How Should Therapists Handle “Friending” Requests?

Course excerpt from Ethics and Social Media

The Phenomenon of “Friending”

Friending Request from ClientA “friend” used to be an individual of one’s personal acquaintance, with whom a sense of liking, trust, and camaraderie had been built over some period of mutual experience and interaction. Many people considered themselves fortunate if – over the period of a lifetime – they were able to count a handful of others among those they considered to be friends.

With the advent of Facebook, that concept has morphed into something that may or may not bear any resemblance to the original definition. In many cases, people who are friends on Facebook were personal real-life friends before joining up on Facebook. In other cases, new friends are made online, without the benefit (or bother) of any face-to-face interaction. In still other cases, individuals spend a great deal of time and effort collecting “friends” online for the sake of amassing a very large audience for their postings.

In some cases, these numbers are quite extraordinary. According to a survey by the Pew Research Center (2014), the average number of friends a person has on Facebook was 338. A generational ranking revealed – not surprisingly – that number of Facebook friends was inversely correlated with one’s age. Millennials (age 18-29) averaged 300 friends (a quarter of these young users had more than 500 friends in their network), Gen Xers (age 30 – 49) 200, and Younger Boomers (age 50 -64) 75. People over the age of 65 average 30 friends.

To Friend or Not to Friend

One of the more complex challenges facing contemporary therapists (at least those who use Facebook) is the question of how to respond when receiving a friending request from a client. It is the arrival of this simple electronic message that precipitates a cascade of questions concerning a broad spectrum of ethical issues from privacy and confidentiality to multiple relationships and clinical competency. Zur (2012) states it this way:

“Currently, more than 900 million people around the world and more than 157 million in the United States [these numbers are already outdated] have Facebook pages, and at least some of them may be your clients. Clearly, the issue of when, or whether, to use Facebook touches on just about every clinical and ethical issue of importance to therapists, particularly issues relating to boundaries and dual relationships. Should you even have a Facebook page, and if so, how much of your private life should you show? Who should see what? Should you use Facebook’s privacy settings to distinguish what you show among colleagues, best friends, family members, and old, new, and potential clients? How do you respond to clients who want to ‘friend’ you?”

These questions are answered in different ways by different therapists. Kolmes (2009) offers this view:

“Inviting clients to your personal profile can also be perceived as inviting them into your personal life. Unless you utilize very strict privacy settings on your profile, those who become your ‘friends’ can post and view messages posted to your Wall, they can view your photo albums and read the comments on these albums, and they can see and interact with your other ‘friends.’ This can send mixed messages to clients, especially if they are unclear about therapeutic boundaries to begin with. If you would never think of inviting a client to a cocktail party at your home with your friends and family present, then you may want to think twice about inviting them to be your friend on Facebook (or approving their friend requests). It is the online equivalent of inviting them into your social circle.”

Laura Hahn, a counselor in private practice, suggests that therapists refrain from friending clients on Facebook. “Make it a policy by adding a statement to your informed consent documentation and inform your clients up front. Counselors who find clients being overly interested in the counselor’s personal life and conducting intrusive online searches can explore that topic with the client in therapy” (in Shallcross, 2011).

Questions for Psychotherapists to Consider Before Responding to Clients’ Friend Requests

It is useful – probably even necessary – for a therapist to spend some time pondering the friending issue before plunging into the world of digital friendship. On the Zur Institute website (http://www.zurinstitute.com/socialnetworking.html) there is a list of questions for therapists to consider as they face this decision.

Learn more: https://www.pdresources.org/course/index/6/1147/Ethics-and-Social-Media

Ethics and Social MediaEthics and Social Media is a 2-hour online continuing education (CE) course that examines the use of Social Networking Services (SNS) on both our personal and professional lives. Is it useful or appropriate (or ethical or therapeutic) for a therapist and a client to share the kinds of information that are routinely posted on SNS like Facebook, Twitter, and others? How are psychotherapists to handle “Friending” requests from clients? What are the threats to confidentiality and therapeutic boundaries that are posed by the use of social media sites, texts, or tweets in therapist-client communication? The purpose of this course is to offer psychotherapists the opportunity to examine their practices in regard to the use of social networking services in their professional relationships and communications. Included are ethics topics such as privacy and confidentiality, boundaries and multiple relationships, competence, the phenomenon of friending, informed consent, and record keeping. A final section offers recommendations and resources for the ethical use of social networking and the development of a practice social media policy. Course #20-75 | 2016 | 32 pages | 15 posttest questions

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Living a Better Life with Chronic Pain

Certainly no one would choose a pain-filled body over a healthy, pain-free body. Yet every day, people unwittingly choose actions and attitudes that contribute to pain or lead to other less-than-desirable consequences on their health, relationships or ability to function. These actions and attitudes are what are called self-defeating behaviors (SDBs) and they keep us from living life to the fullest – if we let them.

Living a Better Life with Chronic Pain: Eliminating Self-Defeating BehaviorsLiving a Better Life with Chronic Pain: Eliminating Self-Defeating Behaviors is a new 5-hour online course that “walks” readers through the process of replacing their self-defeating chronic pain issues with healthy, positive, and productive life-style behaviors. It progresses from an analysis of the emotional aspects of living with chronic pain to specific strategies for dealing more productively with it. Through 16 guided exercises, you will learn how to identify your self-defeating behaviors (SDBs), analyze and understand them, and then replace them with life-giving actions that lead to permanent behavioral change. Course #50-12 | 2014 | 49 pages | 35 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account after purchasing) and mark your answers on while reading the course document. Then submit online when ready to receive credit.

Professional Development Resources is approved by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).