. I also take care to delete the quoted text of the original email, in the event that someone else has access to it:</p>
<blockquote><p><em>I am legally and ethically unable to provide psychological advice,<br />
diagnoses, or assessments via email to people who are not my<br />
patients.</em></p>
<p><em>If you have concerns you wish to discuss, you may wish to consider<br />
contacting a therapist who lives in your area and scheduling an<br />
appointment to discuss these matters with them.</em></p></blockquote>
<p>Bear in mind that situations involving initial emails may be stickier if the individual sends information related to intent to harm self or others. Choosing whether and how to reply in cases like this should involve consultation and may entail locating crisis resources in the client&#8217;s location.</p>
<h3>Software Security</h3>
<p>Recent privacy flaps such as <a href="http://drkkolmes.com/2010/02/18/google-buzz-alarms-therapists/" target="_blank">what happened with Google Buzz</a> illustrated for me how important it is to use an encrypted and secure email address if you plan to exchange <em>any</em> email with patients. Digitally signed and encrypted email can be exchanged on sites like <a href="http://www.ciphersend.com/" target="_blank">ciphersend</a> or <a href="http://www.hushmail.com/" target="_blank">hushmail</a>, and  some offer secure forms that you can add to your website so that client data is protected. Be sure that this is the email address you put on your cards, website,  and any public information. Also, if you are having mail notification sent to  another email account to alert you that you have a message on a secure site, select the option that does not show the sender&#8217;s  name/address in the forwarded mail. This ensures that you are not advertising secure mail and then having client data sent to a non-secure site which would be misleading.</p>
<p>If you have  clients who want to use email to send you anything, have them come up with a password that you can use to encrypt each message. This can easily be included on your intake form. Each client  should have their own unique password that only you and them know. Clients may also want to create their own secure address on one of these sites if they wish to bypass the password step and exchange secure messages with you.</p>
<p>If you are advertising use of secure email, and you use any web-based referral sites which mask your email address but allow clients to email you from the site, be sure you have linked all these business-related services to your secure email address to avoid security loopholes and being misleading to clients. Do the same if you use sites like PayPal or other credit card payment sites which are sending you information related to the people you treat. And be aware that email sent from data forms on these non-secure sites will compromise privacy. If you use any kind of VOIP messaging service which sends voicemail messages to your email account (sometimes with names/numbers attached to messages), also make sure you&#8217;ve selected a secure email address to which they are sent. In essence, clean up all of your various points of contact to be sure that all information related to clients goes to a secure account.</p>
<p>If you are someone who has used another email address with clients and you are transitioning to a service that offers encryption or more secure email, make sure you remove all client names and emails from your former email account so the names are not stored in your contact list. Remind clients to do the same for your old email address.</p>
<p>Lastly, it&#8217;s good to be cautious when responding to email from accounts where email was forwarded. Some  sites, such as Google, have occasionally exposed the forwarded email  address even when you have chosen reply to show  the originating address. If you are writing from an email address you&#8217;d prefer to keep personal, it may be safer to log out and log into the appropriate email account to respond to some messages.</p>
<h3>Hardware Security</h3>
<p>It goes without saying that if you are downloading emails to your computer or accessing them via a mobile phone, then you should at the very least be logging out of sites when you are done reading messages and using a password on your phone or computer at login or wakeup to prevent others from accessing these accounts.</p>
<p>Be aware that cellphones and laptops are frequently lost or stolen. Encrypting messages or other client data is an important way to protect any client data stored on these devices in the event of loss or theft. If you keep a separate laptop at work, don&#8217;t leave it on your desk after hours. Instead, store it in a locked file cabinet.</p>
<p>Be cognizant that we do not just have to be concerned about what  happens on our end with messages to clients, but we should also be  protective of what may happen on the client end. Even with protections  in place, emails can be viewed by system admins or others in an office.  If your client is in a public place and leaves her computer unattended,  it is possible that anyone walking by may read your message.</p>
<p>Spouses or significant others may also have access to a client&#8217;s  computer or cellphone which may contain email messages. This is another  reason to keep disclosure of sensitive material out of emails, even when  security measures are taken. A confidentiality notice in email is also a  good reminder to clients about being conscientious about the use of  electronic communication.</p>
<h3>Social Networking Sites</h3>
<p>Do not use the same email address you give your clients when you create accounts on social networking sites. You can post your practice email address publicly, but if you want to avoid popping up as a &#8220;suggested&#8221; friend or contact to your clients on these sites, create a different email address for logging into these sites. I also include in my own policies that clients who see or find me on such sites should never use the direct message systems on any of these sites to contact me, as they are not secure. Messages sent and received on these sites may also become a part of the legal record of treatment and may need to be incorporated into the client&#8217;s chart.</p>
<h3>Shared Email Lists</h3>
<p>If you are a member of any email list, there is the potential for one or more clients to also be on the same email list. These could be either personal or professional lists. Social circles do overlap, and cultural and community interests easily draw people together and make the world a smaller place. What this means on the Internet is that it is also very possible that you may discover you are on a shared email list with one of your clients or with others who know or are closely related to one or more of your clients.</p>
<p>Given these possibilities, you may have to choose carefully at times which email address you want to use and how much you care to disclose about your personal life on such lists. There are pros and cons for different approaches.</p>
<p>If you are using the email list for personal support, community, or socializing, you may prefer not to use your professional email account&#8211;but this opens up the possibility that your personal email may be discovered or shared with those you didn&#8217;t want to have it. On the other hand, sticking to your professional email address for all types of interactions on the Internet may make you identifiable as a clinician in places you&#8217;d prefer not to be identified, and you may not wish to publish personal things on the Internet with your professional name.</p>
<p>Some prefer one email address for all interactions while others feel that having a personal email and a professional email address makes for stronger branding and less blurring of personal and professional roles. Clearly, this is something to be thought through and your choice will depend upon your own comfort, as will the amount of personal sharing you&#8217;re comfortable doing on places where your messages may be accessed or archived.</p>
<h3>Policies</h3>
<p>It is appropriate to make clear and explicit policies for whether and how you use email in clinical care. You should put a statement about this in your policy forms. Clients should be informed about how long it typically takes you to  respond to email messages, and they should be informed that email is not  appropriate to communicate emergency situations to you. If you do not wish to have clients emailing you for any purpose, then do not put your email address on your website or business cards. If you allow email in specific cases, make this clear.</p>
<p>My own policy states that I prefer to only use email for business items such as changing appointments and it also notes that all emails sent and received are printed and placed in the client&#8217;s file. It should be noted that many practitioners feel that it is only essential to document emails that reference clinical material, and there are varying views and practices on whether administrative emails (e.g., schedule changes) should be documented.</p>
<h3>Non-Confidential Exchanges</h3>
<p>Some may prefer to continue to use non-secure email for professional exchanges that are non-confidential in nature, including listserv use, research, or exchanges with other clinicians. If you decide to use secure email, you can always retain less secure account for non-confidential exchanges. Just be careful not post or publicize this email address on business cards or other public listings and make sure your colleagues know not to give it out to clients.</p>
<h3>References</h3>
<p>Drude, K, &amp; Lichstein, M. Psychologists Use of E-mail with Clients: Some Ethical Considerations. (2005) The Ohio Psychologist. Retrieved April 28, 2010 from <a href="http://kspope.com/ethics/email.php" target="_blank">http://kspope.com/ethics/email.php</a></p>
<p>Kolmes, K. (2010) Google Buzz alarms a psychotherapist. Retrieved April 28, 2010 from <a href="http://drkkolmes.com/2010/02/18/google-buzz-alarms-therapists/" target="_blank">http://drkkolmes.com/2010/02/18/google-buzz-alarms-therapists/</a></p>
<p>Recupero, P.R. E-mail and the Psychiatrist-Patient Relationship. J Am Acad Psychiatry Law, December 1, 2005; 33(4): 465 &#8211; 475. Retrieved, April 28, 2010 from <a href="http://www.jaapl.org/cgi/content/full/33/4/465" target="_blank">http://www.jaapl.org/cgi/content/full/33/4/465</a></p>
<p>Taube, D.O. (in press). <em>Confidentiality for California psychotherapists</em> (pp. 68 &#8211; 108).</p>
<p>Zur, O. (2010). I Love These E-Mails, or Do I? The Use of E-Mails in Psychotherapy and Counseling. Retrieved month/day/year from <a href="http://www.zurinstitute.com/email_in_therapy.html" target="_blank">http://www.zurinstitute.com/email_in_therapy.html</a></p>
<p><span style="font-family: Verdana,Arial,Helvetica,sans-serif;"><br />
</span></p>
<h5 style="text-align: center;"><strong><strong>©  2010 Keely Kolmes,  Psy.D. </strong></strong><strong><strong> </strong></strong></p>
<p style="text-align: center;"><strong><strong>To cite this page: Kolmes, K.  (2010) Email tips for clinicians.  Retrieved month/day/year from </strong></strong>http://drkkolmes.com/2010/04/28/email-tips-for-clinicians/.</p>
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		<title>Facebook Does it Again: More Privacy Changes Without Adequate Notification to Users</title>
		<link>http://drkkolmes.com/2010/04/23/facebook-does-it-again-more-privacy-changes-without-adequate-notification-to-users/</link>
		<comments>http://drkkolmes.com/2010/04/23/facebook-does-it-again-more-privacy-changes-without-adequate-notification-to-users/#comments</comments>
		<pubDate>Fri, 23 Apr 2010 07:29:43 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[privacy]]></category>
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		<category><![CDATA[social networking]]></category>

		<guid isPermaLink="false">http://drkkolmes.com/?p=1645</guid>
		<description><![CDATA[Facebook released news of some big privacy changes this week. As always, changes that affect our privacy settings are important to  fully understand. The biggest changes allow third-party websites to access and store information about individual users. You can find out more information here along with some instructions on how to restrict information. Just to [...]]]></description>
			<content:encoded><![CDATA[<p>Facebook released news of some <a href="http://money.cnn.com/2010/04/21/technology/facebook_conference_f8/" target="_blank">big privacy changes</a> this week. As always, changes that  affect our privacy settings are important to  fully understand. The  biggest changes allow third-party websites to access and store  information about individual users. You can find out more information <a href="http://iandouglas.com/2010/04/21/facebooks-social-web-will-not-be-a-private-web/" target="_blank">here</a> along with some instructions on how to restrict information. Just to be clear, if you&#8217;re someone who uses a number  of Apps that connect outside services to Facebook and if you&#8217;re hitting  the Like button on sites and connecting that to your Facebook profile,  this will affect your privacy. There are also further instructions on how to <a href="http://iandouglas.com/2010/04/21/howto-protect-yourself-as-best-you-can-from-facebooks-f8-platform/" target="_blank">protect yourself from Facebook&#8217;s F8 platform</a>, with the caveat &#8220;as best you can.&#8221;</p>
<p>Another change that will affect everyone is the change to Pages. On  people&#8217;s profiles, the <strong>Pages</strong> section will now be folded into <strong>Interests</strong> and users will be asked to convert <strong>Pages</strong> into <strong>Interests</strong>.</p>
<p>To quote from the CNN article linked to above:</p>
<address>Doesn&#8217;t sound like such a big deal, but here&#8217;s the kicker:  Users who  choose to convert their interests to &#8220;pages&#8221; will lose  privacy control  with the new changes. Many parts of users&#8217; profiles,  including  hometowns, birthdays, education, religion and work interests  would be  considered &#8220;connections&#8221; if a user converts them, making them  public to  anyone.</address>
<address> </address>
<address> </address>
<p>So what happens when you are asked to convert your <strong>Pages</strong> into <strong>Interests</strong>?  Let&#8217;s take a look.</p>
<p>When I logged into my Facebook account last night, I was informed that  they had &#8220;improved&#8221; the profile so that it links to <strong>Pages</strong>, and I  was offered the opportunity to convert my <strong>Pages</strong>. I wasn&#8217;t given a  <strong>No</strong> option. Simply <strong>Link All to My Profile</strong> or <strong>Ask Me  Later</strong>.</p>
<p><em>You can click on all images below to view larger  versions.</em></p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-1.png"><img title="Picture 1" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-1-300x171.png" alt="" width="300" height="171" /></a></p>
<p>You&#8217;ll note that in the image, there is small print saying, <strong>Learn  more</strong>. When I clicked on <strong>Learn More</strong> here is what I learned: I  learned that this was a really great thing that was going to enhance my  Facebook experience and make my life an overall happier place.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-2.png"><img title="Picture 2" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-2-300x199.png" alt="" width="300" height="199" /></a></p>
<p>There was no clear or accessible information to learn more about a  decision <em>NOT</em> to convert <strong>Pages</strong> or how to not have them show  up or even how it might compromise my privacy to just go ahead and <strong>Convert  All</strong> as I was being encouraged to do.</p>
<p>In order to remove the <strong>Pages</strong>, I had to go at it sideways. I  went back to my profile and selected <strong>Edit Information</strong> when  viewing my profile.</p>
<p>Here is where I was able to select or deselect the <strong>Pages</strong> and  confirm whether I did, in fact, want them on my profile.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-4.png"><img title="Picture 4" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-4-300x198.png" alt="" width="300" height="198" /></a></p>
<p>Since the privacy updates will now make you connected to others via a  number of your interests, I unchecked the boxes next to these <strong>Pages</strong>,  and was subsequently warned that this would create blank spots on my  profile. Okay with me.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-5.png"><img title="Picture 5" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-5-300x195.png" alt="" width="300" height="195" /></a></p>
<p>Back on my main profile page, I was given a message to explain why  some of my information had disappeared.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-6.png"><img title="Picture 6" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-6-300x228.png" alt="" width="300" height="228" /></a></p>
<p>It is disturbing that never once in the process was I given any  information about how the changes would affect my privacy. There was no  link to a privacy policy or statement about what this step would do.  There was just subtle pressure to go ahead and make the changes and  warnings that I was going to make myself a Facebook pariah by not having  certain information on my profile.</p>
<p>So where is this information to be found?</p>
<p>If you click on <strong>Help Center</strong> under your account on the right  side of the screen, you will be taken to the Help pages.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-41.png"><img title="Picture 4" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-41-300x294.png" alt="" width="300" height="294" /></a></p>
<p>In the <strong>Help Center</strong>, on the far right, there is a statement  about <strong>New Profile Connections</strong> and a link to where you can Learn  more about the new Community Pages and profile connections.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-11.png"><img title="Picture 1" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-11-300x127.png" alt="" width="300" height="127" /></a></p>
<p>When you click on that link to learn more, here is where all the  information I should have received upon login was hiding:</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-21.png"><img title="Picture 2" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-21-300x290.png" alt="" width="300" height="290" /></a></p>
<p>And of course, you can click on each topic to expand it, and there is  the information about how this will affect the content on your profile.</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-31.png"><img title="Picture 3" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-31-300x279.png" alt="" width="300" height="279" /></a></p>
<p>Lots of people use Facebook. But not everyone is tech-savvy. There are moms and dads on Facebook, young people who are not  tech-smart, teachers, doctors, and just plain old people who care about  their privacy now and then. Even folks who are tech-savvy shouldn&#8217;t have to hunt around for updated privacy information.</p>
<p>So come on, Facebook. When you make changes that influence privacy,  the very first pop-up we see when we sign into your site shouldn&#8217;t be a  link asking us to <strong>Convert</strong> our <strong>Pages</strong> to <strong>Interests</strong>.  It should be a link to how the action you&#8217;re asking us to respond to <em>right  now</em> is going to affect our privacy.</p>
<p>Some further changes to Facebook?</p>
<p>There&#8217;s a Wall posting that&#8217;s been forwarded by folks saying:</p>
<p><em>FACEBOOK is at it again&#8230;violating your   personal information: As of today, there is a new privacy setting called   &#8220;Instant Personalization&#8221; that shares data with non-facebook websites   and it is automatically set to &#8220;Allow.&#8221; Go to <strong>Account &gt; Privacy   Settings &gt; Applications and Websites</strong> and uncheck &#8220;<strong>Allow</strong>,&#8221; then  confirm  that you&#8217;re opting out. Please repost.</em></p>
<p>I followed this path, and sure enough, here is what I saw:</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-12.png"><img class="aligncenter size-medium wp-image-1647" title="Picture 1" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-12-300x177.png" alt="" width="300" height="177" /></a></p>
<p>When I clicked on &#8220;<strong>Allow</strong>&#8221; to deselect it, here&#8217;s the message I saw:</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-22.png"><img class="aligncenter size-medium wp-image-1648" title="Picture 2" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-22-300x188.png" alt="" width="300" height="188" /></a></p>
<p>More information about how I may be depriving myself of a &#8220;richer&#8221; Facebook experience and the disclaimer that even opting out will not prevent my friends from sharing this information with others. Again, how come I had to be notified about this by my friends, Facebook, and not the service itself? Shady.</p>
<p>If you&#8217;re a mental health professional trying to keep a low profile  on Facebook, you might consider emptying your profile of information you  don&#8217;t want to share with people you are not directly connected to. Or,  you may wish to also remove <strong>Pages/Interests</strong> from your profile to  reduce the likelihood of being connected to others. A new option is becoming available which allows you to hide this information on your actual profile&#8211;again something I discovered through active searching but not made clear to me at any point during login.</p>
<p>A number of folks are talking about committing <a href="http://www.downloadsquad.com/2009/12/24/commit-facebook-suicide-no-really-theres-an-app-for-that/" target="_blank">Facebook suicide</a>. As we enter a new world in which our privacy is compromised without our notification, I can see the appeal.</p>
<h2>Update, April 23</h2>
<p>Kurt Opsahl at the Electronic Frontier Foundation also offers some detailed information on <a href="http://www.eff.org/deeplinks/2010/04/how-opt-out-facebook-s-instant-personalization" target="_blank">How to Opt Out of Facebook&#8217;s Instant Personalization</a>.</p>
<p>One last note from me. A lot of folks recommend that you choose &#8220;<strong>Only Friends</strong>,&#8221; for many of your privacy settings. As I say to my colleagues, when it comes to Social Media, I am equal mixes of conservative, paranoid, yet adventurous. The paranoid part of me would like to recommend that you click on &#8220;<strong>Custom</strong>&#8221; for many of these settings and choose &#8220;<strong>Only Me</strong>,&#8221; for many of these settings if you really want to limit what folks can see on your profile. Why not? If they are really your friends, they know this stuff about you anyway, right?</p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-33.png"><img class="aligncenter size-medium wp-image-1655" title="Picture 3" src="http://drkkolmes.com/wp-content/uploads/2010/04/Picture-33-300x181.png" alt="" width="300" height="181" /></a></p>
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		<title>Location Based Check-In Sites for Mental Health Professionals</title>
		<link>http://drkkolmes.com/2010/02/26/location-based-check-in-sites-for-mental-health-professionals/</link>
		<comments>http://drkkolmes.com/2010/02/26/location-based-check-in-sites-for-mental-health-professionals/#comments</comments>
		<pubDate>Fri, 26 Feb 2010 19:31:25 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[ethics]]></category>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=1438</guid>
		<description><![CDATA[This article is part of an online course: Digital and Social Media Ethics for Psychotherapists for 8 CE credits 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 [...]]]></description>
			<content:encoded><![CDATA[<p style="text-align: center;"><strong>This article is part of an online course: <a href="http://www.zurinstitute.com/digitalethicscourse.html" target="_blank">Digital and Social Media Ethics for Psychotherapists</a> for 8 CE credits</strong></p>
<p style="text-align: left;">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 <a href="http://foursquare.com/" target="_blank">Foursquare</a>, <a href="http://www.loopt.com/" target="_blank">Loopt</a>, <a href="http://brightkite.com/" target="_blank">brightkite</a>, and <a href="http://gowalla.com/" target="_blank">Gowalla</a> when one is involved in the provision of clinical services. I have met with a few trainees 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.</p>
<p>It&#8217;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 <em>your</em> encouraging clients to publicly check-in on these sites which raises a number of sticky issues.</p>
<p>When sites like foursquare encourage business owners to <a href="http://foursquare.com/businesses/" target="_blank">put their sites up</a> 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&#8217;s a bit more dicey whether it&#8217;s simply strategic marketing and business promotion or an invitation for people to check-in. Given that ethics codes for <a href="http://www.apa.org/ethics/code/index.aspx" target="_blank">psychologists</a>, <a href="http://www.socialworkers.org/pubs/code/code.asp" target="_blank">social workers</a>, and <a href="http://www.aamft.org/resources/lrm_plan/Ethics/ethicscode2001.asp" target="_blank">marriage and family therapists</a> 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 &#8220;check-in&#8221; 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.</p>
<p>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 really 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.</p>
<p>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 she attends therapy and the disclosure is hers to make. But the question remains whether the invitation alone could be perceived as subtly influencing some clients to do so.</p>
<p>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 <a href="http://www.apa.org/ethics/code/index.aspx" target="_blank">APA Ethics Code</a> applies only to activities that are a &#8220;part of (our) scientific, educational, or professional roles as psychologists.&#8221; 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&#8217;s worth it to be mindful about which risks you want to take in your own professional practice.</p>
<p><strong>References</strong></p>
<p><em> </em></p>
<p style="padding-left: 30px;">American Association for Marriage and Family Therapy. (2001, July 1). <em>AAMFT</em><em> code of ethics. </em>Retrieved from http://www.aamft.org/resources/lrm_plan/ethics/ethicscode2001.asp</p>
<p style="padding-left: 30px;">American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. <em>American Psychologist</em>, 57, 1060-1073.</p>
<p style="padding-left: 30px;">National Association of Social Workers. (1999). <em>Code of Ethics of theNational Association of Social Workers</em>. Washington, DC: Author.</p>
<h5 style="text-align: center;"><strong><strong>©  2010 Keely Kolmes, Psy.D. </strong></strong><strong><strong> </strong></strong><strong><strong>To cite this page: Kolmes, K. (2010) Location based check-in sites for mental health professionals. Retrieved month/day/year from </strong></strong>http://drkkolmes.com/2010/02/26/location-based-check-in-sites-for-mental-health-professionals/.</h5>
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		<title>Google Buzz Alarms a Psychotherapist</title>
		<link>http://drkkolmes.com/2010/02/18/google-buzz-alarms-therapists/</link>
		<comments>http://drkkolmes.com/2010/02/18/google-buzz-alarms-therapists/#comments</comments>
		<pubDate>Thu, 18 Feb 2010 07:17:09 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[office information]]></category>
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		<guid isPermaLink="false">http://drkkolmes.com/?p=1383</guid>
		<description><![CDATA[Wake up and smell the smoke 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&#8217;t really know at all. We just happened [...]]]></description>
			<content:encoded><![CDATA[<h3>Wake up and smell the smoke</h3>
<p>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&#8217;t really know at all. We just happened to be active participants on shared email lists, but we&#8217;d never met.  I&#8217;d heard the murmurs about Google Buzz, so I knew something was brewing. But what arrived wasn&#8217;t what I expected. I certainly wasn&#8217;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.</p>
<div>
<h3>Warning bells</h3>
<p>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&#8217;t I been asked or alerted <em>before</em> this morning, by the way?</p>
<p>At this point, it hadn&#8217;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.</p>
<h3>Google Buzz and Psychotherapy</h3>
<p>This is problematic for a mental health professional for a number of reasons.</p>
<p>1. A number of my clients prefer email as their primary way of contacting me. If clients show up on my follow list (or I show up on theirs), that is a big breach of their privacy without any warning.</p>
<p>2. I deserve some privacy too. I don&#8217;t necessarily want clients or business contacts to know who else I regularly exchange email with, whether those people are clients, friends, or colleagues.</p>
<p>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.</p>
<p>I wasn&#8217;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, <a href="http://www.businessinsider.com/warning-google-buzz-has-a-huge-privacy-flaw-2010-2" target="_blank">articles</a> started to emerge that were <a href="http://www.nytimes.com/2010/02/13/technology/internet/13google.html?th&amp;emc=th" target="_blank">addressing </a>the privacy flaws.</p>
<p>I turned Buzz off immediately. But I then discovered that I had to go back in and manually block the folks I&#8217;d been following as well and remove the links to our names if I did not want them showing up on my public profile.</p>
<p>But this was a wake up call for me.</p>
<h3>Confidentiality</h3>
<p>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.</p>
<p>My response has been to completely move my email to <a href="http://www.hushmail.com/" target="_blank">hushmail</a> 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 <a href="http://www.nytimes.com/2010/02/15/technology/internet/15google.html?th&amp;emc=th" target="_blank">apology from Google</a> and a <a href="http://www.businessinsider.com/google-making-more-changes-to-buzz-after-privacy-outcry-2010-2" target="_blank">number</a> of <a href="http://www.pcworld.com/businesscenter/article/189334/after_outcry_google_revamps_buzz_networking_application.htmlEdit" target="_blank">privacy updates</a> to correct the Google Buzz problems. Here is Google&#8217;s <a href="http://gmailblog.blogspot.com/2010/02/new-buzz-start-up-experience-based-on.html" target="_blank">official reply</a>.</p>
<h3>Steps for therapists</h3>
<p>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:</p>
<p>1. Go into your Gmail settings and select &#8220;Disable Buzz.&#8221; You can also directly access this setting by selecting &#8220;Turn Off Buzz,&#8221; at the very bottom of your Gmail Inbox. <em>(Click on photo for larger version.)</em></p>
<p><a href="http://drkkolmes.com/wp-content/uploads/2010/02/Picture-1.png"><img class="aligncenter size-medium wp-image-1394" title="Picture 1" src="http://drkkolmes.com/wp-content/uploads/2010/02/Picture-1-300x129.png" alt="" width="300" height="129" /></a></p>
<p>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 <a href="http://www.ciphersend.com/" target="_blank">ciphersend</a>. 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&#8217;re not on gmail.</p>
</div>
<div>3. Remember that it is not enough to switch emails. Encourage your clients to delete your gmail address from their contact list and do the same for any clients with whom you have exchanged email in order to avoid future exposure or crossover on sites.</div>
<div>4. If you have mail from these sites forwarded to other email accounts, make sure you have opted not to have the email sender&#8217;s name included in the forward.</div>
<div>5. Update your web presence and advertisements to redirect to the new email address.</div>
<div>6. Be aware that if you use Google Reader, you may continue to get requests to share and follow items there.</div>
<p>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.</p>
<h3>Other resources</h3>
<p>For some more Gmail privacy tips, lifehacker has a good post <a href="http://lifehacker.com/5470671/top-10-google-settings-you-should-know-about" target="_blank">Top 10 Google Settings You Should Know About</a>. Here is another informative post <a href="http://abdpbt.com/tech/2010/02/15/3-things-you-should-know-before-using-or-continuing-to-use-google-buzz/" target="_blank">3 Things You Should Know Before Using (Or Continuing to Use) Google Buzz</a>.</p>
<h2>Update: November 2, 2010</h2>
<p>Today, Google has notified users of a class action settlement in the lawsuit regarding Google Buzz. An excerpt from their email:</p>
<p style="padding-left: 30px;"><em>The settlement acknowledges that we quickly changed the service to  address users&#8217; concerns. In addition, Google has committed $8.5 million  to an independent fund, most of which will support organizations  promoting privacy education and policy on the web. We will also do more  to educate people about privacy controls specific to Buzz. The more  people know about privacy online, the better their online experience  will be.</em></p>
<p style="padding-left: 30px;"><em>Just to be clear, this is not a settlement in which people who use Gmail  can file to receive compensation. Everyone in the U.S. who uses Gmail  is included in the settlement, unless you personally decide to opt out  before December 6, 2010. The Court will consider final approval of the  agreement on January 31, 2011. This email is a summary of the  settlement, and more detailed information and instructions approved by  the court, including instructions about how to opt out, object, or  comment, are available at <a href="http://www.buzzclassaction.com/" target="_blank">http://www.BuzzClassAction.com</a></em></p>
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<h5 style="text-align: center;"><strong><strong>©   2010 Keely Kolmes,  Psy.D. </strong></strong><strong><strong> </strong></strong></p>
<p style="text-align: center;"><strong><strong>To  cite this page: Kolmes, K.  (2010) Email tips for clinicians.  Retrieved  month/day/year from </strong></strong>http://drkkolmes.com/2010/<strong>02/18/google-buzz-alarms-therapists/</strong>.</p>
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