When Psychotherapists Digitally Eavesdrop on Social Media
This post was first published on PsychCentral.
Mental health professionals have worried for years about their clients digging for personal information about them on the Internet. But what about when psychotherapists consult Google to unearth personal information about their clients? Do psychotherapists carry the same concerns for client privacy that they do for their own?
Some mental health professionals assert that what clients post on the web is public information, and — as such — it is fair game for review. And, yes, it is one thing if you are in a forensic role, and your job is to investigate your client. But what if your role is clinical and involves building a relationship of trust and authenticity? Do we somehow have a right to access all of a person’s archived Internet data simply because they visited our office seeking care?
Those who assert that clinicians have a right to search for this information seem to be expressing a sense of entitlement to a patient’s out-of-session life. Reasons given for looking for this information include assessing risk and verifying information shared in treatment. But would these same clinicians attend a performance or a talk a client was giving and not tell the client they had attended? Would they go observe other social events secretly and not share with their client that they had done so? It is the discretion provided by the Internet that seems to allow some clinicians an excuse for engaging in online behaviors they would never endorse offline.
For most people, taking time to develop trust and a connection before divulging difficult information is part of healthy boundaries, even when seeking psychological treatment. A psychotherapist who rushes to discover what a client hasn’t yet shared may be contaminating the therapy relationship or re-enacting boundary violations that the client has already experienced. Many clients of mine share deeper secrets as the therapy progresses, and for me to race ahead to these points of vulnerability in a web search would seem to to be shortchanging both of us in the clinical relationship.
Those who argue clients look us up on the Internet, and therefore it is fair game for us to do the same, are failing to note a key difference in that there is a significant power differential when psychologists seek supplemental personal information about clients.
As mental health professionals, we have the ability to use this information to influence our diagnostic impressions. We hold authority in our relationships with our clients that they do not hold with us. We are not equals. That is why we have licensing boards and an informed consent process with clients in which we are required to share with them our policies and protocols. When patients look us up before retaining our services as professionals, they are typically seeking information about how we practice or if others recommend our services. If we routinely engage in the practice of researching our clients without informing them that we do so, I’d say it has the potential to be exploitative, harmful, and deceptive.
While the extent of such a search and whether it is clinically warranted may alter the significance of it, in my opinion, those who do so without engaging in a thoughtful analysis of their motivies and those who do not inform their clients of this practice may be taking advantage of electronic access to those who are in our care. If you are compelled to seek out this information, why not do such a search with your client present? Why not do it openly, with full disclosure, so that the two of you may discuss the accuracy of what you find then and there and actually incorporate it into treatment?
None of this is to say that it’s possible to avoid incidental contacts with patients on the Internet. It is all too easy to stumble onto a client’s Facebook page or Twitterfeed by following a shared connection.
But what one does when they arrive there does matter. Do you read every post on the client’s Wall and browse his photo albums? Or do you hit the back button on your browser and let your client enjoy a life outside of the therapy room, choosing himself what to bring into treatment?
I’d vote for the latter.
Agree or disagree with this post? I’d love to know your thoughts. Feel free to comment.
September 12, 2013 @ 7:47 am
I so appreciate your work/blog. I need to tell you that first (I recommend it to all of my colleagues!). Anyway, I fully expect my clients to google me and I have a large footprint because I’m also a freelance writer and I’m all over the web. That’s fine, we can talk about it if they find anything that concerns them. I, however, do not go find them even though I’m adept at googling (it’s part of writing work — vetting sources, finding interviewees, etc.). I have run into clients on Facebook before (Central Ohio is a fairly small community in a lot of ways) and I just blocked them. In my social media disclosure I say that I will do this. I don’t tell them when it happens but I like to make it clear upfront. Even though they wouldn’t be able to see much about me (because I keep my FB on lockdown), I do it so that their space on FB won’t feel violated by running into me on a friend’s wall or community page.
September 12, 2013 @ 11:26 am
My only quibble is with the assumption of a power differential between therapists and clients. I know that’s an assumed thing in our professions, but I’m not convinced that it is as ever-present or monolithic as it is often made out to be.
However, I agree that a quid-pro-quo approach to judging whether or not to seek out information about a client on the Web seems inappropriate. It strikes me as much like indiscriminate self-disclosure or other boundary crossings done for the benefit of the therapist. I.e. if one is inclined to Google a client, it seems to me that a personal check-in around the reasons for the search and an examination of whether or not the search is in the client’s interests or one’s own, would be indicated.
September 18, 2013 @ 12:40 pm
Roy, I’m happy to argue with you on this. 🙂
I will acknowledge that there are some more egalitarian types of therapy. But I have heard so many stories the emphasize the power differential in variety of ways. One of the more typical stories I hear is about clients who want to end therapy but a previous therapist made termination very difficult, either telling them that they were not finished or they were avoiding something they needed to work on. Given how many patients then feel pressured to continue, I think we can surmise that this is not a relationship that is experienced as two equals.
I also think that the power to diagnose creates quite power differential.
I have also met many people socially or at parties who, upon hearing I’m a psychologist, assume I am analyzing them or I am able to know things about them. So think there is a certain kind of mythology that we sometimes hold.
And all of this is separate from the fact that if we are using the information we find on the Internet to actually make treatment decisions or adjust diagnoses that influence a client’s life, it’s hard for me to see that as psychotherapists and patients being on equal footing. Just saying.
Thanks for commenting. Always nice to see you here.
September 13, 2013 @ 2:37 pm
Keely, thank you SO much for this thoughtful, intelligent posting. I always appreciate your fresh, ethical perspective on these contemporary issues for therapists and clients in the digital age. Googling clients feels like opening their mail without permission (remember snail mail?), a boundary violation, and yes, you are right; this is an informed consent issue. Conversely, I fully expect that clients will search for info about us on line, which raises a whole ‘nutha basket of issues for the therapeutic relationship. It’s also why I have a professional website that allows my own voice to have an intentional on-line presence.
September 17, 2013 @ 10:31 am
Thank you so much for your blog. I loved to read your article and will recommend it to our clients. All the best for further publishing!!!