I have profiles on Youtube, Twitter, LinkedIn, Digg, Reddit, Technorati, Ning, Squidoo, XING, Yahoo Answers, MySpace, Yedda, Furl, Blogger, Wordpress, StumbleUpon, del.icio.us, Yelp, Knol, Facebook, Orkut, Foursquare, and Skype… to name a few.
Most of these accounts I hardly use. Several I’ve been on once to create the account and only remember them when I receive email newsletters, which I unceremoniously delete. And, now that I’m thinking of it, a few of the above sites might be defunct by now.
Students and colleagues have been finding me online for several years, so I’m used to getting the occasional “friend request” from someone I have taught or worked with. However, more and more often I am receiving social networking requests from clients—either my own, or from clients of other providers at Thrive Boston Counseling. This poses some clinical and ethical considerations.
When I started receiving networking requests from clients, my initial reaction was to decline them. It’s hard not to conclude that the wisest policy is to dissuade any online social networking (i.e., “Facebooking”) between yourself and your clients. However, such connections may not be wrong per se, and might be justifiable under certain conditions.
Taking a look at my personal Facebook page, I have over six hundred friends—it’s not an exclusive network. In fact, I use it for professional purposes as much as I do personal ones. And with that, my policy has been to accept almost all networking requests (excluding spammers and clients) without reservation. Hence, if I decline a client’s request to join such a non-exclusive network, the question ensues, am I being too rigid? If the client realizes that I’ll connect with anyone other than him/her, could that harm therapeutic rapport?
Approving a client as a “friend” on Facebook, or a connection on LinkedIn (the two places where I most often receive requests) will grant him access to mostly benign information: a few photos, links to articles I like, my status updates (which, since they are syndicated to over 600 ‘friends,’ are benign), and some biographical information that is public anyhow, as I don’t have that information set to private (i.e., anyone can go to www.facebook.com/anthonycentore and see my information).
However, approving the connection will also allow the client to see comments and photos of the students, colleagues, family, and ‘friends’ I have added prior. And this could blur professional boundaries, as well as spell disaster for psychoanalysts who prefer to be a blank slate for client projection.
Moreover, if the client is in anyway a dangerous person, increased access to my loved ones becomes risky, even downright scary.
For all of these reasons, I have decided that I need a policy for any client who requests a “personal” online networking connection.
Online Networking Policy (an evolving draft)
If you are plugged into Online Social Networking, here are a few guidelines for handling connections and interactions with clients.
1) Never solicit a personal connection.
While it may be a stretch, a personal online connection could constitute a dual-relationship. According the ACA code of ethics (A.5.c. Nonprofessional Interactions or Relationships (Other Than Sexual or Romantic Interactions or Relationships)),
“Counselor–client nonprofessional relationships with clients, former clients, their romantic partners, or their family members should be avoided, except when the interaction is potentially beneficial to the client.” The code continues on to detail that therapists have a responsibility to document and justify why the nonprofessional relationship is taking place, and how it will be beneficial to the client.
Having a client connected with you on LinkeIn or Facebook probably isn’t enough to constitute a full-blown nonprofessional interaction or relationship. However, because it’s a grey area, refraining from soliciting these connections is advisable.
Note: Soliciting clients to become “fans” of a professional / business page is different from a personal online networking connection, and would not constitute a dual role. In fact, when done correctly, having a business presence on Facebook (or other social networking sites) is a great way to add value for your clients, and promote your practice (a topic for a future article).
2) Discuss with the client his or her reasons for requesting a connection.
Irvin Yalom once wrote that if a client went to hug him at the end of a session, he would hug the client, but then talk about the meaning of the hug with them in the next appointment. Similarly, addressing client motivations for an online connection could be good “grist for the mill” in the therapy process.
Questions to consider: What is the client’s motive to establish an online connection? Is it:
1.To learn more about who you are?
2.To read articles you are writing?
3.To have another method of contacting you for clinical or scheduling questions?
4.A friendly courtesy?
5.An attempt to use the counseling relationship as a friendship?
6.An attempt to become a part of your personal life?
Sometimes there is no motive! Social networking sites are often asking for permission to connect users to everyone in their email contact lists. Almost every week, I receive a networking request on Facebook or Linkedin from someone who I don’t know, and respond, “Hi, thanks for the networking request. Have we met in person?” The person responds that they were a client—or a potential client who never scheduled—of Thrive, and received the request because they solicited a connection with everyone in their email contact list.
3) Discuss risks and liabilities with the client.
Clients may not have considered the risks of being connected with you online. These risks vary depending on the client, but may include the following:
First, clients may underestimate the potential for negative emotions they might feel being in your network. For instance, perhaps clients have not considered what it will be like to see pictures of your friends and family—people who have a personal relationship with you; potentially one that your clients might desire.
Second, simply being in your network may compromise a client’s confidentiality, as he/she is visible to your other connections. This risk is increased if the client comments on, tags, re-tweets, reposts, or “likes” content that you post. If others inquire as to whom this connection is, you (the counselor) may be unable to respond.
Third, the client might attempt to use the therapeutic relationship as a friendship, which could hinder a therapeutic goal of clients developing healthy relationships outside of counseling.
4) Address expectations with the client.
What purpose does the client believe the online connection will serve?
The client may have unspoken, misguided, expectations about the online connection that you cannot accommodate, such as:
•Will the client expect you to message with him online?
•Will the client expect you to view, post on, or comment on his page?
•Will the client expect you to never view or comment on his page?
•Does the client hope to be added to your “Top Friends” list (ok, this is a bit 2004)?
5) Clean up your profile.
Consider minimizing the risk of blurring professional-personal boundaries by making your account less personal. Some time ago, I decided this was a necessary endeavor: gone are some of the pictures of my sisters and me making faces at the camera. Gone is the survey that says my “superhero personality type” is the Green Goblin.
Many of my new social networking accounts are for Thriveworks, not me personally—which minimizes future conflicts. Once, I considered making two profiles for each website (one personal, one professional), but rejected the idea when I realized there is nothing to prevent my clients from soliciting a connection with the “wrong” profile.
6) Establish boundaries.
While having a client in your online network may be permissible, there are some things not to do. Don’t solicit interactions, comment on their wall, or make a habit of “liking” their posts—it’s the online equivalent of going up to clients in public and saying “Hi!” And, please, don’t play Farmville with your clients!
Today, there is a client in my “friend request” pending list, in limbo, neither declined nor approved. I might approve him, but not before we talk about it.
Connect with me online!
Facebook (personal): Facebook.com/anthonycentore
Facebook (professional): Facebook.com/thrivecounseling
Anthony Centore is a counselor, and helps other counselors build successful practices. For more information on private practice and insurance panels go to http://thriveworks.com .