Eight U.S.-based psychotherapists were interviewed regarding their personal and professional use of social media networks (SMNs), professional SMN policies, and experiences of navigating a significant Facebook (FB)-related discussion with a client. Discussions were stimulated by clients seeking FB contact with therapists, with the majority being attempts to "friend" therapists. Most discussions involved therapists explaining why they do not "friend" clients, largely because of concerns about boundaries and how the therapy relationship differs from relationships clients have with others. Positive consequences included the impact of the incident and discussion on strengthening SMN practices/policies and enhancing the therapy relationship. In contrast, negative consequences included evoking distressing emotions in clients and eliciting discomfort for practitioners. Participants offered a range of advice for avoiding problematic FB interactions with clients, with many suggesting strict and consistent policies regarding FB/SMN with clients. Implications for practice and research are discussed. Public Significance StatementGiven the ubiquity of social media networks, psychotherapists must be duly careful regarding any interactions with clients on such platforms. Findings from the current study suggest that therapists clearly articulate to clients their concerns regarding potential breaches of boundaries and confidentiality on such networks. Furthermore, if clients seek contact with therapists via social media platforms, therapists are encouraged to engage in open conversation regarding their policies about such interactions with clients.

Evidence suggests that masculine socialization may serve both to restrict men’s potential in ways that lead to psychological distress, while also restricting the ways in which they respond to such distress. Although we are beginning to understand masculine and paternal depression, little is known about how stay-at-home fathers (SAHFs) experience depression, nor their experiences and beliefs regarding help-seeking and psychotherapy. To that end, this qualitative study focused on how SAHFs experience depression and help-seeking via in-depth interviews with 12 participants from across the United States. Results indicated that SAHFs who have experienced depression during their tenure as SAHFs focused on relational distress, isolation, loss of independence, and social stigma as contributing to their depression. They appeared to retain a high value on providing for their families, both in the decision to take on the role of SAHF and in deciding to ultimately seek help for depression. The idea of seeking help as a means to protect and provide for their families appeared congruent with their descriptions of masculinity, which recast the SAHF role as being definitionally masculine. Finally, this growing minority of men appeared to be building social networks both on- and offline to support their sense of identity and as a means for coping with the unique stressors they face. These results have implications for therapists, medical practitioners, public health officials, and family members of SAHFs.

The final draft of this chapter was updated and approved by the study participants, especially regarding whether their confidentiality had been adequately protected.

Providing psychotherapy changes the therapist in a variety of ways. This article discusses one doctoral student's perceptions of these changes, such as increasing her patience, gratitude, and reliance on faith; stretching her ability to tolerate ambiguity; and influencing her interpersonal relationships.