Ethics and Social MediaKelly Scaggs, LCSW, LCAS, CCS, MAC, ICAADCFellowship Hall, Greensboro, NCSeptember 24, 2018 2018 Kelly S. Scaggs

Ethics and Social MediaKelly Scaggs, LCSW, LCAS, CCS, MAC, ICAADCFellowship Hall, Greensboro, NCSeptember 24, 2018 2018 Kelly S. Scaggs

DefinitionEthics?ETHICSRules of behavior based onideas about what is morallygood and badMerriam-Webster Dictionary 2018

PROFESSIONAL ETHICSWhat is the right thing to do in a givenpractice situation?Where would we find thisinformation?

Codes OfEthics Addictions ProfessionalsNational Association of Alcohol & Drug Abuse Counselors (NAADAC) PsychologistsAmerican Psychological Association (APA) Social WorkersNational Association of Social Workers (NASW) CounselorsAmerican Counseling Association (ACA) Marriage and Family TherapistsAmerican Association of Marriage and Family Therapists (AAMFT)

Question What’s the problem?

Question What’s the problem?Technology is advancing faster thanour codes of ethics can keep up.

Question NAADACis advancing2016Technologyfaster than APA2016can keep up.our codesof ethics NASW2017 ACA2014 AAMFT2015

The Digital AgeWe Are SurroundedBy Technology ThatHas Changed TheWay We Practice.

The Digital AgeAccess To PersonalComputers ChangedEVERYTHING!

The Digital AgeThey Have Become: Smaller More Affordable Faster More Versatile

What isSocial Media

Social Media What Constitutes Social Media?Social media: Forms of electroniccommunication (such as Web sites forsocial networking and microblogging)through which users create onlinecommunities to share information, ideas,personal messages, and other content(such as videos).Merriam-Webster Dictionary 2018

SocialMediaSocial Media Lends Itself ToA Multitude Of PossibleEthical Issues:Conflict of InterestPrivacy and ConfidentialityInappropriate Self-DisclosureDual Relationships

Question What Information Can Be FoundOut About You On A GoogleSearch?

Remember If It Is On The Internet,It’s Public Information!

Social MediaClinicians postings on socialnetworking sites may constitute aninadvertent form of self-disclosureto clients and colleagues whoexplore these sites.

Social MediaResponsibility falls on theclinician given the possibility ofeven private sites being hacked andexposed, or information being visibleunintentionally via networks

Social MediaHow do you respond if a client tells you they“googled” you?

Social MediaWho else is searching yoursocial media presence?

Potential EmployersAre SearchingSocial MediaProvocative or inappropriatephotographs46 percentCandidate bad-mouthed previouscompany or fellow employee34 percentInformation about candidate drinkingor using drugs40 percentPoor communication skills30 percentDiscriminatory comments related torace, religion, gender, etc29 percentCareerBuilder Survey 2015

Question Do We Or Don’t We?

Question Google Our ClientsDo We OrDon’t We?‘Follow’ a Client’s Twitter FeedHave a Presence On FacebookAccept a Facebook Friend RequestBlogUtilize Online Dating Sites

Question Have You EverConsidered Looking AClient Up On A SocialNetworking Site?

ConsiderLooking Up A Client?Stop Right There!All clients have a right to theirprivacy, to their own lives, and tothe content of their socialnetworking sites.

ConsiderLooking Up A Client? One may argue that information posted on socialnetworking sites is public information and anyonehas a right to access what is posted. This assumption is correct, however, cliniciansmust consider the intention behind any searchfor information.

Biggest Ethical Concerns Boundaries Dual Relationships Conflicts Of Interest Confidentiality

Question How Could A CliniciansMembership On A SocialNetworking Site AffectPotential Or CurrentClients?

Example:Consider an anxious client who sees you as a reliable nurturer.Upon pursuing their favorite SNS, they search your name. Youposted pictures from your recent vacation and what the clientdiscovers is far different from the comforting support they seekweekly.

Explanation:“Clients prefer to think of their therapists as existing only in thetherapy space. Potential harm may occur, then, when the clientfeels impinged upon by finding a therapist’s information online.”Scarton, 2010

Conflict Of Interest:Clinicians should not engage in dual or multiple relationships withclients or former clients in which there is a risk of exploitation orpotential harm to the client.

Conflict Of Interest:A situation may be created when a clinician mustdecide whether or not to accept a “friend” request,potentially having to reject the client.

What if you decided to allow a current or formerclient into your social network? Clearly, this could be a case in which a dual relationship couldform. Clients who learn personal details about clinician’s lives mayexperience complex and counterproductive transference. Issues of privacy and confidentiality could also arise if you were toallow a client or former client into a social network that consistedof family and friends. You have your own privacy and boundary issues to consider.

Question Should You Accept AFriend Request FromA Current Or FormerClient?

What TheCodes Say ASWB-MRS4.05 Take reasonable steps to prevent client access to personalsocial networking sites; maintain separate personal andprofessional social media websites4.10 Refrain from accepting “friend” requestsACAH.6.a. use separate personal and professional web pages andprofiles for social media; clearly distinguish between the twokinds of media presence

Social MediaAdditional Digital Dilemmas

Additional Digital DilemmasWhat About Other Digital Technology? EmailTextVideo ConferencingOnline CounselingSmartphone Apps

Additional Digital Dilemmas Addiction Professionals who choose to engage in the use oftechnology for e-therapy, distance counseling, and esupervision shall pursue specialized knowledge andcompetency regarding the technical, ethical, and legalconsiderations specific to technology, social media, anddistance counseling. Competency shall be demonstratedthrough means such as specialized certifications andadditional course work and/or trainings.NAADAC Code of Ethics 2016

Delivering ServicesIn The Face Of New Challenges Must be sure to use sophisticated encryptiontechnology to preventing confidentiality breaches(hacking) by unauthorized parties and to comply withstrict HIPAA guidelines. The ethical burden falls on the clinician to ensuretrustworthy encryption by software vendors.

Delivering ServicesIn The Face Of New Challenges Other Considerations: Do you clearly explain, in writing, your guidelines forinteracting with clients via other digital or electronicmeans at various times of day and night, weekends,and holidays? What protocols do you or your agency have in place toensure that clinically relevant email, text, socialnetworking, and telephone exchanges are documentedproperly in the case record?

Distance CounselingInformed Consent A thorough e-therapy informed consent shall be executed at the start of services. Atechnology-based informed consent discussion shall include:Distance counseling credentials, physical location of practice, and contactinformation;Risks and benefits of engaging in the use of distance counseling, technology, and/orsocial media;Possibility of technology failure and alternate methods of service delivery;Anticipated response time;Emergency procedures to follow;When the counselor is not available;Time zone differences;Cultural and/or language differences that may affect delivery of services; andPossible denial of insurance benefits; and social media policy.NAADAC Code of Ethics 2016

Distance CounselingVerification Addiction Professionals who engage in the use ofelectronic platforms for the delivery of services shalltake reasonable steps to verify the client’s/supervisee’sidentity prior to engaging in the e-therapy relationshipand throughout the therapeutic relationship.Verification can include, but is not limited to, pictureids, code words, numbers, graphics, or othernondescript identifiers.NAADAC Code of Ethics 2016

Distance CounselingAccessAddiction Professionals shall assess and documentthe client’s/supervisee’s ability to benefit from andengage in e-therapy services.NAADAC Code of Ethics 2016

Distance CounselingProviders shall consider: The client’s/supervisee’s cognitive capacity and maturityPast and current diagnosesCommunications skillsLevel of competence using technologyAccess to the necessary technologyGeographical distance to nearest emergency medical facilityEfficacy of client’s support systemCurrent medical and behavioral health statusCurrent or past difficulties with substance abuseHistory of violence or self-injurious behavior.NAADAC Code of Ethics 2016

Delivering ServicesIn The Face Of New Challenges Other Considerations: Giving at-risk clients your personal cell phone numberfor use in an emergency Engaging in clinically relevant email communicationswith a client who will be traveling abroad for anextended period of time

Did You Know Emails may be considered part of theclients’ record, so clinicians should beaware that electronic communicationscan be subpoenaed, accessed byauditors, requested by the client, orotherwise disclosed or used in a varietyof legal or administrative proceedings.

Recommendations Obtain Appropriate Supervision Review Relevant Ethical Standards Consult With Colleagues Who Have Specialized Knowledge or Expertise Review Relevant Literature Review Relevant Regulations, Laws, and Policies Develop a Social Media Policy For Clients and Employees Obtain Legal Consultation When Necessary Document Decision Making StepsReamer 2015


Social Media PolicyWhy Do We Need One?The substance abuse professionalscode of ethics states:“The addiction professional will informthe client of his/her confidentiality rightsin writing as part of informing the clientof areas likely to affect the client’sconfidentiality.”

Social Media PolicyWhat Should Be Included? “Friending”FollowingBusiness Review SitesInteractingUse of Search EnginesLocation Based ServicesEmailContact information for licensing board

Sample PolicyHTTP://

Question Wouldn’t It Just BeEasier To Avoid SocialMedia All Together?

Wouldn’t It Be Easier To Avoid Social Media AllTogether? As internet-age clinicians we are obligatedto understand social media. To be culturally competent, we mustunderstand that the most commonlyencountered “foreign” culture is the digitaluniverse.

Our Responsibilities Familiarize ourselves with new technologies What they areHow they are usedHow they are misusedThe upside and the downside

Practice TipsSet Healthy Boundaries From The OutsetHave a Written Social Media PolicySecure Informed ConsentReview Code Of Ethics And Practice Standards FrequentlyWhen Using Social Media Have Professional And Personal ProfilesConsider A PseudonymInform Clients How Records Are Maintained And SecuredGoogle Yourself Regularly And Correct InaccuraciesConsider Cyber Liability ProtectionStay Current On New Technology

As professionals, we are told to practice within areas ofcompetence. We need to be competent in the areas we practice,and that extends to our use of technology. We need to remain alertto the ways in which our online presence compliments or conflictswith our professional self.Kathryn ChernackNY-NASW Chapter Ethics Committee


REFERENCES: American Association for Marriage and Family Therapy.(2001). AAMFT code of ethics. Retrieved from plan/ethicscode2001.asp American Counseling Association. (2014). ACA code of ethics. Retrieved from thics.pdf American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Retrieved from Kays, L. (2013) Must I Un-Friend Facebook? Exploring the Ethics of Social Media. The New Social Worker, 13-15. Kolmes, K.(2014). Private practice social media policy. Retrieved from NAADAC, the Association for Addiction Professionals (2016). NAADAC/NCC AP Code of Ethics. Alexandria, VA: NAADAC. National Association of Social Workers (2008). Code of ethics of the National Association of Social Workers. Retrieved // Reamer, F.G. (2015) Clinical Social Work in a digital environment: Ethical and risk management challenges. Clinical Social Work Journal, 43, 120-132. Reamer, F.G. (2015) Ethical Challenges in the Technology Age. Social Work Today, 14-17. Reamer, F.G. (2001) The Challenge of Modern Technology. Social Work Today, 23-25. Social Media and Social Work: A Question of Ethics. Social Networking and Ethics. Stanford Encyclopedia of Ethics (Spring 2015 Edition), Edward N. Zalta al-networking/ Weiss, R. (2015) Is Your Therapy Practice Ready for the Digital Age? Counselor Magazine, Vol.16, 66-71. Young, T.B. (2014) Facebook and Clinical Considerations. The New Social Worker, 7-10.Permission is granted to copy (unmodified) all or part of this PowerPoint for educational, personal, noncommercial use off-line as long as the copyright message (Copyright 2015 by Kelly S. Scaggs) is maintained onthe title page. This material may not be sold, duplicated on other websites, incorporated in commercialdocuments or products, or used for promotional purposes.

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