Verified by 
Are Facebook "fan pages" or MySpace accounts appropriate vehicles to promote a psychology or mental health practice? And is it okay to publicly post films of client or patient sessions, even with informed consent, on FB? It's happening-and it's bringing up a number of questions about how some mental health practitioners are using social networking platforms such as Facebook and what exactly constitutes client welfare in the age of the Internet.
I am Cathy and I am a member of the 250 million humans inhabiting Facebook Nation. I visit FB several times a day, IM my friends, and post daily messages, photos, and media like millions of others. I am a FB believer, having built a large network of contacts via the platform; I used it to establish an organization with over one thousand members literally overnight, promote my writing for PT and other publications, and "Big Tweet" an art therapy story on a regular basis.
While social networking platforms such as FB are generally used to stay in touch with family and friends, many individuals are also now using them to promote causes, events, and business interests. Therapists are using FB too, even setting up "fan pages" for their private practices. A fan page is sort of the ultimate "uber-narcissist" way to shamelessly promote whatever you want to on FB; in the past, these pages were devoted to a famous athlete, actor, or public figure. But now even realtors, marketers, and yes, even therapists apparently have established fan pages for themselves.
Okay--I can live with the idea that many therapists want to use FB to advertize their businesses, whether a coaching practice or traditional psychotherapy practice. But how some therapists are using this platform is where I start to get a little queasy. One FB fan page for an art therapy
private practice included both photographs of artwork made by clients during sessions and a series of unedited video posts of actual client sessions with a minor. I fully understand that informed consent may have been obtained to post this material. And possibly the intent of such material is to demonstrate the value of art therapy in treatment-certainly, film and image can promote art therapy more effectively than words alone. In fact, art produced in community, clubhouse, or art therapy open studios is often created in public, because part of the "treatment" is to reframe clients as artists. But art produced as part of psychotherapy or counseling sessions is created in a very different context. Under such circumstances, no matter what consent was obtained or what the intent, inclusion of recordings of client sessions is really pushing the boundaries of ethics and individual welfare. Does any person really understand what it means to have one's therapy session visible in one of the most public cyber-places in the world? How well does any client understand that anything on a social networking site is accessible and downloadable by anyone with a few clicks of a mouse? I am not convinced that any informed consent document or explanation could adequately convey this to any individual, particularly a child.
It is well documented that participation in social networking and online media [including blogging for PT] punctures the very thin veil of privacy in this age of the Internet. Over recent years, the American Psychological Association has posted several articles about the problematic nature of Internet access, including the increasing number of clients who are "Googling" their therapists to find out where they live, their personal interests, and other information. Like many practitioners I am conscious of what my clients can read about me as well as the difficulties that I face in keeping appropriate boundaries with patients in a world of electronic communication.
These issues are complex and I do not pretend to be able to answer-- or even identify-- all of them here. And being over 30 years old, I am part of a generation that did not grow up with an exclusively digital worldview; younger cybertravelers are possibly more comfortable with the public platforms like FB and nonplussed about the increasing lack of privacy of personal lives. So it's hard to say how my FB colleagues will react to what I observe; maybe I will be cyberflogged for bringing this to light. But statement made by Stephen Behnke, PhD, JD, Ethics Director for the APA, sums it up for me: "Putting something on the Internet is no different than leaving it on a table at a coffee shop at the mall." Maybe the Internet has redefined the nature of self-disclosure and privacy, but ethically, it's just too much information.
© 2009 Cathy Malchiodi
Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO], www.internationalarttherapy.org. One world, many visions...working together to create an inclusive and sustainable future for art therapy.
Subscribe to my Twitter and get the latest art therapy news at http://twitter.com/arttherapynews.
