The type of psychotherapy I offer (attachment-based psychoanalytic psychotherapy) relies on maintaining a level of neutrality with regards what clients know about my personal life – that way, clients can truly concentrate on themselves.  However, because I enjoy using social media there is a large amount of information about me available on the world-wide web, making the desired neutrality of the therapeutic relationship impossible.  Also, in today’s world, it is virtually impossible to work without using digital technology of some sort (e.g. email, texts), which potentially impacts on client confidentiality.

This document acknowledges the complex world of digital media and attempts to address issues that may impact the therapeutic relationship.  It is based on my own research and choices I have made with regard my online presence, and will be, by its very nature, an ever-evolving document.  I ask all my clients to read through this document so they are familiar with my position.

My media activities

I enjoy using social media (Twitter, Facebook) to communicate issues relating to psychotherapy, attachment, mental health and the overlap of these to relevant current events to as wide an audience as possible.  This is separate to my work as a psychotherapist – I hold my duty of care and confidentiality to my psychotherapy clients as sacrosanct.  My involvement in social media is related to, but separate from, my clinical work.

Maintaining boundaries

The nature of an online presence can blur interpersonal boundaries.  Therefore, it is important to strive for clarity about how to maintain appropriate boundaries in psychotherapy: 

Email:

I always request a client's preferred email address as part of the initial session/s.  If clients choose to communicate with me via email, it is important to be aware that all emails are retained in the logs of Internet Service Providers. Furthermore, they can be vulnerable to viruses and unintended forwarding or replication.  If clients are concerned about the confidentiality of emails, they can contact me via telephone instead.  I check emails only during standard office hours.  Unless the issue is urgent or pertains to a weekend session, emails received outside of these hours may be checked, but would not be replied to until the following week.  However, emails should never be used in the event of an emergency, in which case you should contact emergency services.

It is best to be thoughtful about what you include in emails to me, and which email address you use to communicate with me.  I use an end-to-end encryption email provider (Protonmail), as well as a standard email provider (Fastmail). I prefer people do not send sensitive personal information via email, but if you want to share information I recommend downloading Protonmail (the basic programme is free to use).  I encourage people to use email for non-confidential communication, like setting up appointment times and the like. 

I endeavor to respond to all emails within two working days, unless I am away. 

E-invoicing:

If I invoice you for sessions on a monthly basis I send invoices via email.  If you would prefer not to receive these invoices by email, please let me know and I can bring you a printed copy at the beginning of each calendar month.  I do not supply receipts for money paid via BACS unless requested to do so.

Text messages:

Please feel free to contact me via text message to alert me if you are running late for a session, or for similar reasons.  However, as it is difficult to communicate nuanced information via text, it is generally not a good way to communicate other matters.  In such instances, please phone and leave a message.  Please note, I am unable to offer emergency input via phone unless this is something we have planned (e.g. via text).

Should you experience a medical or similar emergency, contact the relevant emergency services. If you are feeling actively suicidal outside of session times, ring The Samaritans (free tel. no. 116 123).  But also do discuss this with me – I cannot offer emergency input around suicidal feelings, but therapy is a place to think about such issues in a calm and thoughtful way.

Telephone/video calls:

Whilst I primarily work face to face, there are times when it is not possible to do so (e.g. when a client is working away).  At such times, sessions via remote means can be an important way to maintain a connection. Since such forms of communication feel very different to face to face work, it is important to discuss how the use of telephone or video calls change the therapeutic work.  I make every effort to choose video conferencing software that is recognised to be adequately encrypted - so this may involve me requesting you to download certain software, or logging into a web-based application. When engaging in phone or video calls, we both agree not to use any recording devices.  

Client safety is paramount, so I ask clients to ensure the environment they are contacting me from is safe and secure. With this in mind, I do not engage in sessions where clients are driving as we talk, or if they will be driving immediately following a session. I also require clients not to engage in activities that would be distracting or affect their concentration (e.g. smoking or drinking alcohol).

Social Media:

As already stated, my use of social media is not directly related to client work.  Despite my online presence, I prefer that our therapeutic relationship remain as much as possible between us in the consulting room.  As such, I do not knowingly follow any current or former clients on Twitter. You have the right to follow my Twitter feed, which is purely for my work, or you may choose to keep our therapeutic relationship entirely separate.

Like many, I maintain a private Facebook account for my personal use, which I aim to keep as private as possible. Similarly, I have a Linked-In account for professional networking. Being Facebook 'friends' or Linked-In with current or former clients is not appropriate or desirable.

As with the nature of social media, sometimes it might happen that these boundaries are not easily manageable. If this is the case, I would aim to think about that with a client in session.

Google:

The use of Google as a way to find businesses or services has become the first port of call for many people. However, I wish to avoid encountering information about clients that does not directly come from them. As such, I avoid Googling clients. There is one possible situation where I may feel the need to complete an internet search about clients - if I am concerned about their wellbeing and I am unable to contact them in any way, I may search for information via Google.  This is something I would name in our next session.

It is obviously a client's right to Google me. However if doing so raises questions about me, I encourage clients to discuss this in session. 

Thanks to:

Dr Aaron Balick for the option to adapt his own digital policy, (http://aaronbalick.com/pdf/digital-policy.pdf), which was itself based on the digital policy of Keely Kolmes, Psy. D. (www.drkkolmes.com).