Our networking group for Bay Area Psychotherapists has a new mission statement:

We are a group of San Francisco Bay Area psychotherapists and psychotherapy students who affirm that sexual and gender diversity are natural expressions of the human experience.

We provide a safe haven for mental health clinicians to gather, network, support, and
consult.

Our psychotherapy practices welcome and serve:

● Clients who engage in consensual sexual behaviors, including but not limited to kink and polyamory.
● Clients who are gender variant.

Our group welcomes:

● Students seeking mentorship in working affirmatively and responsibly with said clients.
● Professionals seeking networking, support, and consultation in working affirmatively and responsibly with said clients.

We are committed to expanding affirmative psychological understandings of sexual and gender diversity, and to counteracting the historical and present day harm done by pathologizing diagnoses, stigma, and invisibility.

We are committed to identifying standards of affirmative and culturally competent care, and to sharing this information with each other and our colleagues so that we may better serve our clients and their communities.

We have all agreed to abide by the ethical guidelines of our respective disciplines.

If you are interested in joining our group, please email Keely Kolmes, Psy.D. PSY21284

In your email, please provide your name, license, practice and/or school information, and a brief bio about your interest in the group. This information will be shared only with other members of our group.

We look forward to hearing from you!

Are you a TADS?

Please join our group: Bay Area Therapists Affirming of Diversity in Sexuality

This is a free group for mental health professionals in the Bay Area of California. We offer support, networking, and consultation for Bay Area clinicians and mental health trainees who embrace the full range of sexual expression of consenting adults. Our respective practices explicitly welcome and serve clients who engage in alternative sexual behaviors and relationships, including kink and poly folks.

We offer an email list and meet every other month at a member’s office.

We are especially interested in reaching out to students who may not have mentors or support in their clinical programs around working with sexually diverse populations.  Most clinical programs encourage students to explore their cultural identities and offer student groups organized around ethnicity, religion, LGBT-identity, disability, or other cultural affiliations.

But students who are kink or poly-identified or who want to work with these populations may have a more difficult time identifying one another and forming such groups. Many schools still don’t recognize these alternative identities as deserving of non-biased care and respect. We are seeking to bridge this gap. We offer a safe space to connect with other mental health professionals who are affirming of the full range of diverse sexual expression.

Contact me at drkkolmes at hushmail dot com if you would like to get connected with us.

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

The past two days, a subsection of the Internet was ablaze with commentary related to the Facebook privacy changes that I blogged about yesterday. Some users didn’t mind the changes. Some didn’t realize they had lost privacy options. But those who were upset were, like me, extremely upset.

One post by Heidi N. Moore, Facebook to Privacy: Drop Dead, accurately referred to it as a “bait and switch,” and addressed why reporters may wish to keep their friend lists private. Joseph Bonneau, a security researcher, wrote Facebook Tosses Graph Privacy Into the Bin, about why friend lists should be regarded as sensitive data. And then there is Kevin Bankston of EFF’s post Facebook’s New Privacy Changes: The Good, The Bad, and The Ugly.

Since the initial changes were made, Facebook has added back the ability to hide your friend list from other users. Nevertheless, in some of my exchanges with other mental health professionals, the option of blocking users has come up more than once as a means of ensuring greater privacy. Before last night, I had never tried using the Block feature on Facebook, as the original privacy settings had met my needs well. I experimented with it yesterday and it does seem to be a useful way to restrict access to one’s profile and I can see some benefits to using it in certain situations.

That said, I have some strong objections to relying upon the Block feature as a means of restricting access to profiles, particularly when health care providers use it to Block patients.

Does it work?

My first concern is technical: blocking particular email addresses assumes that you know which email address a person is using to access their Facebook profile. Many users link multiple email addresses to their Facebook accounts, so blocking the email address you know does not completely ensure that someone doesn’t have access to you. It also doesn’t address users who have used one email address to contact you but have their mail forwarded to another address. These users may still be able to view your profile when using an email address with which you are not familiar.

More privacy infringement

My second issue is related to overall privacy violations: forcing users to choose the Block feature as the only way to restrict others’ access to their profile is simply another means of collecting data. Typing names into a Block list is one more infringement on personal privacy. When we do this, we are providing specific information to Facebook about people and saying something about our connections to them. This is much more information than I care to provide to Facebook when there is a much easier way to restrict access that does not entail my providing the company with information about my specific relationships.

Our own commitment to client privacy

Just as we expect Facebook to honor our privacy, our clients expect us to do the same. As an issue of professional ethics, it seems to me to be a violation of patient privacy to enter client names and/or email addresses into Facebook unless that is specifically indicated in our treatment contracts.

My current treatment agreement states that I keep patient information private and do not share it with others unless there is reason to believe that the patient or another individual is at risk. My policy does not indicate that I may also share client information with Facebook. It is easy to forget that when we type names into a search engine or a field on a social network, we are also sharing information with others. Doing so without, at the very least, informing our clients seems to be a breach of trust.

However, if Facebook continues to make it impossible for us to restrict profiles to users of our choosing, those of us who wish to continue using the social network in our private lives may find Block to be a useful feature. If I ever decide to employ it on my own Facebook profile, I will include a statement about this in my Social Media Policy, so that clients are aware that I do this and why. Clinicians who are already Blocking clients may wish to consider explaining that they do it not only to prevent clients from stumbling onto their interactions with others, but also to prevent therapists themselves from seeing their clients’ personal interactions with shared friends if they should have overlapping social circles.

That said, I’d greatly prefer that Facebook just do the right thing and allow their users to have back the greater control over profile privacy that they enjoyed up until just a few days ago.

References

Bankston, K. (2009, December 9) Facebook’s New Privacy Changes: The Good, The Bad, and The Ugly. Retrieved December 11, 2009 from http://www.eff.org/deeplinks/2009/12/facebooks-new-privacy-changes-good-bad-and-ugly

Bonneau, J. (2009, December 11) Facebook tosses graph privacy into the bin. Retrieved December 11, 2009 from http://www.lightbluetouchpaper.org/2009/12/11/facebook-tosses-graph-privacy-into-the-bin/

Kolmes, K. (2009, December 10) How Facebook is Getting it Wrong: New Privacy Settings Offer Less Privacy. Retrieved December 11, 2009 from http://drkkolmes.com/2009/12/10/how-facebook-is-getting-it-wrong-new-privacy-settings-offer-less-privacy/

Kolmes, K. (2010, February 1) Private Practice Social Media Policy. Retrieved April 26 2010) from http://www.drkkolmes.com/docs/socmed.pdf

Moore, H. (2009, December 10) Facebook to Privacy: Drop Dead. Retrieved December 10, 2009 from http://www.thebigmoney.com/blogs/sausage/2009/12/10/facebook-privacy-drop-dead

Muller, A.Y. (2009, December 9) Updates on Your New Privacy Tools. Retrieved December 11, 2009 from http://blog.facebook.com/blog.php?post=197943902130

© 2009 Keely Kolmes, Psy.D.

To cite this page: Kolmes, K. (2009) Should mental health professionals block clients on Facebook? Retrieved month/day/year from http://drkkolmes.com/2009/12/11/should-mental-health-professionals-block-clients-on-facebook/.

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/.

I am organizing a support/networking/consultation group for Bay Area clinicians that would allow students from various training programs to meet and network with one another and also allow them to connect with those of us who are already established as kink & poly aware professionals.

More about my motivation for this can be read below.

Recently, I’ve had the opportunity to reflect on my experience as a graduate student doing research on kinky sex. Taking on therapist bias against BDSM as a dissertation topic was challenging. I frequently felt misunderstood or I worried that professors and other students might make assumptions about my sexual practices. When I wasn’t busy worrying about those things, I worried about the burden of responsibility that I suddenly felt to the BDSM community, by virtue of choosing this topic. I went back and forth several times and nearly changed my topic to something….less adventurous.

However, I’d had the experience in my early 20′s of discovering books and friends who taught me that BDSM wasn’t the terrible, dirty thing I had once assumed it was. I learned that it was actually something that could be about trust, love, safety, and consensuality.

I had my mind changed.

Thus, with the earnestness and conviction that can only come from having your own prejudices revealed to yourself, I took on the issue as a personal challenge to myself, and eventually completed my dissertation on BDSM. This also meant that I experienced anxiety and dread in anticipation of every class I took over the next five years, as it was standard protocol to introduce yourself and your dissertation topic on the first day of every first class each semester.

Of course I hoped that my doing research in this area might mean that it would help reduce bias for BDSM clients entering therapy one day. But I also dreamed that psychology graduate students who identified as kinky or poly might also feel safer as they navigated graduate school or at least feel that the profession had become more welcoming.

It’s now thirteen years since I started my graduate training, and I’ve recently heard from students in training programs who do not feel that their programs adequately provide support or mentoring for developing clinicians who identify as kinky and/or poly or who simply wish to work with those populations.

Most programs these days encourage students to explore their cultural identities and they have student organizations allowing students to connect around ethnicity, religion, LGBT-identity, disability, or other cultural affiliations. But students who are kink or poly-identified may have a more difficult time identifying one another and forming such groups. Students struggle with how–and whether–to come out in a professional capacity either as members of the kink or poly communities themselves or as simply having knowledge or interest in serving these populations. Many schools still don’t recognize these alternative identities as deserving of support or outreach.

My support/networking/consultation group for Bay Area kink/poly-aware clinicians would allow students from various training programs to meet and network with one another and also allow them to connect with those of us who are already established as kink & poly aware professionals.

I will be the featured guest at Betty Sullivan’s next Smart Women Business Networking event on Wednesday, July 29th at Catch Restaurant, 2362 Market Street, in San Francisco. The event is from 5:30 – 7:30.

Smart Women provides a space for women in business and their friends to gather, socialize, and share business ideas while enjoying drinks and appetizers. It’s relaxed and friendly, and it’s a great place to make personal and professional connections. Most of the attendees are subscribers and contacts of “Betty’s List,” an online information service for the San Francisco Bay Area’s LGBT community.

I will speak briefly about my psychotherapy practice and current projects and I will answer your questions. I will also lead the “Shout Out!” activity in which each attendee has the chance to introduce herself and her business.

The event is free to members of the Betty’s List directory and non-members can attend for $10.00. If you want to meet other business women, you want to know more about psychotherapy, or you just wanted to meet me, please come out and join us.

I’m looking forward to meeting you!