Managing Professional Boundaries _ ____________________________________________________________
2. Decrease social networks—Clinicians should be selective when accepting friend requests and should limit the visibility of their posts so they are not public. 3. Hide profiles—Social media profiles should be hidden from search engines to remove profiles from public searches on Google, Bing, or Yahoo. This makes the therapist’s profile less easily accessible. 4. Limit posts—Global positioning system (GPS) functions should be turned off so that geotagging of pictures is not possible. Clinicians should not post their schedule, vacation plans, or upcoming event locations. 5. Review profiles—Clinicians should review their profiles periodically to ensure sensitive and private information is not available to the public through photos or videos and should consider the impact viewing those would have on a client. 6. Protect passwords—Passwords should be at least 14 characters long, created with numbers, special characters, uppercase and lowercase letters, and should be changed every 60 days. 7. Search online persona—Clinicians should google themselves regularly to see what information is available about them on the internet and social media platforms. 8. Discussions with clients—Clinicians should consider the benefit of having explicit discussions with clients about their expectations and policies regarding social media use. DATING APPS Connecting on social media networking sites forms a virtual nonsexual multiple relationship. The newer and increasingly popular dating apps, however, have the potential to create in- person connections. Clinicians are aware that sexual relation- ships with current clients are a firmly prohibited boundary violation. Yet how does the therapist manage the inadvertent “matching” with a current or former client on a dating app? Unhejm and colleagues (2021) reviewed these situations and noted that there are few specific guidelines detailing how a clinician should present themselves on a dating app, what they are allowed to disclose on that app, and how they should place boundaries when a current or previous client matches with them on the app. How a clinician chooses to present themselves on a dating app can not only affect the perception of the therapist by the client, but it also has implications for the credibility of the healthcare profession as a whole. Clinicians should make sure that their decision about self-disclosure and presentation on these sites are in line with ethical boundaries. They offer several recommendations to clinicians who choose to use a dating app or site:
1. Boundaries should be explicit in the initial informed consent forms. The form should state that there will be no communication between the clinician and client on dating sites, including messaging, swiping, or liking. 2. Keep profile information to a minimum. Do not include political orientation, religious views, place of employment, or substance use information. 3. Although there are no specific dress codes in ethics codes, be aware of posting photos that are too sexual, revealing, or inappropriate. 4. The therapist should not swipe or send a “like” to a past or current client. 5. If the therapist is liked by a current client on the app, a direct conversation with the client should take place emphasizing that this crosses a boundary. Although uncomfortable, discussion about attraction is warranted. Clinicians should normalize the realities of attraction but discuss that those feelings must be addressed in order to move on in therapy. 6. If a client sends a “like,” or mentions in session that they have seen the therapist’s profile on a dating app, the client’s reaction to this should be discussed: “Yes, I use a dating app in my personal life like many others do. How do you feel about this? Does this change your view of my role as a therapist?” 7. After discussion with the client, consider if blocking may be appropriate. Blocking involves removing a user’s ability to view a profile; this may help to avoid potential problems in the therapy relationship. EMAIL AND TEXTING Email or text communication with clients allows the clinician to be more accessible and to answer simple questions between appointments. However, this risks replacing in-person sessions and, more importantly, risks misunderstanding in the commu- nication due to lack of voice and body language and the ability to immediately clarify if needed. Clear guidelines about the use of electronic communication should be spelled out in the initial informed consent paperwork. Consider limiting the use of these communications to the more mundane administrative aspects of the therapy relationship and encourage in-person meetings for process-oriented issues. Self-Assessment Quiz Question 4. “Friending” or “following” a current client on social media: A) Is not addressed by most codes of ethics B) Does not have the potential for client harm C) May cause inappropriate therapist self-disclosure D) Is not a privacy issue for client and/or therapist
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