Let’s talk about the ethics of your therapist following you on social media

Written by Jamie Klingler

Writer, activist and Reclaim These Streets co-founder Jamie Klingler shares her experience of searching for a therapist and encountering the strange dynamic of already being followed by some on social media.

Last month when I was searching for a new therapist to work with long term, I sought out some advice as I really didn’t know where to begin.

A very trusted friend (and my barrister), Pippa Woodrow, told me to make sure to find a therapist that is smarter than me. Another friend, who has qualified to be a therapist, pointed me to the ’find a therapist’ function on the British Association for Counselling and Psychotherapy (BACP) website. Given my public-facing work campaigning for women’s safety and discussing male violence against women, I wanted to work with a therapist that understood the speciality around vicarious trauma.But in doing so, three of the therapists I contacted were aware of my work in the sector and already followed me on Twitter.It made sense but it totally freaked me out; they would already have an opinion of me before we’d even meet for a formal session.

It really made me think about how I present on Twitter, how I present in person and how I would present to a therapist.I am inherently a people pleaser and often have to stop the urge to try and paint myself in a good light in therapy sessions.As my best friend has told me before, though, you can’t win therapy.

I had an enlightening conversation with one of the women I contacted. Incidentally, she was going on sabbatical so wouldn’t have been able to work with me, but I was curious about the ethical issues around already being professionally known to therapists who I may want to work with in a personal capacity, and I wanted to know her suggested course of action.She said that she would have insisted that we both block each other if we were going to work together as seeing tweets in either direction would cross ethical client boundaries.

I appreciated her honesty. It made me think about how differently I would tweet knowing that my therapist would see it. You don’t want your therapist to be out to dinner with her husband and worrying that you are ranting about a boyfriend (or in my case, police brutality) online, and for that then to influence the trajectory of your next scheduled session.

The relationship with your therapist is sacred, and any therapist worth their salt will lay out those boundaries at the very beginning of the relationship.They will share nothing that comes to light in your work together externally unless they worry that you are in danger of hurting yourself or someone else.Even then, the steps they will take to involve other medical professionals or the police will still be in consultation with you.The trust is sacrosanct. They are your partner to help you heal past traumas and find a version of yourself better equipped to navigate the world as a stronger person. At no point should you ever feel like you are just the next chapter in their book or their next viral video.

Last month, I read an article in the New Statesman about TikTok not being the appropriate platform to receive mental health advice; I also read a recent study from Hall & Partners that found TikTok was increasingly becoming the top place to seek medical advice in place of going to the doctor, with over 25% of millennials turning to the site to discuss, highlight and cope with chronic conditions. I’ve watched my fair share of mental health videos on the platform and believe that TikTok is casting a wider net than other services can and reducing the outdated stigma and shame that was long associated with needing counselling in the UK. The stiff upper lip need not apply here.  

That said, I liken using TikTok to self-help books: the available advice should be sense checked and you should always review the source of information, but investing time and energy into your mental health is ultimately a good thing. And not everyone has access to or funds for one-on-one counselling. In fact, it currently takes over three months for mental health treatment on the NHS to be available in most cases, and even then the availability of services is limited, except in the most severe circumstances. 

There have been some shocking headlines recently about the ethics of therapists sharing your deepest darkest secrets for their own content online, and I don’t believe any respectable therapist would do that. There are strict professional guidelines on what can and can’t unwillingly be shared beyond the walls of your counselling sessions. It is a major aberration. Though the platforms that we have at our disposal have evolved, the crucial basis of a therapist-patient relationship will always be trust. Social media promotion certainly exacerbates the immediate opportunities for things like this to happen but, essentially, if someone isn’t ethical, they’ll be able to break your trust on any platform – TikTok, self-help book or otherwise.

Publicly sharing your own experience and processes as a patient is a different matter, and fair game if you ask me. I don’t recommend self-diagnosing or basing your whole life plan on advice from therapists on TikTok, self-help books or anywhere else, though. A good therapist is your partner in working to build, adjust and commit to the change and progress that you are seeking.It isn’t an instructional relationship where they tell you what to do, you follow suit and suddenly get better.

I’ve heard that some coaches, especially accountability coaches, may charge you to monitor your social media. But again, I don’t think that this can translate to true accountability between therapist and client. And it is not necessarily conducive to building self-efficacy or boundaries. Therapy is ongoing, intentional work that can’t quite be achieved through monitoring the incidental nature of one’s social media posts. Especially when you consider, like I have had to, the versions of yourself you share professionally or socially as a separate entity from how you would like to be addressed and respected in a therapy session.

Images: Getty

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