Michael Griffin, JD, LCSW (CAMFT Staff Attorney)
The Therapist
September/October 2009
Reviewed January 2022 by Sara Jasper, JD, CAE (CAMFT Staff Attorney)

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Do you Tweet?¹ Are you LinkedIn?² Do you Facebook?³ Is your Blogger blog^{4 5} on your Wikispaces⁶ wiki?⁷ If you know what these terms mean, you belong to a very large group of people who participate in various forms of social networking.⁸ If this sounds like gibberish to you, it means that you haven’t made such forms of electronic communication part of your daily life, yet. This article briefly discusses the nature of social networking, blogging, and related activities on the Internet and considers some relevant concerns for psychotherapists.

What is Social Networking?
Since their inception, social networking sites, such as Facebook,⁹ Twitter,¹⁰ LinkedIn¹¹ and many others, have attracted millions of individual users.^{12 13} These sites are based upon a simple, but powerful purpose: To help a person identify his or her extended social network and facilitate his or her contact with other individuals who are connected to that network.¹⁴ As a general rule, the members of a particular social networking site share some common interests. Professional networking sites, such as LinkedIn, which emphasize the professional and career advancement interests of their members are one example.¹⁵ 

Social networking sites have provided their members with the opportunity to share brief, contemporaneous commentaries with others about what he or she is doing at the moment.¹⁶ Twitter and similar status updating services were developed for this unique purpose and they are also used for disseminating information about a particular event or cause or for documenting a then-occurring event.¹⁷ In one famous example, a passenger on the ferry that rushed to the scene of the US Airways flight that crashed into the Hudson River took a photograph of the scene with his cell phone and sent it out to the world via his Twitter feed. And, in a first of its kind event, several members of Congress used Twitter to provide a running commentary during President Barack Obama’s address to a joint session of Congress.¹⁸

The Personal Profile
A new member of a social networking site must create a personal profile, which is derived from the information that he or she provided upon joining the site.¹⁹ The personal profile reveals as much or as little information about the member as he or she desires, and generally includes descriptive information about him or her, which may include one or more photographs or other information regarding his or her interests.²⁰ The information is used to facilitate and encourage the member to interact with other members with whom he or she shares a particular interest or social connection. Depending on the site, such connections may be referred to as “friends,” “contacts,” or “followers,” etc.²¹

A member is able to control the access to his or her personal profile, depending on the rules of the site. For example, a member of Facebook may permit unrestricted access to his or her full personal profile to anyone. Or, he or she may decide to offer unrestricted access to his or her profile only to those persons whom he or she personally identified as friends. As a third choice, he or she may limit unrestricted access to his or her full personal profile to his or her friends and to their friends.²²

Much has been written about the fact that some individuals disclose vast amounts of sensitive and personal information in their personal profiles. Some researchers believe that social networking sites tend to establish privacy settings that err on the side of permissiveness and disclosure, rather than protection.²³ A commonly held belief is that social network users (especially young users) tend to disclose extensive detail about their personal lives based upon a perception that they see themselves in a “safe space,” that is populated by individuals who are similar to themselves.²⁴ Interestingly, there is data that suggests that younger users of social networking sites are not necessarily less cautious regarding issues of safety and privacy on the Internet, compared to older participants. In a 2006 study of Internet users, researchers discovered that teens who maintained an online profile were much more cautious and restrictive concerning access to their personal profile compared to their adult counterparts.²⁵ In this study, researchers found that 60 percent of the adults who maintained a personal profile online reported that their personal profile could be viewed by anyone, versus 38 percent who said that their profile was accessible only to friends.²⁶ By comparison, 40 percent of the teens in this study who maintained a personal profile said that their profile was available to anyone and 59 percent indicated that their profile could only be accessed by friends.²⁷ Perhaps “younger” users of social networking sites are more cautious in general than “older” users concerning their privacy and safety on the Internet by virtue of their familiarity with social networking sites and their overall experience using the Internet. 

Is Anything Private?
Social networking sites typically gather information about each of their members from other sources, including newspapers, blogs, etc., to supplement the member’s personal profile. In addition, most sites record information about a member’s Internet habits, including the web-pages that he or she visits, the search terms used and any advertisements that he or she clicks. Facebook, for example, uses a system called Beacon that tracks a member’s activity, even when he or she is logged-out of the site and then sends him or her ads based upon the information obtained. Similarly, when a Facebook member purchases movie tickets on Fandango.com, Facebook may send a notice about the movie that he or she is seeing to his or her friends via a connecting News Feed. Every social networking site has a privacy policy that spells out the specific rules that apply to that site and that explains to the member how he or she can opt-out of many or most of these activities.²⁸ As a result, a member is able to impose significant control over the access to his or her personal information by taking the time to read the privacy policy of the specific site and identifying each of the privacy options that are available.

Your Digital Identity
When someone engages in the practice of “Googling” him or herself, it means that he or she has typed his or her name into an Internet search engine in order to see what information exists about him or her online.²⁹ This practice is quite common; nearly half of all adult Internet users have used a search engine for this purpose.³⁰ The information which emerges in response to a person’s online search about him or herself is sometimes referred to as his or her “digital identity.”³¹ An individual’s digital identity develops and evolves as new information is posted about him or her online.³² As more and more information is posted about a person on the Internet, his or her digital identity will not only evolve, it actually becomes easier to access electronically as the total volume of data that is available on the Internet about him or her increases.³³ There is of course, no guarantee that all of the information that may be posted about a person online is accurate. Although accuracy would seem to be an important issue to most people, studies of Internet use suggest that it is quite unlikely that an individual will take the time to monitor the accuracy of the information that is posted about him or her online.³⁴

What Does Any of This Have to Do With Psychotherapists?

Therapist-Client Boundaries
Psychotherapists who engage in social networking face a number of challenges related to privacy and self-disclosure. To begin, a client may belong to one or more of the same sites as his or her therapist. A client may request that his or her therapist identify or otherwise “connect” with him or her as a member of the therapist’s inner circle of friends. In such circumstances, there are important questions to consider, such as: Is the client hoping to develop a personal friendship with his or her therapist? If so, how should the therapist respond? Will the client’s perception of his or her therapist change after viewing the therapist’s personal profile? How will the therapeutic relationship be impacted? Does the therapist’s personal profile include information that may potentially embarrass him or her if seen by a client? Will any of the information, (including photographs) which are posted online by the therapist, potentially embarrass, or harm his or her professional reputation?

Any client (past and present) is free to embark on an online search for his or her therapist. If a therapist elects to provide unimpeded access to his or her private thoughts and feelings and information about his or her personal habits, likes and dislikes, etc., it shouldn’t come as a surprise when one of his or her clients discovers the information and reacts to it. A therapist must not only consider what is, or what isn’t appropriate to disclose. It’s also important to consider what a client might do with his or her therapist’s personal information, once he or she has it. Although a client may simply be curious about his or her therapist, it would be naive to think that in every instance, his or her motivation is entirely benign. As an example, a client may hope to change his or her therapist’s mind about the termination of his or her treatment, or, he or she may wish to pursue a friendship or romantic relationship with the therapist. There are also safety issues to consider. An angry client may act-out against a therapist whom he or she blames for some disappointment, such as the loss of a relationship or for a negative outcome in a legal matter, etc. A related question is whether a therapist should ever attempt to access his or her client’s personal information. For example, it could be argued that a client might reveal important information about him or herself on a social networking site that would otherwise be unknown to the therapist. The information learned by a therapist in this manner might help the therapist to better understand his or her client. There are numerous possibilities and questions to consider:

• Should the therapist inform a client before viewing information about him or her on the Internet?
• How will the client feel about the therapist’s efforts to find out about him or her in this manner?
• Will the client believe that his or her privacy was invaded by the therapist (regardless of whether the client’s information was available for public view)?
• What if the therapist learns that his or her client is engaging in behavior that is dangerous or illegal?
• What if the client would be embarrassed or ashamed as a result of the therapist’s discoveries?
• What if the information discovered by the therapist suggests that his or her client has been untruthful in therapy sessions?
• Will the therapeutic relationship ultimately be harmed by the therapist’s actions?

A therapist who contemplates looking into a client’s current activity and/or his or her background via the Internet should consider such questions before engaging in the activity.

In spite of the various concerns raised in this article, it isn’t the author’s intent to suggest that social networking is the equivalent of venturing into quicksand. In general, the problems that are identified here are avoidable. Therapists should discuss their concerns with colleagues who are familiar with these activities and remember to seek consultation whenever needed. One author suggests that therapists develop an Internet and email policy, including a policy for handling the various circumstances that may arise on social networking sites.35 Basically, a therapist (or anyone for that matter) must remember to think before posting any personal information about himself or herself anywhere on the Internet and to exercise reasonable discretion/caution when permitting access to his or her personal profile. Because clear and appropriate boundaries are a key component of any therapist-client relationship, a therapist should not establish, or permit the development of a “friendship” with his or her clients outside the context and boundaries of therapy. This admonition is well-founded: The disciplinary actions that are posted regarding Marriage and Family Therapists, Clinical Social Workers and Psychologists provide numerous examples of problems that are likely to arise when there is a lack of appropriate boundaries between a therapist and his or her client.

Therapists should remember that the ethical standards provided by CAMFT and other professional associations offer guidance on these and other issues. For example, if a psychotherapist enters into a “friendship” with one of his or her clients on a social networking site, the existence of such a relationship may violate the provisions of Sections 4.1 and/or 4.3 of the CAMFT Code of Ethics.^{36 37}

Section 4.1 of the CAMFT Code of Ethics requires a therapist to avoid engaging in a separate relationship with a client (either simultaneously with the therapeutic relationship, or during a reasonable period of time following the therapeutic relationship), that is reasonably likely to impair his or her professional judgment or lead to exploitation. Section 4.3 of the CAMFT Code of Ethics strongly discourages a therapist from engaging in a close personal relationship with a patient, or, with a patient’s spouse, partner, or family member.

4.1 Dual/Multiple Relationships: Dual /multiple relationships occur when a therapist and his/her client/patient concurrently engage in one or more separate and distinct relationships. Not all dual/multiple relationships are unethical, and some need not be avoided, including those that are due to geographic proximity, diverse communities, recognized marriage and family therapy treatment models, community activities, or that fall within the context of culturally congruent relationships. Marriage and family therapists are aware of their influential position with respect to clients/patients, and avoid relationships that are reasonably likely to exploit the trust and/or dependence of clients/patients, or which may impair the therapist’s professional judgment.

4.3 Unethical Dual/Multiple Relationships: Acts that could result in unethical dual relationships include, but are not limited to, borrowing money from a client/patient, hiring a client/patient, or engaging in a business venture with a patient, or engaging in a close personal relationship with a client/patient. Such acts with a client’s/patient’s spouse, partner or immediate family member are likely to be considered unethical dual relationships.

Blogging and Self-Disclosure
Blogs are a versatile, highly-valued resource for millions of people and have proven to be an extremely popular vehicle for personal expression.38 The word blog (short for weblog) generally refers to a type of website that is maintained by one or more persons in order to post a wide range of commentaries, articles, pictures, etc., regarding a particular issue or topic. A core feature of most blogs is that they are interactive and permit an individual to leave his or her comments. Thus, the word blog is also commonly used as a verb, to describe the act of adding content to an existing blog.39

Literally millions of blogs are used for numerous purposes, including marketing, networking, research, artistic expression and news reporting.⁴⁰ Blogs are inexpensive to create, are relatively easy to use and can be created to address an unlimited range of subjects. In fact, a blogger may feel that he or she can openly express his or her opinions in an unrestrained, and/or uncensored forum. It is important to remember though, that the statements that a person makes in a public blog (or on a social networking site) can be viewed by anyone with an Internet connection. Once information is posted on the Internet, it may be impossible to retrieve it, or to completely remove it in the future. Even when one limits the disclosure of his or her private information, after the information has been released to anyone, it’s virtually impossible to maintain complete control over where it ends up. This means that an angry rant that is posted in the middle of the night or the disclosure of intimate details about one’s personal life may ultimately be read by someone who was never considered as a potential recipient. To cite just a few examples: An individual may discover that his or her online postings have alienated his or her boss or coworkers;⁴¹ a job applicant may lose out on a career opportunity because a member of the employer’s selection committee was offended by the applicant’s commentary in a blog;⁴² or, a student may get into trouble with university administrators for posting photos on his or her social networking profile which violated the school policy and/or code of conduct.⁴³

Psychotherapists are certainly entitled to utilize the incredible array of resources that are available via the Internet and to enjoy the many benefits that are associated with social networking and blogging. In order to fully enjoy the experience and minimize the likelihood of problems, it’s advisable to research a particular site before joining, taking care to examine the rules of the site and the specific privacy policies and options that are provided.44 And, whether one participates in social networking, blogging, or is simply sending an ordinary email message, it is incredibly important to decide what, and how much, personal information he or she intends to release to the digital world, before posting it anywhere on the Internet.

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¹ Twitter is a social networking site that allows its users to publish short messages (140 characters or less) via mobile texting or on the Internet in response to the question, “What are you doing?” A message on Twitter is known as a “Tweet.” Sending short messages on Twitter is considered to be a form of microblogging. http://twitter.com/
² LinkedIn is a business-oriented social networking site. http://www.linkedin.com /
³ Facebook is a social networking site. http://www.facebook.com/ Psychotherapists, Social Networking and Self-Disclosure on the Internet
⁴ Blogger is a free blog publishing tool that is provided by the Internet company Google. https://www.blogger.com/start
⁵ A blog is short for weblog, a type of website that contains a series of entries which are arranged in reverse chronological order. The word blog is also commonly used as a verb, to describe the act of adding content to an existing blog. http://www.techterms.com/definition/blog
⁶ Workspaces are a program which may be used to create a wiki; a type of website which may be freely changed, contributed to, or edited by visitors to the site. A blog may be a part of a wiki. http://www.wikispaces.com/
⁷ Roeder, Linda, “Add Your Blogger Blog to Your Wiki spaces Wiki,”(2009) About.com, http://personalweb.about.com/od/wikihostingandsoftware/ss/wikispacblogger.htm
⁸ Social networking websites allow people to locate and communicate with other individuals on the Internet as part of a virtual community. http://www.techterms com/definition/social networking
⁹ Facebook, Id.
¹⁰ Twitter, Id.
¹¹ LinkedIn, Id.
¹² Boyd, Danah, M., Ellison, Nicole, B., “Social Network Sites: Definition, History, and Scholarship,” Journal of Computer-Mediated Communication, 13 (1), article 11 (2007). http://jcmc.indiana.edu/vol13/issue1/boyd.ellison.html
¹³ List Serves and email trees are also utilized in social networking. The "CAMFT Community," accessible to members via the CAMFT website, provides a forum for social networking with colleagues.www.camft.org
¹⁴ Boyd, et.al., Id.
¹⁵ CAMFT has a social networking group on the LinkedIn site. http://www.linkedin.com/
¹⁶ Lenhart, Amanda; Fox, Susannah, ‘Twitter and status updating,” PEW Internet & American Life Project Report, February 12, 2009. http://www.pewInternet.org/Reports/2009/Twitter-andstatus- updating.aspx
¹⁷ Id.
¹⁸ Hamby, Peter, “Members of Congress Twitter through Obama’s big speech,” CNN Politics.com, February5, 2009. http://politicalticker.blogs.cnn com/2009/02/25/members-of-congress-twitterthrough- obamas-big-speech/
¹⁹ Lenhart, Amanda, “Adults and Social Network Websites,” Id.
²⁰ Id.
²¹ Id.
²² https://www.facebook.com/about/basics/usr1#youreincharge
²³ DeGroot, Jocelyn M., “What Your Friends See: Self-Disclosure and Self-Presentation on Facebook and MySpace Profiles,” Paper presented at the annual meeting of the NCA 94th Annual Convention, TBA, San Diego, CA, Nov 21, 2008. http://www.allacademic.com//meta/p_mla_apa_research_citation/2/5/4/7/3/pages254733/p254733- 1.php ; Gross, R., & Acquisti, A., “Information revelation and privacy in online social networks,” Paper presented on November, 2005, Alexandria, Virginia. http://www.allacademic.com//meta/p_mla_apa_research_citation/2/5/4/7/3 pages254733/p254733- 1.php; or, http://www.heinz.cmu.edu/~acquisti/papers/privacy-facebook-gross-acquisti.pdf
²⁴ DeGroot, Id. Psychotherapists, Social Networking and Self-Disclosure on the Internet 6
²⁵ Maddon, Mary, Fox, Sussanah, Smith, Aaron, Vitak, Jessica, “Digital Footprints, identity management and search in the age of transparency,” PEW Internet & American Life Project, December 16, 2007. http://www.pewInternet.org/~/media//Files/Reports/2007/PIP Digital_Footprints.pdf
²⁶ Id.
²⁷ Id.
²⁸ Story, Louise and Stone, Brad, “Facebook Retreats on Online Tracking,” nytimes.com, November 30, 2007 http://www.nytimes.com/2007/11/30/technology/30face.html Face book provided its members with the option to opt-out from participation in Beacon in 2007 after fifty-thousand Facebook members signed a petition objecting to the fact that Facebook had not asked for their permission to conduct such online tracking.
²⁹ Maddon, Mary; Fox, Sussanah; Smith, Aaron; Vitak, Jessica, Id.
³⁰ Id.
³¹ Id.
³² Id.
³³ Id.
³⁴ Id. Only about 3 percent of self-searchers regularly monitor the accuracy of personal information that is posted about themselves online.
³⁵ Grohol, John, M., “Social Networks May Blur Professional Boundaries,” psychcentral.com, May 15, 2008. http://psychcentral.com/blog/archives/2008/05/15/social-networks
³⁶ CAMFT Code of Ethics for Marriage & Family Therapists, Sections 4.1, 4.3.
³⁷ See also, Code of Ethics of the National Association of Social Workers, Section 1.06(c); American Psychological Association Ethical Principles for Psychologists and Code of Conduct, Section 3.06
³⁸ Wortham, Jenna, “After 10 Years of Blogs, the Future’s Brighter than Ever,” Wired, December 17, 2007. http://www.wired.com/entertainment/theweb/news/2007/12/blog_anniversary
³⁹ See, Wikipedia, http://wikipedia.org/wiki/Blog
⁴⁰ Id.
⁴¹ Riddle, Warren, “Facebook Rant Results in Disciplinary Action for Firefighter,” Switched.com, March 6, 2009. http://www.switched.com
⁴² Tribble, Ivan, “Bloggers Need Not Apply,” The Chronicle of Higher Education, July 8, 2005. http://chronicle.com/jobs/news/2005/07/2005070801c.htm
⁴³ University of the Pacific, “Online Social Networking Dangers and Benefits,” February, 2009. http://web.pacific.edu/x4989.xml. (Access attempted September 2015. This webpage is no longer available).
⁴⁴ See, Spotts-DeLazzer,Alli, LMFT, "Facebook for Therapists: Friend or unFriend," The Therapist, Sept./Oct., 2012