Our online course, Self Disclosure By Therapists: Ethical & Clinical Considerations
Traditionally, the professional literature has discussed three types of self-disclosure:
- 1. Deliberate self-disclosure includes therapists intentionally disclosing, to clients, personal information about their marital status, spiritual orientation, music preferences, political affiliation, etc. Deliberate self-disclosure also includes information posted by the therapist on their own, and other, Web sites.
- 2. Unavoidable self-disclosure includes a wide range of possibilities, such as the therapist’s gender, age, physical attributes, disabilities, visible tattoos, obesity, manner of dress, wedding rings, etc. Therapists, who practice in small or rural communities or on college campuses, encounter additional significant unavoidable self-disclosure.
- 3. Accidental self-disclosure occurs when there are incidental-unplanned encounters outside the office, or spontaneous verbal or non-verbal reactions.
- 4. Deliberate but unintentional disclosure occurs when therapists post certain information online. One example is when therapists post information online about their clients while neither getting releases nor adequately concealing their clients’ identities. Other deliberate but unintentional types of disclosures are when therapists condone fraud and illegal activities on the Internet.
What And How Clients May Find Information About Their Therapists:
- In the past, intrusive clients were known to have searched and found their therapist’s home address, marital status or who deliberately, or criminally, stalked their therapists.
- The meaning of stalking has radically expanded with the introduction of Internet Search Engines such as Google, and thousands of for-fee services that would find almost anything a client might desire to know about their therapist.
What clients can find using a simple Google search to locate online information not deliberately posted by the therapist:
- Home address, home or unlisted phone numbers, a personal email address.
- Licensing Board’s sanctions or complaints.
- Family members, family trees, or sexual orientation.
- Volunteer activities and community involvement.
- Professional activities and membership in professional organizations.
- Political affiliation and political petitions signed.
- With a click of a (Google) mouse clients can find their therapists’ writings on a variety of Web sites and personal blogs and therapists’ own blogs.
- Other clients’ and peoples’ writings’ about the therapist on a variety of Web sites and personal blogs. These include ex-clients’ complaints, grievances, grouses, cavils, quibbles, grumbles; charging accusations, criticism;
- IF YOU ARE NOT SURE WHAT ELSE CLIENTS CAN FIND ABOUT YOU, GO TO GOOGLE AND ENTER YOUR NAME.
Ways in which clients can join social networks and find very personal info about their therapists:
- With a click of a mouse clients can join online social networks, such as Facebook.com.
- Ways in which clients can join social networks, such as Facebook, and find personal information about their therapists:
a) Clients can “friend” their therapists online, and gain access to all sorts of information, including relationship status, religious views, hobbies and even favorite songs.
b) Clients can also read their therapists’ blogs, if their therapists use their real names. Other clients are able to find the identity behind the screenname; those savvy in research may have little trouble at all.
- IF YOU WANT TO FIND OUT HOW EASY IT IS TO JOIN SUCH SOCIAL NETWORKS AND FIND INFORMATION ABOUT PEOPLE, JOIN ONE OR TWO AND SEE FOR YOURSELF.
What information clients can obtain about their therapists by paying for specialized online background checks:
- Financial information, including credit reports, debts, liens, Bankruptcies, etc.
- Criminal records.
- Small claims civil judgments.
- Past and present law suites.
- Marriages and divorces; including divorce records and allegations of domestic violence or molestation.
- Ownership of property and businesses.
- Tax information, such as taxes paid and tax liens.
- Cell phone records, including a 10-year history with available listed phone numbers!
- IF YOU DO NOT BELIEVE THIS, SIMPLY GO TO GOOGLE AND TYPE “BACKGROUND CHECK” AND SEE WHAT COMES UP.
Ways that clients can locate information online about their therapists’ professional lives and what their therapist are posting on listservs and in chatrooms:
- Clients can often join professional listservs and chatrooms with rather simple pseudo-names. Often no one checks.
- On many listservs anyone can join. This information is then given, from these open sites, to “invitation only” listservs. Although there may be a registration form required, often all that is requested is: name, business name, address, phone number, Email address, and area of practice. The information is rarely checked for honesty or accuracy.
- It is rare that more than 10% of list members post with any regularity and some never do. So therapists, at best, have no information regarding the remaining 90% of people on the list.
- To make it even easier to learn about someone who posts on lists, some list owners/ moderators insist that one also post one’s name, credentials and location, i.e., city and state, as a signature. That, of course, would make it easier to Google someone.
- Some listserv moderators invite participants to present cases online. As a result, clients who deceptively join such listservs, may be privy to information about the therapists’ other clients, and perhaps the details of their own treatment. Even when the listserv’s moderator appropriately disguises the identity of the client, the clients may recognize themselves in the details, as they also might if someone they know is in treatment with the same therapist.
- Clients, who join such listservs, may detect information regarding their therapist, illegally or unethically, committing insurance fraud, charging high co-pays, etc.
- In short clients can learn lot about a particular therapist, as well as the private information of his or her clients, from their comments on listservs. This information, accurate, or inaccurate, may be available indefinitely.
Reflections on clients’ search for information regarding their therapists and differences between:
- Curiosity: Clients’ curiosity about their therapists when they Google them or check their therapists’ professional web site. This search may yield professional orientation of therapists, training, etc.
- Due diligence or thorough search: Clients who are more seriously looking for information about their therapists. This “due diligence” or thorough approach may include searching the licensing board’s web site to see if their potential therapist had any complaints filed against him or her. It is important to honor clients’ wishes to learn about the people whom they wish to trust and learn from and not to confuse due diligence search with intrusive search.
- Intrusive search: Clients may ‘push the envelope’ and intrusively search for information about their therapists. They may search for home address or to identify martial status or family members, etc. This may also include disguising one’s identity and joining social networks, listservs, etc., in order to find information about therapists; paying for an online service which legally gathers information about the therapist that is not readily available online. This may include divorce or other court records that are considered public records.
- Illegal search: Hiring online services, which illegally gather information about the therapist. Such information may include cell phone records and tax records.
- Note about therapists searching for information about their clients: The above four categories are equally applied to therapists’ ways of finding out information about their clients. Therapists may be generally curious about their clients and try a simple quick Google search to see if anything significant is revealed. If therapists are concerned about their clients, they may search more carefully on issues of criminality, litigious situations, such as past board complaints or lawsuits. Of course, the intrusive and illegal searches are applied to therapists as they do to clients. An example is when a therapist, who is willing to run a bill and carry a debt, may choose to run a credit check on the client with the client’s permission.
What therapists should pay attention to when it comes to Internet disclosure:
- Assume that EVERYTHING that you post online, whether it is on your own web site, private or public blogs, listserves, online bulletin boards, chats, social networks, etc may be read by your clients.
- Be very careful in discussing case studies online and make sure that you either get permission from the client to discuss it, or make sure that identifying information is removed or changed. In HIPAA terminology make sure you ‘de-identify’ your clients’ identity.
- Be aware that your clients may read what you have posted as advice to other therapists in consultation regarding their own cases. Your clients may then draw conclusions based upon what you proposed, or even take the information personally.
- If you find out that a client or potential client has acted in an intrusive manner in regard to online searching, think about the clinical, ethical and legal ramifications, document your concern, respond appropriately, and, if necessary, seek consultation.
- Google yourself periodically so you are aware of what your clients may be privy to. Google yourself using different combinations of name and degree, such as “Mark Smith, Ph.D.,” “M. Smith, Ph.D.,” “Dr. Smith,” etc.
- If , in your search, you find private information about yourself that you do not want to be public, or misinformation that you want to correct, find out whether you can have it removed. If the information was obtained or posted illegally or is defamatory, it is more likely that the therapist can remove this information by contacting the web site master and the server who either take the information off line or shut off the web site all together. However, if the therapists put the information online themselves, it may be harder to remove.