The Social Media Psychologist Part 2 - The Therapeutic Relationship

Last time I wrote about some of the ethical dilemmas that arise from being a psychologist on social media and entering such public space. How can that affect the relationship with clients? And what ethical guidelines exist for psychologists on social media?

The Client-Therapist Relationship

 Particularly for those who come from psychoanalytic traditions, the therapeutic process between therapist and client is a really key part of therapy. The relationship itself becomes part of the work, and the relationship is used to inform the therapy and bring about change. This can only be achieved if the therapist is seen as a blank slate on which the client can project their own expectations and patterns of relating. In other models, the therapist might bring more of themselves and their experiences to the relationship. Although, no matter what the type of model which is used in therapy, a growing body of research has demonstrated that it is the relationship between the therapist and the client which will most influence the outcome of the therapy.

In recent years, mental health communities and services have challenged the ‘expert’ position even more with a heightened value of hearing from those with lived experience - experts by experience. More and more therapists have spoken out about their own lived experience of mental health difficulties and use this to inform their work.

 

There is a fine line between sharing our experiences as therapists and disclosing information that could burden our clients. As I said above, as therapists our role is to hold on to others’ distress, not share our own. Of course it can be helpful to share experiences when this can offer hope – and sometimes these are the most powerful interventions that clients speak about. Even small pieces of information could make a big difference to clients. Most of my clients are aware that I have my own children, and I talk sometimes about techniques that I have found helpful with my own kids – which I try and ground in an evidence base rather than my own anecdotal experience. But other therapists would not reveal even minor details about their life outside the therapy room. I’m aware that many fantasies could exist around my own parenting, and the more of an ‘expert’ I appear, the stronger these fantasies could be. Ideas about whether I lose my temper with my own children, whether I’m always patient, what patterns from my own past might influence my decisions as a parent (and therapist!) Even in a small way, I’m aware that these snippets can set up ideas that change a very fine balance at a time when people are feeling particularly vulnerable to judgement or criticism.

 

There’s no easy way of resolving these dilemmas, other than speaking about them as they arise either online or in person. My hope is that, having ‘met’ me via Instagram, potential clients might feel that they know me a little already and perhaps make it easier to meet in person. Discussing a little about the common challenges of parenting should counter the idea that I - or anyone - gets it ‘right’ all the time. And hopefully it feels easier to reach out to any therapist knowing a bit about what goes on behind the scenes.

 

Ethical Guidelines for Therapists on Social Media

It’s a bit of a brave new world for us as therapists, navigating this new online society for the first time. My professional body, the British Psychological Society, has published a rather short double-sided guidance document about using social media, which mainly focuses on being aware of the potential for professional misconduct. Certainly, individually I’ve noticed the need to navigate new boundaries on social media. This might include not offering clinical advice, but also not having personal relationships with clients via social media, not sharing information about clients, maintaining professional relationships with colleague and, that good old favourite, not bringing the profession into disrepute. But there are many other issues that arise when you take psychology into the sphere of social media, concerning both clients and therapists.

 

We also need to think closely about self-care. Social media makes us accessible 24/7 and, being in the profession we are, we tend to want to help people. It is really hard to leave a message unanswered. But it’s helpful to think about what expectations you want to set up long term. Are you only going to use social media during office hours, or perhaps only answer DMs during office hours? Or limit checking social media to certain times of the day? Being constantly available can only lead to burn out, and also sets up an expectation that we may not be able to sustain.

 

These boundaries, just as in our clinical work, have to be constantly negotiated and shifted. The openness with which we can access other people’s lives via social media also changes our expectations about therapists too. Generally, while perhaps in the past we did want a therapist to be a blank slate, now in our age of ‘authenticity’ maybe we need to know they are human.

What do you think? Do you want to know about your therapists’ life or do you prefer that this doesn’t muddy the waters? What ethical challenges do you think we as therapists need to consider now that we are accessible 24 hours a day?