What Is The Power of Social Media For Therapy?

Many of my colleagues in the psychotherapy profession get that social media is here to stay, and a force of nature in the lives of our patients.  Therapists have grown more accustomed to listening to recorded arguments on smartphones, getting introduced to patient’s Facebook pages, and watching patients thumbtype texts in sessions.  And whether we have accounts or not, most clinicians have at least heard of Twitter, Facebook, and other forms of social media.  But in terms of our own practices, what good can social media be to therapists?

At least when it comes to therapists, we aren’t so excited by bells, beeps and whistles.  We didn’t gravitate to a job that usually involves 2 people, 2 chairs (or a couch and a chair,) 4 walls and a door.  That therapy space was chosen by us and subsequently shapes us.  We choose it for many reasons: shyness, preference for intimate one-on-one relationships, privacy, and stripping down human relationships to their essentials so we can focus on them.  And we often become shaped into more private, more independent, less tolerant of distraction, and more habitual people as a result.  If any of you are like me you may have noticed that when you meet a friend for coffee you begin to get antsy 45-50 minutes into the chat.  I’ve hung out with therapist friends and we both wind down the conversation at the 50 minute mark without even thinking about it!

In short, we aren’t inclined to immediately warm to the social aspects of social media.  We’re less than dazzled by the wide and sweeping networks of connections we can make all over the world, and multiple instant messages from several different people pinging us every minute or so doesn’t thrill us.  In fact, we often make the judgment that we prefer narrow depth in our relating to wide “shallowness.”  And truth to tell we’re a bit snooty.  I’ve had colleagues criticize some of the sites and blog posts I have recommended to readers merely because they aren’t “vetted” by a group of our peers:  They would rather trust the judgment of 12 folks with degrees on a committee somewhere than someone with unknown credentials.  This isn’t wrong necessarily, but it is limiting.  And it slows down the flow of information.

A growing number of us are choosing to differ with, or at least diversify from, that prevailing sentiment.  We’ve realized that Twitter can be a powerful, economic, and rapid way of sharing new articles, recent studies, upcoming workshops, and sometimes even snippets of those workshops!  Links to speakers, presentations and findings are being tweeted more and more from therapists who are interested in research and dissemination of knowledge.

In addition, private practitioners are finding ways to leverage social media to market their practice, reach more people and grow both their sphere of influence and their business.  This is an exhilarating and accelerating time for our work in this regard!  Technology has enabled us to be more social in our business than ever before in history.

But none of this makes social media powerful in ways that therapists care about much of the time, and this weekend I was reminded of what the true power of social media has for us.

The power of social media for therapists and therapy is not that it is social by nature, but that it has the potential to be personal.

I had forgotten this, as I sometimes do, in my zeal and excitement with the technology and its reach and speed.  Those of you who have followed these posts or attended my workshops are no stranger to my enthusiasm for social media.  This past month I had used the social media of Twitter, Facebook, YouTube, blogging and Constant Contact to pull together a workshop on video games and psychotherapy.  I credit the power of social media in helping me market and get a great group for this workshop.  And then social media bit me in the behind.

I had sent out my latest newsletter and was starting to get responses from various articles.  Now most of these responses are usually positive, but in the mix this time was a very angry and negative one from a recent workshop attendee.  It was actually more than negative, it was what I would consider my first real attacking hate email.  Needless to say I was disturbed and unhappy to read it.  After reading it I sent out this Tweet:

@MikeLICSW :  Eek. Just got my first hate email from someone who had actually said she really enjoyed my workshop. Guess she changed her mind. #ouch

I put down my iPhone and got ready to do some other work, when seconds it pinged, TWICE:

@susangiurleo:  @MikeLICSW Hate mail means you’re doing something right…*high five* : )

and

@Leilanimitchel :  ‘interesting’ – wonder whats going on for her – might not be about you of course!!

Leave it to my colleagues to help me reframe and regain some perspective on the hate email.  But what was even more striking was the personal feeling of warmth I experienced to get two thoughtful and caring responses seconds after my post.

The Power of Social Media in Therapy is the Personal.

This truth is something I have known for several years.  We learned it at Sparta Networks a long time ago and in the same way.  Initially when we began our company we were in love with the technology of social media.  We loved coming up with new functionality and features!  We’d actually spend hours playing with different ones–one of my favorites was our birthday reminder feature, which we were using way before people began to track their friends birthdays via Facebook.  Our feature not only sent you a reminder, but put a little birthday candle next to your avatar.  Boy did we geek out about that stuff, and sometimes still do.

But that ultimately wasn’t what grew our company the most.  What ended up being the most important aspects of social networking solutions at Sparta were the personal elements.  One example was our long and ongoing conversations with each client who wanted personal customization (i.e., all of them 🙂 )  These people needed to engage in a personal conversation with us to feel understood uniquely about what their business was trying to achieve.  We ended up spending much more time on consulting and education around social media than if we’d just been cranking out one boxed software product.

And often we didn’t just develop the social media network for them, but engaged in creating the sense of community that makes social media work, brick by personal brick.  For example, if we were doing a social network to support the product testing of a certain big food manufacturer, we needed to participate regularly with other members of the social network.  At first again we thought the majority of this would be systems administration stuff in the form of bug reports or permissions.  Again we were wrong.  That was a part of it, but if we didn’t engage in a personal way with each member of the group and start off conversations or games the network wouldn’t take off.  A successful launch of a social media site requires both a certain social critical mass and a focussed personal engagement with each member by other members.  At least that has been our company’s experience, and continues to be part of our consultancy component at Sparta.

This is the part that therapists need to get, the part I have alluded to in previous posts about gamersThe power of social media in therapy is the personal. It is getting those caring Tweets from real people and real friends.  It is the use of social media like Facebook, Twitter, and blogs to reach out person to person to convey “Hey, I understand you.”  We all need to feel known deeply and meaningfully by others, one relationship at a time.  When therapists critique the technology as shallow and superficial, they are in some ways correct.  But they are usually looking at it from the outside in, rather than having the subjective experience of warmth and recognition by the Other that social media has the capacity to convey.

The truth is that social media technology is by nature social, but by potential personal.  The social nature of these technologies is much more easily understood from the “outside in” than the potential personal capacity of it.  For that you need to be within it.  Even listening to your patients speak about it won’t quite do it; because at best you have to make an effort to imagine yourself into their experience, and at worst you make the empathic failure of dismissing their real emotional experiences within the social media and virtual world.

So if you have been reluctant to engage in social media on a personal level, please give it a try.  I think you’ll discover and experience real feelings in real time if you do, and that is what I believe ultimately powers good therapy or good social media.  What do you think?

Comments

  1. Hi Mike
    I have recently been involved in similar debates/exchanges about the power of social media on my own blog. I am ambivalent. I agree with you that the connections made and ideas and feelings exchanged can be very personal, supportive and hugely stimulating – but look at a Wall of FB comments and you might just change your mind.
    As with anything, it is all about how you use the tool. And maybe if you are someone who prefers a room with two chairs and what feels like a deeper and more genuine exchange, then the application and even design of some of these tools can be just a little bit crude, limiting and disappointing.
    My thoughts at the moment,
    Karin

    • Mike Langlois, LICSW says:

      Hi Karin, welcome back! I think the disappointment comes when we over-idealize either the therapy relationship or social media or alternately underestimate either’s capacity to be experienced as crude limiting or disappointing. My main point was that the personal is the current of energy that can run through both mediums for good or ill.

  2. Jaclyn Eaton says:

    Mike, I agree with some of what you’re saying. I think therapy could benefit from using new tools especially in reaching out to people with their own limiting issues. I know in Alberta, a therapy by phone program has worked quite well, especially for people with social anxiety, and those in rural areas and low access to therapy.
    I also find what you said about how the traditional therapy has a preferential bias towards certain personality types. What an interesting point that clearly deserves more attention!
    However, I have a few problems with your points. I agree that online networking is helpful (of course, I’m on Linked In!) and that you CAN get social support from online relationships. However, I also have seen how it can be used as an escape by individuals especially those suffering from anxiety. As I’m sure you know, a key to treating any anxiety disorder is to reduce escapism and the avoidance response which will help them to desensitize to what causes anxiety. This is one example, but there are more ways in which the internet and our societies addiction to social media can actually contribute to isolation and mental illness. Furthermore there are HUGE privacy issues about promoting the use of internet tools. Because of the known susceptibility of the internet to employers looking for information about possible future employees, such a use of the internet could easily cause considerable harm in a patient’s life.

    So the question becomes, how can you use this resource in a way that is actually helping individuals and not hurting them. It is not ethical to subject individuals to potential harm or damaging consequences in their life who you are supposed to be engaging in a therapeutic relationship with.

    Anyways, like I said you bring up some great points, but there are a few things I would be concerned with, depending on how you pursue such use of online media.

    • Mike Langlois, LICSW says:

      Hi Jaclyn, thanks for the thoughtful response! I don’t think we disagree as much as you think, with the exception of society being addicted to social media.

      I think my main point was that social media, like electricity, is powerful in terms of its potential to be personal. It is not at all personal automatically, and often pseudo-personal. But as long as there are two human beings using it, it has the potential to be personal for good or for ill. Personal can also mean attacking or hateful as well as warm and reassuring.

      If you have a specific vignette about what you mean regarding a therapist subjecting individuals to potential harm or damaging consequences feel free to post again, I’m interested in hearing what you were thinking of.

  3. Bravo for a great posting and I completely agree how important it is that therapists understand the context of their clients lives by experiencing social media for themselves. I became sensitized to this several years ago when a client came in distraught about being bullied by “friends” on Facebook. At the time, I didn’t fully appreciate what it is like to have your virtual identity and public sense of self mistreated. I quickly immersed myself in social media and co-founded Psychology21C — a group examining the interface of social technologies and behavioral health. We all need to get into the conversation about how the social media and virtual world tools will shape us and how we can shape them. I for one am very excited about the potential for serious games and virtual worlds to provide behavioral and organizational health solutions. I look forward to your next postings…

    • Mike Langlois, LICSW says:

      Hi Suzanne, please send me the link to 21C, or post here! Thanks for the kind words about the blog, pass it on.

  4. Hi Mike,
    I really enjoyed this post and the subsequent conversation. A couple things though come to my mind. First, I was waiting for this post to get into some practical areas of how you use social media in therapy, and then also speaking to some the ethical issues inherent in doing so. But perhaps you have addressed that elsewhere on your blog?

    The other thing is that I completely agree with you about the personal nature of social media. I’m not sure if you are familiar with Stefana Broadbent’s research on how social media, text messaging, IM etc. are creating deep and personal relationships. Here is a link to her Ted talk she gave in 2009. http://www.youtube.com/watch?v=_Lk5nU8FrXo

    I have encountered many naysayers, if you will, when it comes to social media and social work. I think it stems from a feeling of taking the humanistic principles out of the profession, although that is not what is happening. At least not in my mind. I mean no disrespect, but I have found from others that it is much easier to critique something when you have never engaged in it. So I say cheers to you for bringing this up and also for your blog dedicated to using gaming in therapy. I think that the profession will soon see a shift to more acceptance of this type of practice in the future.

    • Mike Langlois, LICSW says:

      Hi Jimmy,

      Thanks for the TED link, I hope others check it out. I sure will. Your hope that I would get into practical areas of how I use social media in therapy is a good reminder to blog about this soon. Suffice to say the two reasons I don’t blog about that or ethics often is:

      1. I never blog about patients, and so giving examples is difficult. But perhaps I can start to think about general ones for a future post.
      2. I think a lot of blogs about ethics for therapists vis a vis social media is really another way of stirring up fear and shutting down therapist’s willingness to explore social media. As my friend and colleague Susan Giurleo frequently posts (I paraphrase) we’re all so preoccupied with getting sued we’re paralyzing ourselves.

  5. Mike,

    Thanks for furthering the discussion about the impact of social media and how it affects our thinking about therapy. I believe you are right in saying that social media is another outlet for people who are seeking a ways of meaningfully connecting in relationships.

    However, there seems to be another aspect of how social media affects our therapeutic relationships that you failed to mention. With so much personal information out on the web, clients can Google their therapists and find out personal details which then might impact the therapeutic relationship. This is an aspect of social media that therapists need to keep in mind as they share certain information, but it doesn’t have to scare therapists off from any social media connection either. How do you see the information people share on-line impact therapeutic relationships, if at all?

    • Mike Langlois, LICSW says:

      Hi Jaclyn, great ask. I think that anything you write on the web is fair game as a therapist. I’d encourage therapists never to write or do anything on the web that they would mind everyone in the world knowing about it. And the problem now is that even if you start today, everything you ever did on the internet is probably there somewhere. Being thoughtful is key.

      But frankly I am less concerned about our patients googling us and finding out things than I am about therapists googling their patients! Patients do not have the same ethical responsibilities in treatment that we do, and I encourage supervisees and consultees not to do it. There’s an excellent article about it here.

      • ButMadNNW says:

        I’d also point out that it’s good for users (whether therapists or not) to get to know the security/privacy features of a given service. Not everything HAS to be accessible by EVERYONE.

        Twitter: You can have a private Twitter account to gripe about things you wouldn’t want clients seeing, and there are a couple ways to handle that (and most good Twitter clients make it easy to post to more than one account, separately or simultaneously): 1) Set up a separate account that’s attached to a different email address and doesn’t list your real name (or at least not your full name). I already have a personal Twitter account with only my first name and will set up a “professional” account at some point. 2) Do this AND make your tweets private. Then you have to approve people before they can follow you and read your tweets; but it can also adversely affect other interactions.

        Facebook: I have issues with some of Facebook’s actions around the privacy of users’ information, but generally they have fantastic tools for maintaining your virtual “personal space”. If a person isn’t on my Friends list and searches for me, all they can see is my picture (which is currently GIR from Invader Zim, not me), my name, that I’m female, and my Facebook short URL. Once I accept a Friend Request (and I’m picky), 99% of my list can see everything, but I will selectively hide some posts from people with a different take on the topic (I get tired of “arguing” with hypnosis skeptics, for instance) or keep certain people from seeing my contact information. And, again, as I start setting up my professional life, I’ll set up a professional profile. Personally, I’d rather maintain two completely separate profiles where I can fully interact in different ways with different audiences rather than prevent part of my audience from interacting at all (pet peeve of mine based on some past experiences).

        To summarize this: It’s not so much that therapists (or anyone else who might want to maintain separate private/business personas) have to avoid social networking; we just have to familiarize ourselves enough with it to know how to use it to its full potential. It is possible to be engaged and still maintain privacy and boundaries.

        But then, I’ve always maintained a certain line between my working and personal lives. The email address on my résumé is completely different from my “normal” email address. And it’s the latter that I used to set up my personal Twitter/Facebook/whatever (partly to organize email, partly to keep employers from searching for me). I don’t tell coworkers my Twitter name. I don’t accept Friend Requests from work contacts (if they can even find me; my real name is common enough to make that difficult). I rarely tell coworkers about my blog.

      • ButMadNNW says:

        “dismissing their real emotional experiences within the social media and virtual world.”

        I am so very familiar with this; in the early days of my online life, no one believed me that I had real friends who didn’t live within driving distance.

        As I hinted in a comment on another blog post, I tend to have weird interests – by that, I mean I get fascinated by films/characters/subjects that no one in my “real world” understands. The Internet has saved my sanity so many times by giving me a community – people to talk to about The Shadow or V for Vendetta or [obsession du jour]. When you’re the only person you know who likes something, it can start to make you wonder if you’re nuts for being fascinated by a hero from (now) 80 years ago…finding that others share your interest helps normalize it and reassure you.

        And I’ve made genuine friends through these online communities. The three women I consider my best friends were all met online. One of them has been my housemate for the past 4 years, and I’ve met the other two in “real life” multiple times. They truly are three of the most important people I’ve ever been lucky enough to have in my life.

        This isn’t as odd as non-Internet-denizens seem to believe, either; especially those who believe that everyone on the ‘Net is lying about who they are. Research has shown that you can generally trust someone’s online personality (my own experiences have proven it), and we all know that truly liking/being attracted to someone depends on how you click with their personality and thinking (rather than physicality), so why is it so hard for some people to think that online friendships are genuine?

        • ButMadNNW says:

          I’m having trouble with your Comments form. Every time I hit submit, I get an error screen even though the comment has posted. And this comment (starting “I am so very familiar with this”) was supposed to be a stand-alone at the bottom, not a reply to another comment! Sorry about that.

  6. Hey Mike,

    I really enjoyed this piece. There are so many of us figuring this one out together, and apart from one another as well. Here’s a piece I did on online therapy a short time ago: http://www.zeitgeistnyc.com/2011/03/15/interviews-with-smart-people-paul-fugelsang-psychotherapist/

    All best –

  7. Great article. I am on the fence about using social media in practice. While it is a far reaching tool and social by nature, as you said, I also find that it can be quite…terse. The average response from friends or followers is often limited to one-liners or cliche phrases. While it might feel good to see that people out there are “rooting” for you, so to speak, it is often misleading. Patients with decent judgment will be able to see social support on Twitter, for example, as a positive thing. “There are people who understand me.” Patients with poor judgment may latch on to the responses they are already seeking, thus perpetuating bad decision making.

    If social media can be used to help patients find supportive outlets for their problems then it is definitely a positive. If they use it to discount their own therapy, believing that their friends or followers give “good advice” then they’re missing that mark. Therapy isn’t about advice, it’s about personal exploration. I don’t know about you, but I haven’t been able to figure out a way to do much exploring in 160 characters…or less.

    • Mike Langlois, LICSW says:

      Hi Greg, thanks for the thoughtful post. I’m not sure about how you practice therapy, but a lot of therapists I know, psychodynamic ones in particular, are terse when they talk in treatment anyway!

      I am not sure if you have had the experience of patients using social media to criticize their therapist or make decisions about their treatment, it seemed from your examples that you may, or were worried about that. I have never seen social media used that way, unless you count the therapist review sites.

  8. Hi Mike,

    I love this! I think that the key to the future of mental health is using technology. Just last week I wrappped up my first “trial text program” and loved it. Currently am doing a “Meditation Challenge” which is based primarily online with a text piece.

    In addition next week I will be doing a presentation at the ArMHCA spring conference on “Mobile Mental Health and Behavior Change”.

    I am so excited about following your blog…just found it!

    Thanks for what you do.
    Jamie

    • Mike Langlois, LICSW says:

      Hi Jamie, glad you came across this. Please explain or link to your trial text program or the Meditation Challenge, they both sound very interesting. If you are interested in mobile mental health and behavior change, have you checked out the Epic Win App for iPhone? Hope you’re recording the presentation!

      • I will check out the Epic Win App…thanks for the tip. Thanks for the interest in my programs too.

        The text program was a psychoeducational program focused on changing behaviors. The initial program was free and was open for willing participants with the understanding that it was a trial! Each day I would send a text to all participants with encouragement and ways to help them reach an identified goal. Some texts were generally motivational, quotes etc and some were more detailed approaches to making behavior changes.

        The Meditation Challenge started on April 1 and was open to any who wanted to participate. It includes a downloadable guided meditation, worksheets and practice sheets to keep up with their practice. The practice worksheets include “mindfulness mini’s” with ideas on how to introduce mindfulness into everyday life. I update my progress on my blog and encourage participants to share there or on Facebook. It also has a text message piece that involves daily (or almost daily) motivational texts.

        I’ve had so much fun doing both and I love, love, love being able to get info out to anyone who wants it. We can reach people where they are, from where we are! We need to take advantage of that.

        If anyone is interested my website is http://www.jamiestacks.com. It has more info on my practice and links to my blog, Facebook and Twitter accounts.

        Thanks for the interest and letting me share. I love talking about this. It is exciting stuff for sure.

  9. C.R. Macchi says:

    Mike, thank you for offering your thoughts about social media in therapy.

    I have begun noticing one aspect of the use of FB in therapy – focusing on boundaries. A discussion about the critieria used for making decisions to friend or defriend as well as the establishment of appropriate privacy settings can be convenient ways to discuss boundaries with a social media-savvy client.

  10. Lynn Kerner says:

    My home-based program for elders is considering ways of getting into social media for the explicit purpose of connecting isolated elders to each other, to family members and to our team. We have noticed that when older adults are isolated due to physical limitations they may also often cancel appointments due to not feeling well or for doctor’s appointments. The same factors also sometimes mean that working in shorter “sessions” is the best option. Our program is short-term by design (10 sessions) and includes a lot of clinical case management. Our biggest challenge is that the population we serve doesn’t typically use computers to begin with, never mind social media. But there is a company on the west coast that uses a touch screen to connect an elder with his/her network and uses easy avatars for each person in that network. We are eager to try that technique to include the social worker (we say social worker instead of therapist b/c of the stigma attached to therapy for our group and also because we do ‘old-fashioned’ social casework) in that network. We also are interested in connecting people to each other in a group format via technology, such as a caregivers support group. Funding for these is a barrier but we are working on it and see a lot of potential for isolated folks of all ages.
    Lynn

  11. Very useful POV. Thanks, Michael.

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