This past week social work colleagues Ericka Kimball and JaeRan Kim had an article published in Social Work entitled: “Virtual Boundaries: Ethical Considerations for Use of Social Media in Social Work.” It’s a good article, and more importantly it’s a nice start. The article discusses if, when and how to use social media ethically. The authors don’t purport to have a solution to every potential problem that social media poses clinicians, but they have some good suggestions.
I have mixed feelings about the constant yoking of “technology” to “ethics” in our profession. (In general, not specifically the article above.) It always seems to imply that social media and ethical problems go hand-in-hand. No other ethics issue, even patient abuse by psychotherapists, gets as much play in our current professional development course offerings, and the irony is that there is evidence to support the much higher prevalence of the latter than the former. It seems the only way the majority of psychotherapists can get curious about social media is if somebody scares them with the idea of ethical or legal violations.
Is there an ethical dimension to integrating technology into psychotherapy? Absolutely. It’s just not the only dimension. And the problem with always focusing on ethics is it often encourages fear-mongering and contempt prior to investigation. Part of the problem is that most of the people talking about ethics and technology in clinical practice have little to no experience with the technology side of things. And as a result, they can’t engage us with ideas and brainstorming, but instead often adopt the fall-back of “you need to be careful.”
The result is that many clinicians get understandably scared: You told me something is dangerous, and that the only solution is to be careful. So seasoned clinicians often adopt what I call the “just say no” attitude. Firewalls go up. Patients can’t be emailed. Agencies adopt no-Facebook policies, and in general evoke an air of monasticism. I have even heard cases where clinicians are told they need to renounce having personal social media. Though Shalt Not Tweet.
Into this “just say no” milieu come our trainees. Many of them are digital natives, and have been wired for technology in a way we digital immigrants may never be. In many cases they are more digitally literate than we are. They come into their supervision sessions with questions about cell phones in the office, suicide posts on Facebook, and being followed by patients on Twitter.
And they get “just say no.”
So let’s get real a sec here.
The Pew Internet Research Group states that roughly two-thirds of North Americans are on Facebook. It, along with other social media, has become a primary source of communication and shaper of culture for our society. This means that a majority of our trainees and their patients are probably using it. We can’t just say no. We can’t just say, “be careful out there.” Our trainees look to us for supervision, and understanding social media and technology is part of 21st century clinical work.
I can’t tell you how many times I have heard horror stories in my classes about how supervisors fail their students this way. And I get emails detailing, for example, how a young clinician tried to bring up the positive impact of social media to a supervisor: “I thought her head was going to implode.”
Psychotherapy has a past history of using innovations in technologies to enhance our work, and our theoretical models. Freud used the newer technologies of hydraulics to explain drive theory. Similarly, advances in thermodynamic technology helped pave the way for family systems theory. By now, many of the principles and parallels of those technologies have become so commonplace in our lives and understanding that we don’t even connect them with being familiar with technology.
Historically technology creates a period of suspicion and confusion before integration into culture. A favorite example of mine is this:
Prior to the Gutenberg printing press, books were a much rarer technology. In the 8th Century, approximately 12,000 books were published in all of Western Europe; by the 18th century that number had risen to 1 billion. As this technology became cheaper and more easily accessible, literacy rose. But this was also a time when things got overwhelming. When you had a handful of books read by a handful of people, the knowledge in them was much easier to locate. But when the number of books and readers increased, there was an overwhelming amount of information to remember and locate. The book index was the technology we came up with to solve that problem, but we needed to experience the technology as problematic before a solution was necessary.
Today we take indices, books and literacy largely for granted. We know how they work, we aren’t afraid of them. If anyone wanted to hold a workshop on the “Ethical Considerations of Printing” they’d be hard-pressed (heh) to get anyone to attend.
So now we find ourselves faced with a new technology, one as revolutionary in many ways as the printing press. Only this time we are the generations that need to get used to it and confused by it. And it’s risky and scary, because we don’t fully understand its implications yet. But just as we wouldn’t have wanted our ancestors to forbid us to read and write, we need to let our trainees learn how to use the newer technology of social media in our lives and work. And to do that, we need to learn it too.
This takes time, and it takes someone with expertise to teach you. So before you hire a consultant, keynote speaker, or workshop presenter to talk about social media or technology in general, ask yourself, and them, these questions:
1. What do you plan to teach me beyond ethics about technology?
2.What strategies can you help me and my agency deploy besides be careful or “Just say no.”
3.What if any experience do you have with technology? Do you use social media? Professionally? Personally?
Just asking potential consultants those 3 questions could save you or your professional organization a lot of money down the line, as well as make the difference between helping you embrace innovation or stagnation.