Every mental health attorney I have spoken to in the last two decades has expressed concerns about therapists sharing inappropriately or sharing too much on Facebook.
I’ve spoken to over 300 therapists about this on an individual level.
Some have initiated those conversations with me after being appalled at what they’ve read on their own social media sites; others have responded defensively to colleagues’ statement of concern; sometimes they have actually been defending other therapists who have spoken out of turn; and, still other conversations have occurred when I’ve been the one to reach out either publically or privately to offer cautionary tales.
And, still these acts of either careless or intentional over-sharing occurs by those of us who have been entrusted to hold space for our clients’ vulnerabilities and deepest secrets.
I’ve seen other therapists including Kat Mindenhall, LCSW, Dawn King, LPC, Pam Dyson,LPC, Rob Reinhardt, LPC, bravely engage in conversations with peers in an attempt to respectfully and yet professionally curb these practices.
Today, Rosellen Reif is back with us to share her thoughts about this common problem of therapists running off at the mouth on Facebook and other social media platforms.
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A Guest Post by Rosellen Reif, MS, LPCA, CRC, QDD/MHP
Oh . . . Facebook.
We’ve all logged on, read someone’s status, and thought “I can’t believe you just posted that for everyone to read!?!”
Since becoming a counselor and having a social media feed comprised of more and more counselors, I’ve realized that even therapists aren’t immune to these kinds of posts.
The kind that make you shake your head and wonder ‘what were they thinking?!?’
Even on our personal social media pages, counselors have a lot to be thinking about.
Aside from liking cute baby pictures and weighing in on political shenanigans, we have to be vigilant about following our ethical codes and upholding our clients’ rights to confidentiality.
Whenever I’ve seen a close friend who is a therapist post something that makes me cringe, I’ve talked to them about my concerns.
In most cases, they have seen how their post could be misconstrued and they’ve removed the posts.
But screenshots are a real thing and since I’m not Facebook friends with all of you (at least, not yet!), I want to share my list of the top five status updates counselors make that are troubling to me and elaborate on the reasons why you might want to reconsider before clicking “Post.”
#5 – Paid to Post or Listen?
My client said ‘X, Y, Z’ and it was so funny/horribly tragic/exactly what I thought when I was their age etc.”
I see this All. The. Time.
Usually about adolescent clients, which is extra concerning.
If my doctor posted my lab results on his Facebook page and shared his thoughts about them, even if he didn’t say they were mine, I’d be finding a new Doctor AND a team of Lawyers immediately.
And you’d better believe I’d see to it that the Doc lost his license and his practice if it was my child’s medical info he chose to share with a few hundred closest Facebook friends.
We are healthcare professionals, specializing in mental health.
The things our clients say and do in session is the data that we use to diagnose, to plan treatment, and, hopefully, to help them become healthier.
What your client says to you during a confidential session is no different from any lab test that your medical doctor might run.
It is information that a paying client has allowed you to collect in the hope of helping them assess and improve their health and wellbeing.
I assure you that when that client shared in session whatever it was you quoted and posted, they did not do so in the hope that it would get a few likes from your old high school buddies.
They did it so that you, as a professional listener, could help them heal.
#4 – Telling on Yourself
My client cancelled today – pool time!”
Of course, we all know you should keep a list of things to work on when clients cancel.
But maybe you needed some self-care and this cancellation gave you the opportunity to squeeze it in.
Is it still bad to post when clients cancel?
YES!
You never know how a Facebook friend may be peripherally related to a client.
They may know exactly who your 2 o’clock session was with.
We learned in grad school to never confirm or deny via phone or email if someone is our client or if they attended their session without having a release of information on file.
This is just the internet-age equivalent of that old ethics lesson.
There are other ways that a post like this could be harmful, too.
What if one of your Facebook friends is considering going to therapy or is in therapy and is thinking of skipping their upcoming session?
The subtext of this post is that counselors appreciate it when their clients cancel.
Of course, you are not responsible for your friends’ behavior and choices when it comes to their own therapy.
But would you really want to know that you contributed to someone not getting the help they needed?
I wouldn’t.
And I’m guessing you wouldn’t either.
#3 – Being Congruent Online
My client wore the prettiest yellow shirt today; she looked like a walking ray of sunshine. So lovely!”
What’s wrong with a compliment?
When posted on Facebook about a client, lots.
This sends the message that we judge our clients on superficial measures.
Sure, it’s within the scope of our job to take note of whether clients look disheveled or unkempt and to make that a clinical issue.
Beyond that, though, there’s plenty else for us to take note of during a session!
Therapy is about unconditional positive regard.
We market our offices as “safe spaces.”
We hand over tissues and say “It’s ok to cry,” and then we stand by as faces contort, eyes well with tears, and people literally wail in pain.
We see the ugly and we are supposed to accept it.
A client shouldn’t feel compelled to “dress to impress” for their counseling sessions.
Might someone with a deep depression who hasn’t felt able to brush their hair for the last two days be embarrassed to come to therapy if they feel they aren’t living up to what other clients do, or to what their therapist likes clients to do?
We also market ourselves as listeners and observers who pick up on the minutia of behavior and non-verbal communication.
If we’re spending time being distracted by how someone is dressed when it’s not clinically relevant, what are we missing that’s going on in session?
To me, this status sends the message that we aren’t everything we claim to be.
#2 – Talking Yourself Right Out of a Job
Check out this Calm-Down jar I made for my client . . . .
2 years of an graduate study and 1 grueling internship and all I have to show for it is that I can follow directions I read on Pinterest.”
The theories and tools of our trade are becoming more and more accessible to the public at large thanks to the internet and social media.
Because of that, I think it’s so crucial that we as professionals continue to clarify what it is that we do and why and how we do it.
We all know people, sometimes even close loved ones, who confuse what we do with some pop-psychology nonsense they saw on BuzzFeed.
Social media posts like this further the idea that psychology and counseling are even less than even the “soft” sciences.
They imply that anyone who can follow a crafty “how-to” or watch a YouTube video has as much knowledge as an educated, experienced clinical professional.
If we are not careful, we will self-deprecate our fields out of existence.
Accessibility of counseling tools is a fine thing . . . but only if we continue to position ourselves as what we are – trained, knowledgeable guides who can help our clients select the right tools and use them in the most meaningful ways for them as individuals.
#1 – Getting What You Need – But Not on Facebook
. . . Three back-to-back Borderlines – is it wine o’clock yet?”
I almost didn’t include this one because it seems so painfully obvious, but I went back through my Facebook feed over the past few months and saw statuses of this ilk at least half a dozen times – which, to be clear, is shocking!
There’s so much wrong here!
This sends a message that we only view clients as their diagnoses and that we need to be drunk just to bear spending time with them.
I can’t imagine how hurt a client would be if they read this.
And I can’t personally imagine referring anyone to the clinician who wrote it!
Yes, what we do is difficult work.
Our clients are not always appreciative, and not a lot of people understand how demanding it is to be a counselor.
We need to have outlets for expressing our frustration, and for receiving guidance and support from other clinicians who are knowledgeable and compassionate.
Our clients are not always appreciative and not a lot of people understand how demanding it is to be a counselor.
We need to have outlets for expressing our frustration and for receiving guidance and support from other clinicians who are knowledgeable and compassionate.
Facebook is not that outlet.
I almost didn’t write this next bit either, but I’m pretty sure I’d be wracked by guilt if I didn’t, so, here goes.
If your work leaves you feeling this way, it goes way beyond a Facebook post that’s in poor taste; something BIG needs to change in your practice . . . and in your life.
Maybe who your ideal client is has changed and you just need to update your marketing to find them.
Maybe it’s time to adjust your hours or fees so that you feel your time and the services you provide your clients are valuable and valued.
Or maybe it’s time to truly question if counseling is still your calling.
A snarky post on social media and a few volleys of comments may help you feel temporarily rewarded in the way that you work in session didn’t but it’s not a long-term solution to what is a genuine problem.
Engaging in Reflective Practice
If you’ve posted a status like this, I sincerely hope you will re-evaluate what’s going on in your life and your practice to cause this behavior.
I hope you will make the real changes you need to be fulfilled enough, personally and professionally, that you don’t resort to petty posts like these to feel validated in your work.
This might mean:
- Seeking out clinical consultation or supervision, even if you’re fully licensed,
- Working with a practice consultant like Tamara, a business coach, or another professional as an accountability partner, and / or
- Attending therapy with a really spectacular counselor.
Why I Wrote This Post
To be sure, I wrote this post because I hoped to show how social media posts might be perceived by potential referral sources or therapy clients on Facebook.
Ask yourself whether you’re truly upholding your ethical obligations to your clients and to your profession.
And, if you’re not, I’m asking you to rethink your presence on social media.
If I’ve succeeded in doing this, I hope you’ll join the conversation below.
That being said, I’m sure plenty of you disagree with what I’ve written here.
I would especially love for you to stick around and start a conversation with me if you think I’m wrong.
If you believe there is a distinction between your professional image and your personal use of social media and if you believe that Facebook can be a place where you can be unbound by ethical codes and laws, I want to talk to you.
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About the Author: Rosellen Reif is a Professional Counselor Associate based 
in Cary, North Carolina. She helps kids, adults, and families affected by disabilities and blogs at www.reifpsychservices.com. Her Facebook feed is little more than cute pictures of her kids that her husband has tagged her in.
Hi – I really appreciate this thorough and insightful post. I made a decision early on to opt out of Facebook too many reasons to list. Nevertheless, this post truly is educational and provides a “guide” on dialogue on this topic. Thank you so much .
Hey Carol! Thanks for sharing that this was helpful to you. I admire you for opting out of something that you recognized wasn’t going to be for you, despite the ubiquitous nature of the Facebook (it is hard to escape that little blue F)!
Hi, Carol! Welcome back!
Facebook is my least-favorite social media tool for many reasons including the fact they the platform repeatedly changes their rules, your settings, and practices.
Errors made on social media can be particularly costly to clients and to therapists.
Sometimes therapists get defensive claiming that “This is my best form of marketing.”
However, that often turns out to be “coaches” rather than mental health professionals or mental health professionals-turned-coaches that are marketing something other than mental health services.
For counselors, social workers, addictions professionals, and psychologists offering traditional counseling and psychotherapy to the general public, Facebook is often a waste of time.
Thanks, Carol, for dropping in to chat today!
Tamara, thank you for sharing this post with your tribe! I’m really hoping that some of you will chime in with your own experiences and perspectives, since I know this is a touchy and complex subject!
Rose, thank YOU for taking time to share your thoughts about this issue.
I had a therapist just this week want to consult on social media about a client.
I appreciate you taking the high road and reminding us all of our clients’ expectations and our professional contracts to always do what is in the best interest of our clients and our professions, too.
GREAT post. Although I haven’t come across Facebook updates like those mentioned above (and find it hard to believe my fellow therapists have been guilty of them!), I wholeheartedly agree with your advice, Rosellen. Thanks for this important reminder.
Hi Carol,
Thanks for reading! I’m fairly new to the field, and so my social media feed is made up of many new therapists. I was also the dinosaur in my school cohort, so, many of them are a bit younger than me. I’m guessing there’s absolutely a generational divide on this topic, with younger therapists feeling more comfortable sharing some of these comments…though I will admit that, like you, I sometimes can’t believe what I’m reading!
And, let’s face it . . . many of us began our work in the field with less-than-ideal boundaries.
The longer I’ve been in the field, the better my boundaries have gotten.
Can anyone else relate to that evolution?
Oh, my goodness, Anne! I’m surprised that you haven’t seen them!
I would like to think that’s because there are moderators in therapists groups who are addressing these practices or deleting these posts but . . . there are far too many that I stumble across on a regular basis.
And, sometimes I think moderators of online groups don’t realize that they are ethically and legally responsible for the behaviors their members engage in.
I’m with Carol. I haven’t seen many either. I make it a practice not to mention clients or work on social media.
Hope I’m doing a good job ethically speaking when it comes to my personal page.
ThanksTamara! As always excellent food for thought and always thorough!
Hi, Sally! Thank you for taking time to drop in to chat!
I’m glad that you haven’t noticed these gaffs.
Different groups definitely have established different cultures – some aren’t moderated at all, some are moderated poorly, some are better at self-policing themselves than others, and some are rigidly moderated.
Like you, I don’t talk about my counseling clients or clinical work online – so much so that I’ve had several therapists think I only coach and train on practice-building! Ha! Wrong!
Hope your day is going well, Sally!
Dear Tamara and Rose,
Thank you so much for sharing this information. I have seen colleague share similar kinds of information and I have cringed. Now I will have the courage to say something (privately) to them. I hope if I ever say something problematic, a friend would point it out.
I am careful what I post on Facebook and I’m also meticulous about my privacy settings, because I want to be choosing what I say, how I say it, and to what audience. I make a distinction between sharing vulnerably about myself, and sharing comments or thoughts about others. I hope I hit the mark.
Shulamit
Hi, Shulamit! I’ve missed your voice here!
I usually start out with private conversations.
However, if practices don’t change over time, I think it’s important to initiate public conversations.
We all make mistakes and, we all have made poor choices on occasion.
Like you, I would hope a colleague would say “Hey, Tamara! You mispoke . . . ” or “Are you sure you want to leave to post out there for the world to see?”
Just last week I posted something on Facebook and then decided that it was too far over the line.
When a cousin pointed it out to me (Thank you, Charles Bishell), I went back and deleted it.
There’s no shame if making mistakes.
But, when they are pointed out and recognized, there is shame in not cleaning them up.
Shulamit, I’m with you- the touchstone I’ve always relied on when I’ve reached out to another counselor about a post that I’ve found concerning; would I appreciate someone bringing the same thing to my attention? In every case, I would, so, I’ve gone ahead and broached the topic. It is a little unnerving though, because I want to be clear that I’m coming from a place of professional compassion and ethical obligation, and not policing my fellow counselors without reason. It’s a tricky balance to find…
Nicely said, Rose – “professional compassion and ethical obligation.”
However, as counselors, I believe we are mandated to protect (but not “police”) our profession, too.
Great post, thanks for these thoughts. I know having this in mind will help me in the future!
The content is great, but the lack of editing (repeating of sentences, etc), was a little distracting.
Amber
Oh, my gosh, Amber!
Thank you so much for noting the lack of editing in this post!
I’m so sorry!
I have no idea how a rough draft got posted rather than the final draft.
I have now corrected this and hopefully you will find this version distraction-free.
Rosellen Reif, an extra apology goes to you. It was clearly my error and not your own!
No worries, Tamara! Though Amber, I appreciate your seeing past the ‘draft status’ to enjoy the content, glad to have you reading along!
This was a great post but painful – I also see too much sharing on social media. Another thing to note, on Facebook especially, is the number of therapists that don’t have their profiles locked down and/or have pictures of family members in their profile photos. If you don’t have it locked down, clients can see all your photos and all of your posts even if they are not your friend. If your photo is showing, anyone can see that even if your profile is locked down. In my opinion, this is a boundary violation and could be a security issue depending on your clients. Social media is not a bad thing, but I think we have to be extra cautious given our role and responsibilities.
Hi, Lorraine! And, thank you so much for taking time to make this point.
What many therapists don’t understand is that your “favorite” client or your “favorite” referral source today, may very well not be your favorite tomorrow.
I say that as one who has made the mistake of thinking “once a great client, always a great client” and I’ve thought the same about referral sources, too.
People change.
Personalities change.
Sometimes they change because of twists and turns in our clinical work; but, sometimes it’s because of circumstances – including physical circumstances – in their own lives.
For Pete’s sake, we all know that the brain goes through changes – sudden ones from physical injury and more gradual ones resulting from disease processes.
Sharing your beautiful family photos or even personal photos of where you “go every summer to wind down” may very well be putting you and your family at risk . . . And you have no idea now what may be used against you in 5 years.
I am fairly transparent with my clients about many things . . . but I try to keep my family and my personal life locked down online.
I wonder if anyone in our community has made the choice to share online and then regretted it?
Care to share?
Good Morning
Just read your comments on inappropriate use of facebook,
Ihave been a Child protection worker in the UK and Ireland for 20 years, my background is Milan systemic family therapy, John Burnham was one of my tutors,
Unconditional positive regard is a bedrock of my value base , I have had a website designed for me and was looking at facebook, now I will not, I was cringing just thinking of the gaffs i could have placed online accidently so I will be thinking of a blog instead , not sure how to go about it,
I have always worked in very challenging enviroments and so I am quite well known , your message has helped me a lot , have to rethink how to advdertise services
kind regards jarlath
Jarlath, thank you for taking time to drop in to share your thinking on this.
If you have not yet been on social media, I would encourage you to look to other platforms before you look to Facebook.
It’s trickier than some – mostly because they are forever changing their rules and privacy settings.
It’s not that there’s not a place . . . A role for it.
It’s just that the risks are greater.
As for getting the word out about your work, I have found blogging to consistently be the best way to drive traffic to your site, boost your ranking with the search engines, and also to get your message out.
There are lots of ways to learn about blogging; however, if you learn best in a class, I’ll be teaching another round of BlogStart for Therapists before the end of the year.
I’ll try to put a link in here once I get my waiting list up for the next class.
Happy to have you join me!