Digital Ethics: Psychotherapy in the Digital Age

By Ofer Zur, Ph.D.

Digital ethics is an increasingly relevant and important, yet confusing, topic for most clinicians. Therapists who pay attention to the complexities involved with the intersection of their clinical work and social media have increasingly sought consultation and coursework on what the ethics codes have to say about the digital environment. What is the standard of care in regard to their activities on the Internet, search engines, and, of course, social media? Even use of an email address can create clinical challenges if, for instance, your clients discover that you share friend circles, invitations to parties and events are part of meetup groups.
All mental health professionals have a duty to understand how to best protect clients’ confidential information on their smartphones and hard drives. Knowing how to manage your social networking site privacy, activity, and engagement is important. This is especially true since many of us use these sites for both professional and personal use.
Digital ethics focuses on looking at what our ethics codes and professional guidelines have to say about conducting ourselves online in professional, ethical, and clinically appropriate ways. Thankfully, many ethics codes have begun to integrate online activity into their standards and some professional associations have developed special guidelines on how to ethically handle social media and electronic communications.  However, in the absence of clear or specific guidelines, clinicians should apply existing ethical standards to online activities.
Following are the main ethical issues that are highly relevant to the clinical work of psychotherapists and counselors in the Internet era:
  • Staying aware of what can be found out by your clients and others about you, the clinician, on the Internet.  This issue includes posting by clinicians themselves or by others, search engine’s information about therapists, and information found on social media, such as Facebook, Instagram, LinkedIn, Twitter and blogs.
  • Is it okay for you to use search engines to look for information about your clients? If you do, must you tell them ahead of time about your practice or afterwards inform them that you have searched them online?
  • Following are a series of questions regarding the interaction between clinicians and clients on social media that therapists should attend to:
    • Are there any ethical standards that speak to whether you, the clinician, should or should not ‘friend’, follow or connect with clients on social media?
    • If you do ‘friend’ your client, should you do it from your professional social media profile or your private profile?
    • Does ‘friending’, following or connecting with clients on social media constitute dual or multiple relationships? If it does constitute dual relationships, are these relationships ethical, clinically appropriate and within the standard of care?
    • Does it matter whether you connect with clients on your professional profile or your private profile?
  • Is there anything you can do when a client or someone else leaves a negative review about you or your practice on a review site, such as Yelp or Healthgrades?
  • What other ethical standards apply to our online activity or our use of devices?
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