How to Market Your Private Practice with Social Media in Accordance with Ethical and HIPAA Regulations
So, what should I post on social media?
Some of the most informative, organized, and professional social media pages by therapists are those that make use of all the features of the application. Many of these profiles also happen to have thousands of followers too due to the attention and time devoted to the page. This is great as far as getting your name out there and generating business.
For example, Instagram gives you the option to post regular photos and videos; however, you can also make use of Instastories or ‘stories,’ which remain posted for only 24 hours, to provide your followers with daily inspirational/motivational quotes, a brief personal message from you, or even lifestyle related content like a scenic sunset at the end of the day, the ingredients and making of a great green smoothie, or maybe a live deep breathing and progressive muscle relaxation demonstration. As long as you ensure to not reveal your location or information that is too personal (e.g., maybe leave your young child out of the smoothie video or avoid revealing the location of your sunset view or relaxation session), these added features will add variety and interest to your social media page and surely generate a following.
To Accept a ‘Friend Request’ or Not
Let’s say you exert your best effort to create a top-quality, professional, social media page that is updated frequently and is an informative and fun space for your clients and viewers to visit. Despite your time and attention to channeling your clientele to this space, some of your current clients may find your personal page and send you a friend request.
This is an ethical gray area because it can be seen as harmless, but at the same time, your clients are not your friends. Many people may believe that a friend request can’t go any further beyond clicking that ‘accept’ button and forgetting about it, but the reality is that it can lead to comments made under your personal photos or video posts, your client responding to or having conversations with your family/friends who comment on your posts, the client liking your posts, or even a direct message (DM) from your client. Some clients may respect your privacy, but not all clients will understand these boundaries and typically, a client who sends a friend request to your personal account, especially when it is set to ‘private,’ is technically already crossing a boundary whether the client is aware of it or not.
As therapists we understand the value of prevention when it comes to pretty much any problem. Ethical issues are no different: Prevention is key here, too. Talk to your clients ahead of time about social media. It doesn’t need to be a long discussion, but mention that a) you have a professional page and they are welcome to follow you, and b) you have a private page, which you don’t use for anything associated with your therapy practice. Alternatively, you can inform your clients that they are welcome to follow your professional page, but you don’t use the DMing feature or ‘comments’ for any therapy conversations and that all questions/comments need to be discussed in sessions. Explain that you are not allowed to confirm or deny that you are their therapist in any public post and using social media can potentially let other people know that you are their therapist! Tell your client that the same applies to your personal page: You don’t want anyone you know personally to be able to identify your therapy clients because you would be violating HIPAA laws.
Some therapists even put these disclaimers in their ‘bio’ on their social media page, letting visitors know that if they want to contact “Mary Smith, LMHC, please follow me at (insert Instagram handle).”
The point is that it’s always better to inform clients ahead of time when it comes to your intentions and behaviors on social media. This way, you avoid dual relationships, violating confidentiality, or other ethical dilemmas while also ensuring that you don’t offend or hurt a client by rejecting a friend request or other online communication. As therapists, we must ensure that we do no harm to a client, as this is our primary objective.
Keep in mind that accepting a friend request or communicating online with a client does not automatically imply a dual relationship, breach of confidentiality, or any other ethical violation; however, social media or online contact with clients can lead to ethical violations, which is why it is critical to take precautions and have a specific, pre-set plan of how you would handle these situations.
Existing Ethical Guidelines
According to the American Counseling Association (ACA; 2014), counselors that have an online presence must distribute a social media policy to their clients regarding what they are or are not willing to accept regarding online or social media communication.
Public Comments by Clients & Confidentiality
If you write or operate an online blog, Facebook page, Instagram profile, or Twitter page, depending on how big your following is, you will likely receive feedback, comments, and or likes on the content you post. Although a comment on its own cannot necessarily reveal a users identity, the users social media page can if it is set to ‘public.’ If the user also reveals that they are a client of yours, this information could be seen by other users. This is yet another gray area when it comes to ethics because the user, and not you, is revealing his/her own identity. However, the blog or social media page is yours, after all and you are aware that the client’s confidentiality is at risk.
In this circumstance, prevention is again, the best route to take. As a therapist, it’s excellent to blog or post content related to mental health and this can inevitably lead to your clients wishing to make a comment. Some great prevention strategies include asking your clients ahead of time to either make their own profiles private to protect their privacy or to avoid mentioning that they are your client during comments or discussions. Taking these simple precautions can prevent a confidentiality mess that you might find yourself in the middle of.