Can you use Social Media as a Counselor? Can you grow your practice online?

You have profiles on YouTube, Facebook, Pinterest, Pinterest, LinkedIn, Digg, Reddit, Technorati, Ning, Squidoo, XING, Answers.Yahoo, GodTube, MySpace, Yedda, Furl, Blogger, StumbleUpon,, Yelp, and Google Talk, to name a few. Most of these, you hardly use. Some of them, you’ve been on once to create the account, and only remember it when you receive newsletters in your email inbox, which you then unceremoniously delete.

Your colleagues have been finding you online for a few years now, so you’re used to getting the occasional “friend request”/”connection” from someone you work with.

However, what if you receive a Facebook friend request from Elizabeth, a 20-something British-American therapy client?

What do you do?

You are trying to establish trust and rapport with Elizabeth. If you decline her request to join such a non-exclusive network, could it harm your therapeutic rapport? Truly, you would accept a friend request from a stranger’s grandmother’s Labradoodle without thinking twice – so why not Elizabeth?

Potential problems.

Adding Elizabeth as a “friend” on Facebook will grant her access to mostly benign information: a few of your photos, and some biographical information. However, it will also allow her to see comments and photos of the students, colleagues, family, friends (and pets) you have added before her. You must consider, first, that perhaps Elizabeth has not considered what it will be like to view your friends and family – people who have a personal relationship with you that she does not, but one that she might desire herself. Second, Elizabeth may regret being “in network” when she realizes that “your” people can see her profile, which could be a breach of confidentiality. Third, Elizabeth may have unspoken expectations about your online connection that you cannot accommodate, such as:

  • Will Elizabeth expect you to write back and forth with her?
  • Will Elizabeth want you to post on her webpage?
  • Will Elizabeth want you to NOT post on her webpage?
  • Does Elizabeth expect, or hope, to be added to your “Top Friends” list?

Fourth, you might not be able to respond adequately to inquiries from others who ask about the British gal (Elizabeth) who is now in your network, and who is (possibly) commenting on you webpage. Fifth, you might be allowing Elizabeth to use your relationship as a friendship, which could hinder your therapeutic goal of her developing relationships outside of counseling. Sixth, including Elizabeth in your network could blur professional-personal boundaries.

For all of these reasons, you need a policy, not just for Elizabeth, but for any client who requests an online connection in the future.

Online Networking Policy.

Never solicit a connection.

A connection severely jeopardizes client confidentiality, so should never be initiated by the therapist.

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.

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?

Clean up your profile.

Minimize the risk of blurring professional-personal boundaries by making your account less personal. Gone are the pictures of your sisters and you making faces at the camera. Gone is the survey that says your “superhero personality type” is the Green Goblin.

*Obviously, names and faces have been changed.