Patient-Targeted Googling and Psychiatry: A Brief Review and Recommendations in Practice

Cole, Alexander

doi:10.1176/appi.ajp-rj.2016.110504

Cited by 10 publications

(10 citation statements)

References 14 publications

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“…Therefore, up-to-date training and guidelines are needed for qualified and trainee professionals alike. Some suggestions for guidelines exist in the literature; these include only using search terms that limit the chances of obtaining information that is not central to the question being investigated (McNary, 2014), and that if information is found that affects clinical decision-making, this information should be discussed with the patient to give them an opportunity to correct it if necessary (Cole, 2016). However, these suggestions do not mitigate the potential impact of non-consensual searching on the relationship.…”

Section: Discussionmentioning

confidence: 99%

“…As well as serving to maintain respect, obtaining informed consent may result in other benefits. For example, Cole (2016) argues that obtaining informed consent from the patient prior to PTG maintains honesty in the therapeutic relationship, informs patients of the risks and benefits of searching and provides the patient with an opportunity to disclose any of the sought-after information on their own terms.…”

Section: Implications For Practice and Policymentioning

confidence: 99%

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Patient‐targeted googling by psychological therapists: A narrative review of the literature and ethical implications

Cox

Simonds

Moulton-Perkins

2021

Couns and Psychother Res

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Background “Patient‐Targeted Googling” (PTG) refers to a healthcare professional using the Internet to discover information about a patient. The present review explores PTG by psychological therapists. The review focused on the prevalence of PTG, how often consent is sought from the patient, and the motivations for and consequences of PTG. Method A narrative literature review of published PTG studies was undertaken. Potentially eligible studies were identified by searching PsycINFO, PsycARTICLES, Psychology and Behavioural Sciences Collection, and MEDLINE. Results were screened for suitability for inclusion in the sample (n = 9). All studies were appraised for quality using a structured tool developed for this review. Results PTG prevalence rates ranged from 20% to 98%, with rates of non‐consent ranging from 60% to 84%. Motivations for PTG included curiosity, to gather new information and to verify existing information. Consequences of PTG included enhancing the therapist's sense of safety and causing harm to the therapeutic relationship. Discussion Current literature on PTG is limited and focussed largely in the United States. This review revealed no published PTG studies including UK‐based psychological therapists, as well as issues in defining and operationalising PTG. Further research is needed to understand the prevalence of PTG by UK‐based psychological therapists, as well as the motivations behind, and consequences of, PTG. This evidence base will inform the development of PTG professional guidelines and training, neither of which currently exist for therapists practising in the UK. Both would be timely given the increasing move of the therapeutic frame to the online environment due to the COVID‐19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Section: Implications For Practice and Policymentioning

confidence: 99%

Patient‐targeted googling by psychological therapists: A narrative review of the literature and ethical implications

Cox

Simonds

Moulton-Perkins

2021

Couns and Psychother Res

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“…The uncertainty over the ethics, legality, and impact of searching for one’s patients on the internet have been discussed in the literature [ 28 , 29 ]. In our study, the ethics of researching the online behavior of patients when disclosure is not forthcoming appeared to pivot on patients’ awareness of risks, but different trainees interpreted the ethical significance differently.…”

Section: Discussionmentioning

confidence: 99%

Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding

et al. 2020

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Background The use of digital technology can help people access information and provide support for their mental health problems, but it can also expose them to risk, such as bullying or prosuicide websites. It may be important to consider internet-related risk behavior (digital risk) within a generic psychiatric risk assessment, but no studies have explored the practice or acceptability of this among psychiatrists. Objective This study aimed to explore psychiatry trainees’ experiences, views, and understanding of digital risk in psychiatry. We predicted that clinician awareness would be highest among trainees who work in child and adolescent mental health services. Methods We conducted a cross-sectional survey of psychiatry trainees attending a UK regional trainees’ conference to investigate how they routinely assess patients’ internet use and related risk of harm and their experience and confidence in assessing these risks. We conducted focus groups to further explore trainees’ understandings and experiences of digital risk assessment. Descriptive statistics and chi-squared tests were used to present the quantitative data. A thematic analysis was used to identify the key themes in the qualitative data set. Results The cross-sectional survey was completed by 113 out of 312 psychiatry trainees (response rate 36.2%), from a range of subspecialties and experience levels. Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;P=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; P=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; P=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; P=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. Conclusions Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment.

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“…The widespread availability of the Internet and search capabilities have enabled easy and rapid access to information. In the context of medical care, these possibilities can raise numerous concerns related to ensuring privacy, confidentiality, therapeutic relationship, and standards of patient communication and protection [18][19]. Each person using the Internet and social media leaves a record of their activity that constitutes a kind of digital phenotype [16].…”

Section: Patient Targeted Googlingmentioning

confidence: 99%

“…Health care professionals may suggest patients to analyze their content posted in Internet resources or social media as a complement to their medical history [11]. Analysis of information posted by a patient on the Web may also be undertaken when a patient's overall clinical assessment of his condition indicates that the patient is at high risk of engaging in actions that are harmful to himself or others [11,14], and when it is necessary to identify the patient or obtain contact with his loved ones (if no other means of obtaining contact are available) [4,13,19,21]. The rationale for PTG may also be the need to warn the patient of danger, to verify the information provided by the patient (when there are inconsistencies between the interview and medical records or examination and observation results, and when evasive answers are given), when the patient is suspected of being a victim of violence or substance abuse [14] and when the patient is observed to be in a crisis situation [19].…”

Section: Patient Targeted Googlingmentioning

confidence: 99%

Internet as a source of patient information – Patient Targeted Googling

Zurzycka,

Wojtas,

Musiał

et al. 2023

Pielegniarstwo XXI Wieku / Nursing in the 21st Century

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Introduction. Access to Internet resources has resulted in changes in the perception of principles related to interpersonal communication, privacy and sharing of personal information. Medical personnel may use data obtained from the Internet to supplement information gathered during the patient interview or to reveal a different picture of the patient’s health status. In PTG, it is crucial to assess the motivation for such an action, respect the patient’s rights and obtain his consent, comply with the rules of medical ethics, as well as assess the usefulness of such an action for the therapeutic process. There are questions as to whether the information provided is true, and to what extent it is altered by cognitive or mood disorders. Aim. The aim is to present selected issues related to the search for information about patients on the Internet by the therapeutic team. Method. Analysis of research and scientific studies in the Medline and PubMed databases. Summary. Scientific studies confirming the occurrence of PTG phenomenon, refer to the issue of ethical principles, obtaining patient’s consent, reliability of recorded data and true identity of patients, inclusion of obtained information in their medical records and its importance in shaping the relationship between the patient and the therapeutic team.

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Patient-Targeted Googling and Psychiatry: A Brief Review and Recommendations in Practice

Cited by 10 publications

References 14 publications

Patient‐targeted googling by psychological therapists: A narrative review of the literature and ethical implications

Patient‐targeted googling by psychological therapists: A narrative review of the literature and ethical implications

Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding

Internet as a source of patient information – Patient Targeted Googling

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