How therapists navigate Facebook with clients.

Abstract

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.

#socialwork: An International Study Examining Social Workers’ Use of Information and Communication Technology

“…Scholars contend that practitioners should attend to these interactions ( Gabbard et al , 2011; Harrington, 2015 ), as practitioners’ responses to friend requests can influence the working alliance or relationship, the most crucial factor associated with client outcomes ( Falkenstrom et al , 2014 ). Knox et al (2020) found that American therapists’ discussions with clients regarding their decision to decline a friend request often strengthened the therapeutic relationship and process, by demonstrating the therapists’ interest in protecting the clients’ safety and preserving ‘the most facilitative therapeutic milieu for their work together’ (p. 271). Our findings indicate that practitioners require guidance on how to address ‘friend requests,’ while maintaining boundaries and the working relationship.…”

#TherapistsConnect: Our voices are stronger together

“…There is limited research which explores experiences of therapists' social media use and the impact it has on therapists and clients alike. One recent study of eight American psychotherapists explored how they navigated Facebook, specifically in relation to clients making a 'friend' request to their therapist (Knox et al, 2019). The main challenge faced by these therapists was the implementation of boundaries with clients, while acknowledging that the therapeutic relationship was different from other types of relationship.…”

Therapist boundary crossings in the digital age: Psychologists’ practice frequencies and perceptions of ethicality.

“…For example, research findings have revealed that clients request connections with their therapists’ personal social media profiles. Knox et al (2019) found that clients not only extended digital “friend” requests to their therapists and therapists’ family members through Facebook but also initiated contact through private Facebook messages. And, Tunick et al (2011) reported that of the 65% of their participants (U.S. child psychologists and psychologists-in-training) who maintained social networking websites, nearly one quarter received requests from clients to be “friends” or join the client’s digital social network (24%); 3% of the therapists accepted such requests.…”