Boston Counseling and Psychotherapy

Online Social Networking (i.e., “Facebooking”) with Therapy Clients

It finally happened.  I have profiles on YouTube, Facebook, LinkedIn, Digg, Reddit, Technorati, Ning, Squidoo, XING, Yahoo Answers, GodTube, MySpace, Yedda, Furl, Blogger, StumbleUpon, del.icio.us, Yelp, and Google Talk… to name a few. Most of these I hardly use. Some of them I’ve been on once to create the account and only remember it when I receive newsletters in my e-mail inbox, which I unceremoniously delete.
My students and colleagues have been finding me online for a few years now, so I’m used to getting the occasional “friend request” from someone I teach or work with. However, last week I received a Facebook friend request from Cecil, a 20-something British-American therapy client.* I immediately considered declining the request, but stopped short.

“I am trying to establish trust and rapport with Cecil,” I thought. If I decline his request to join such a non-exclusive network, could it harm our therapeutic rapport? Truly, I would accept a friend request from a stranger’s grandmother’s Labradoodle without thinking twice… so why not Cecil?

Potential Problems
Adding Cecil as a “friend” on Facebook will grant him access to mostly benign information: a few of my photos, and some biographical information. However, it will also allow him to see comments and photos of the students, colleagues, family, friends and pets I have added before him.

I must consider, first, that perhaps Cecil has not considered what it will be like to view my friends and family—people who have a personal relationship with me that he does not know, but one that he might desire himself. Moreover, if Cecil is in any way a dangerous person, such access to my loved ones becomes risky, even downright scary.

Second, Cecil may regret being “in network” when he realizes that “my” people can see his profile, which could be a breach of confidentiality.

Third, Cecil may have unspoken expectations about our online connection that I cannot accommodate, such as:

• Will Cecil expect me to write back and forth with him?
• Will Cecil want me to post on his Web page?
• Will Cecil want me to NOT post on his Web page?
• Does Cecil expect, or hope, to be added to my “Top Friends” list?

Fourth, I might not be able to respond adequately to inquiries from others who ask about the British guy (Cecil) who is now in my network, and who is (possibly) commenting on my Web page.

Fifth, I might be allowing Cecil to use our relationship as a friendship, which could hinder our therapeutic goal of him developing relationships outside of counseling.

Taking all of these concerns together, including Cecil in my network could easily blur professional-personal boundaries.  For all of these reasons, I have decided that I need a policy, not just for Cecil, but for any client who requests an online connection in the future.

Online Networking Policy

It is hard not to conclude that the wisest policy is to dissuade any “Facebooking” between yourself and your clients. However, such relations may not be wrong per se, and might be justifiable under certain conditions:
1.) Never solicit a connection.
A connection severely jeopardizes client confidentiality and should never be initiated by  the therapist.
2.) Discuss with the client his/her reasons for requesting a connection.
Is the client using the counseling relationship as a friendship? Does he or she want to be a  bigger part of your life? Addressing motivations could be good “grist for the mill” in the  therapy process.
3.) Address the risks and benefits.
Clients may underestimate the potential for negative emotions they might feel being in  your network. Also, address client expectations—what purpose does the client believe the  online connection will serve?
4.) Clean up your profile.
Minimize the risk of blurring professional-personal boundaries by making your account  less personal. Some time ago, I decided this was a necessary endeavor: Gone are the  pictures of my sisters and me making faces at the camera. Gone is the survey that says  my “superhero personality type” is the Green Goblin.

Many of my new accounts are for my counseling practice, not me personally. I considered making two profiles for each Web site (one personal, one professional), but rejected the idea when I realized there is nothing to prevent my clients from soliciting a connection with the “wrong” profile.

Today, Cecil is still on my “friend request” pending list, neither declined nor approved. I might approve him, but not before we talk.

Note to Readers: Please send your policies and “case histories” on this developing clinical-ethical issue to ThriveBoston@gmail.com.

*Obviously, names and faces have been changed.

****This article may be distributed and republished without permission if this footer is included: Written by Anthony J Centore Ph.D., Counselor at Thrive Boston Counseling and Life Coaching, http://www.thriveboston.com - Call: 617-395-5806   ****

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