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Resources regarding Social Media and Counseling

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Ashley Smith & Andrea Skaflen
James Madison University
February 19, 2011
What is social media?
 “Social” – refers to instinctual needs humans have to
connect with other humans
“Media” – what we use to make connections with other
“Social Media” – how we can use technology effectively to
reach out & connect with other humans, create a
relationship, build trust
Media used for social interaction
2 way communication - interactive dialogue
Types of Social Media
п‚— Written word
п‚— Picture-sharing
п‚— Telegraph
п‚— V-logs (video blogging)
п‚— Telephone
п‚— Wall postings
п‚— Radio
п‚— Music-sharing
п‚— Television
п‚— Weblogs
п‚— Email
п‚— Social blogs
п‚— Websites
п‚— Internet forums
п‚— Photographs
п‚— Podcasts
п‚— Audio
п‚— Social bookmarking
п‚— Video
п‚— Virtual game worlds (video
п‚— Mobile phones (cell phones)
п‚— Text messaging
п‚— Virtual communities
п‚— Social networking
Social Networks
п‚— Social networking accounts for 22% of
all time spent online in the U.S.
п‚— Twitter averages almost 40 million
�tweets’ per day
п‚— 1 in 4 people over the age of 65 use
social networking sites
п‚— Examples:
п‚— Facebook
п‚— Twitter
п‚— Myspace
п‚— LinkedIn
п‚— Skype
“There are over 200 active sites using a wide
variety of social networking models today.”
Possible situations counselors might encounter
п‚— Diagnosing clients with internet, gaming, etc addiction
п‚— Helping a parent understand how technology use is negatively
impacting their child’s life
 Providing psycho-education about dangers of online social sites –
stalkers, sexual predators, bullies etc
 Adults – might be new to technology
 Children – might be oblivious to dangers
 Client’s personal information available online
 Counselor’s information available online
п‚— Personal use
п‚— Professional use
п‚— Dilemma of being friend requested by a client
п‚— Using technology in counseling services
Social Media Revolution
Communicating with Clients
п‚— Face to face
п‚— In the room
п‚— Via computer
п‚— Verbally
п‚— Over the phone
п‚— Written word
п‚— Email or letter
п‚— Chatting or texting
What is social networking?
 “It's the way the 21st century communicates today.”
п‚— A social network service is an online service, platform,
or site that focuses on building & reflecting social
relations among people who share interests &/or
п‚— Essentially consists of a representation of each user
(profile), social links, & other services
п‚— Most are web based; interact through internet, email,
instant messaging(chatting), or phone applications
Dangers of Posting Pictures Online
п‚— Work phone number
п‚— Personal phone number
п‚— Texting
п‚— Hotlines
п‚— Provide free, anonymous and immediate help
п‚— Offer information, emotional support, and referrals
п‚— 234 million people over 13 years old used mobile devices in
Dec 2009
п‚— Reduces response time
п‚— Increases accessibility
п‚— Agencies should have emergency services available 24
hours a day, 7 days a week
п‚— Telephone also integral part of traditional counseling
п‚— Adjunct to face-to-face work with clients
п‚— Few professionals have training in this area though
п‚— Client is in complete control of the duration of the
п‚— Client can hang up when they want
Suggestions for Telephone Communication
with Clients
п‚— Track more
п‚— Tune into nonverbal cues
п‚— Appreciate the intimacy of telephone communication
п‚— Use your body as you talk
п‚— Take notes
п‚— Have vital resource information near your telephone
п‚— Maintain contact
п‚— Email
п‚— Skype
п‚— Chatting
п‚— Social Networks (Facebook, Twitter, LinkedIn)
 “Self-help” websites, blogs, and chatrooms
п‚— Michael Feeny (2001) stated that a large number of
online counseling and therapy sessions will be taking
place every day in the not too distant future
п‚— Currently, about 5,000-25,000 online contacts between
counselors and clients take place daily
Telephone & Internet
п‚— Like using a telephone, most internet communication
does not involve visual cues, however that may be an
 Comfort and privacy of client’s home
п‚— Can take whatever time needed to compose messages
 Because client isn’t seen, may feel sense of anonymity
and be less inhibited and candid
Suggestions for Internet Communication
with Clients
п‚— Use emoticons
п‚— Use acronyms
п‚— Use emotional bracketing
п‚— Offer descriptive immediacy
п‚— Be aware of ethical concerns and legal issues
 Most fundamental task – make yourself known as
someone who can help in a crisis
п‚— In person, in writing, over the phone, or through the
internet – making contact with person in crisis is
essential step in crisis intervention
Initial session vs Established Relationship
п‚— How do you think an established relationship would
influence efficacy of online or telephone
communication with clients?
п‚— Rapport already established
п‚— Trusting relationship built
п‚— How accessible should counselors be?
п‚— 24 hours a day; 7 days a week?
п‚— Monday-Friday 8-5?
п‚— In what ways should counselors be available?
п‚— Texting?
п‚— Voicemail?
п‚— Pager number?
п‚— Personal telephone number?
п‚— Appropriate to text client?
п‚— Policies about emailing clients?
п‚— Phone etiquette
п‚— Available 24/7?
п‚— Difficult to maintain
п‚— People can overhear or accidentally see conversations
п‚— How could the information be used?
п‚— How do you keep records?
п‚— Could a transcript of a session be called into court?
 If using a type of “real time” chat or e-mail how do you
limit the risk of third party knowledge of an online
 encryption—how much does this limit risk?
Ethical Framework for Use of Social Media
п‚— Practitioners are mindful that social media activity can blur
the boundaries between personal & professional lives
п‚— Applicable ethical principles relevant to clinical care &
social media:
п‚— Confidentiality
п‚— Multiple Relationships
п‚— Testimonials
п‚— Informed Consent
п‚— Minimizing Intrusions on Privacy
п‚— Initiating Professional Relationships
п‚— Documenting and Maintaining Records
Ethical Framework continued…
п‚— Social media interactions which relate to ethical
п‚— Personal vs. professional behavior on the web for
Friend and follow requests
Search engines
Interacting using email, instant messaging, etc
Consumer review sites
Location-based services
Online treatment
ACA Code of Ethics (2005)
п‚— A.12. Technology Applications
п‚— Counselors inform clients of benefits & limitations of using
information technology applications in the counseling process
Include but are not limited to computer hardware, software, telephones,
Internet, online assessment instruments & other communication devices
п‚— When providing technology-assisted distance counseling services,
counselors determine that clients are intellectually, emotionally, &
physically capable of using the application & the application is
appropriate for the needs of the clients
When technology-assisted services are deemed inappropriate,
counselors consider delivering services face to face
п‚— Counselors ensure that use of technology does not violate laws of
any local, state, national, or international entity
Code of Ethics continued…
п‚— As part of the process of establishing informed consent, counselors do the
п‚— Address issues related to difficulty of maintaining confidentiality of electronically
transmitted communications
Inform clients of all colleagues, supervisors, employees who might have access to
electronic transmissions
Urge clients to be aware of all users including family members & fellow employees
who have access to any technology clients may use in the counseling process
Use encrypted websites and email communications to help ensure confidentiality
When encryption is not possible, notify clients & limit electronic transmissions to
general communications – not client specific
Inform clients if & for how long storage of records maintained
Discuss possibility of technology failure & alternate methods
Provide clients with emergency procedures (calling 911 or crisis hotline) if counselor
not available
Discuss time zone differences & cultural or language differences that might impact
service delivery
Inform clients when technology assisted distance counseling services not covered by
Scope of Practice
п‚— Indicates the specific area to which a practitioner may
п‚— May also define where a practitioner may practice
 Understanding boundaries & limitations of one’s
specific discipline
п‚— Understanding specific laws or ethics within one's own
discipline or geographic location
 Respect specific laws of potential client’s geographic
п‚— Competence
Training and Supervision of Online
Counseling Work
п‚— Limited course work regarding the specifics of online
counseling work to ensure competency and efficacy
through online medium
п‚— Limited number of Supervisors available with
experience in online counseling work to provide
appropriate supervision of online counseling work
п‚— How effective is it to communicate with clients via
social media
Client’s Access to Counselor’s Personal Info
 “Prior to calling or interviewing their potential
psychotherapists, consumers are likely to search for
the therapists Facebook profile or page, or other social
networking profiles” (Zur, 2009)
п‚— Through social networks
п‚— How much personal information should be available
for public view?
п‚— Pictures, interests, hobbies, phone #, address,
communication with others (Facebook wall, etc)
Counselor’s Profile Related to Professional
п‚— Websites available to the public should include:
п‚— Crisis intervention information
п‚— Counselor contact information
п‚— Counselor education, license/certification information
п‚— Terms of use, privacy policy, & social media policy
п‚— Encrypted transmission of therapeutic & payment
п‚— Informed consent process
Counselor’s Access to Client’s Personal Info
п‚— Pictures, interests, hobbies, communication with
others (Facebook wall, etc)
 Previewing client’s information before initial meeting
(“scoping out client”)
 Gain access to client’s information not expressed in
 “Checking up” on client after sessions have been
Digital “Natives” vs Digital “Immigrants”
п‚— Things to be aware of
п‚— Cautions to remind children/teens of
п‚— Cautions to remind parents of
п‚— Understanding purpose of social networks
п‚— Understanding dangers of social networks
п‚— Privacy
п‚— Cyber-bullying
Themes Counselors Might Address
п‚— Trolling
п‚— Online bullying (Cyber-bullying)
п‚— Lack of interpersonal interaction
п‚— Barrier between kids/teens and parents
п‚— Inappropriate pictures
п‚— Threats
 Teachers and students “friends” online
Ways Social Media will Change Mental
Health Care
 Changing how we communicate & define “relationship”
 Professionals will collaborate more – more comfortable
communicating via social outlets
п‚— Also learn to consult & collaborate more on cases (careful
with confidentiality), share research information, & become
partners on treatment programs
п‚— The stigma & isolation of mental illness could decrease
п‚— Online patient advocacy sites allow people to discuss mental
health issues with one another – share similar experiences &
provide suggestions for coping
Ways Social Media will Change Mental
Health Care continued…
п‚— Increased demand for high quality mental health care
 Surge of “e-clients” – those who are “plugged in” & research,
advocate, & communicate online
п‚— Current & potential clients asking providers educated
questions about their expertise, treatment philosophy, &
expected outcomes
 Stay up-to-date on what’s going on in your specialty – don’t
want a client quoting research you should know about
Ways Social Media will Change Mental
Health Care continued…
п‚— Allow us to create & provide simple follow up programs &
protocols that can be sent out to people daily, weekly, or
monthly via email, text, audio, or video
п‚— Reminders to take medication, exercise, eat right, go to bed
on time, use a journal, etc
п‚— Greater ability to create treatment programs that clients
want & need
п‚— Allows us to listen & discuss with consumers what they would
like in terms of service structure & offerings
Policy for Social Media
п‚— Feel free to provide a policy for clients regarding:
п‚— Friending
п‚— Fanning
п‚— Following
п‚— Interacting
п‚— Use of search engines
п‚— Business review sites
п‚— Email
п‚— Example of Keely Kolmes, Psy.D.
 “My Private Practice Social Media Policy”
Overall Benefits/Advantages
п‚— Convenience
п‚— Client feels comfort in own chosen location (home, work, etc)
п‚— Transportation not required to speak with counselor
п‚— Reach
п‚— Accessibility
п‚— Usability
п‚— Recency
п‚— Instantaneous responses; participants determine delay in response
п‚— Permanence
 Client able to read & reflect upon counselor’s words multiple times
п‚— Especially useful in crisis situations
п‚— Helpful in conjunction with face to face counseling
Overall Disadvantages
п‚— Techniques difficult to employ through social media
п‚— Non-verbal gestures
п‚— Confidentiality difficult to maintain
п‚— Clients might prefer to remain anonymous
п‚— How do you know you are talking to who they say they are?
 How do you collect payment from someone you don’t know?
п‚— Valid evidence supporting efficacy of cyber-counseling
is hard to come by
Things to keep in mind
п‚— Social media offers valuable tools and resources which
can support face to face counseling
п‚— If you want to use social media, remember to prepare
the client - inform them of appropriate expectations
п‚— It is important for each counselor to decide what the
personal advantages & disadvantages are of using
social media in their practice
 Also keep in mind your organization’s policy (if you do
not have a private practice)
American Counseling Association. (2005). ACA Code of Ethics. Retrieved from
Barnett, J. (2005). Online counseling: New entity, new challenges. The Counseling Psychologist, November (33), 872880.
Barnett, J., Levahot, K., Powers, D. (2010). Psychotherapy, professional relationships, and ethical considerations in the
MySpace generation. Professional Psychology: Research and Practice, (41), 160 –166.
Echterling, L., Presbury, J., & McKee, J. (2005). Crisis intervention: Promoting resilience and resolution in troubled
times. New Jersey: Pearson Education, Inc.
Giurleo, S. (2010). 5 ways social media will change mental health care. Retrieved from
Kolmes, K. (2010). Ethical framework for the use of social media by mental health professionals. Retrieved from
Kolmes, K. (2010). My private practice social media policy. Retrieved from
Mallen, M., Rochlen, A., Vogel, D. (2005). The practical aspects of online counseling: Ethics, training, technology, and
competency. The Counseling Psychologist, November (33), 776-818.
Walz, G. (2001). Cyber-counseling: A point of view. Retrieved from
Wikipedia (2011). Social network service. Retrieved from
Wikipedia (2011). Social media. Retrieved from
(n.d.). What is social media? Retrieved from
(n.d.). To accept or not to accept? Retrieved from
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