Ethics

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Social media and distance counseling methods offer unique opportunities for service providers to stay connected with consumers. However, the evolving nature of social media sites and distance counseling methods present some unique ethical concerns.

 

Ethics of Social Media Use

Social media, in contrast to static websites, creates an opportunity for consumers and providers to interact online (Zur, 2015), which can create confidentiality concerns. Additionally, the breadth of strategies for using social media within the job search makes it hard to outline concrete rules regarding use. For example, social media can be used to improve communication with consumers, to help find and maintain employment, or to develop an agency social media presence for sharing updates and upcoming events with consumers.

The diversity of uses, the ever-evolving nature of social media platforms, and the lack of ethical guidelines keeping pace with these changes, can leave providers intimidated or unsure about using social media in practice. Adding to this confusion is limited guidance for social media use by professional organizations.

The Commission on Rehabilitation Counselor Certification (CRCC) Code of professional ethics (2017) includes guidelines for social media use. These guidelines include:

  1. A distinct separation of professional and personal pages and profiles
  2. Acknowledging that information posted on social media sites can be easily shared and become permanent part of the  public domain
  3. Informing consumers about the benefits, limitations, and boundaries of social media use within VR practice
  4. Limiting counselor Internet searches (including google searches) on consumers unless it is relevant to the employment goals and the consumer has been informed
  5. Writing social media posts that do not include any personally identifiable information, without written consent from the consumer

Dr. David Kaplan, Chief Professional Officer for the American Counseling Association, offered the following quote to help guide social media use among counselors:

The question counselors should be asking themselves is not ‘is it OK for me to use social media? The question should be ‘is this particular tool the best way to help this specific client with this specific need?Counselor-Liscense.com, n.d.)

Below we present the four points that directly address social media use in the ACA Code of Ethics and discuss how they may be applied within an employment counselor’s practice.

  1. Virtual Professional Presence: In cases where counselor’s wish to maintain a professional and personal presence for social media use, separate professional and personal web page and profiles are created to clearly distinguish between the two kinds of virtual presence.

Trying to keep your professional and personal social media accounts separate is a great idea in theory, but can be difficult in practice. For instance, some social media sites (i.e. Facebook) stipulate only one account per user in their “terms of use” agreement. Before you create more than one account on the same social media platform, make sure you are compliant with the terms of use policy.

It is a good idea to have a plan in place for how you respond to a “friend” request on your personal account from a consumer, co-worker, or boss. Below we list a few things to think about when considering your response.

  • You may respond differently depending on the nature of the request. For millennials, connecting with acquaintances on social media is second nature. However, if the request comes from someone who has issues with boundaries, you may consider declining the request (Zur, 2015).
  • Think about how connecting with consumers or coworkers will affect your relationship with that person and how you use that platform. For example, consider what would happen if you log onto your Facebook page before bed and see a post from someone threatening to hurt themselves or someone else. You are now likely obligated to take action. On the flip side, you may not want a consumer or coworker viewing pictures of you on vacation.

There may be ways to address some of the concerns by using different privacy settings. For example, Facebook allows users to organize their “friends” into lists which have different viewing privileges. Similarly, you can block certain individuals from viewing certain posts or pictures. Connecting with someone on social media does not have to mean allowing them unfettered access to your social media profiles.

You may also decide to use some social media sites in a professional context and others sites for personal use. For example, LinkedIn might be designated as the professional account you use to connect with consumers.

Another strategy for keeping personal and professional accounts separate is to use different email addresses for different accounts For instance, use a Gmail accounts for your personal social media pages and a work email for your professional accounts. This will keep social media sites from suggesting you as a connection to consumers or coworkers when it combs through their address book for suggestions of people they should connect with.

  1. Social Media as Part of Informed Consent: Counselors clearly explain to their clients as part of the informed consent procedure the benefits, limitation and boundaries of the use of social media.

Many problems that may arise from using social media during the counseling process can be avoided with a well thought out and thorough informed consent form. See the informed consent section below for more ideas about writing a comprehensive informed consent document.

  1. Client Virtual Presence: Counselors respect the privacy of their clients’ presence on social media unless given consent to view such information.

Many people do not effectively utilize privacy settings on social media sites, and most default settings are public. This means that a Google search may pull up a consumer’s complete social media profile and activities. Googling a consumer’s name can be helpful for learning more about a consumer and/or working with the consumer to clean up a consumer’s online reputation before diving into a job search. However, avoid engaging in these activities without a consumer’s knowledge and consent.

Expect that people will Google your name to learn more about you. If you are active on Twitter or write a blog, think about how your posts might influence relationships with consumers or coworkers. Keep in mind that you may not be aware that consumers or coworkers are following you since the face behind a Twitter handle or user name is not always immediately apparent (Kolmes, 2016).

  1. Use of Public Social Media: Counselors take precautions to avoid disclosing confidential information through public social media.

One thing that social media introduces is an increased possibility of unintentional, rather than malicious, disclosure of confidential information. It is best to keep conversations about sensitive topics face-to-face. If that is not possible, use an encrypted email or direct messaging service.

There are many ways to accidentally disclose confidential information. Below we discuss ways a service provider might accidentally disclose information and how to reduce that risk.

  • It can be tempting to come home and share the details of a unique case on a social media account. However, even without names, information may be identifiable which may be a direct violation of the Health Insurance Portability and Accountability Act (HIPPA).
  • Do not post pictures of consumers without their knowledge and written consent.
  • Talk with consumers about how membership in certain groups might disclose health or disability status. For example, following the Multiple Sclerosis Society may disclose disability status or participating in a cancer walk in memory of a family member might disclose family health history. There may be occasions when it is appropriate to disclose information to potential employers, but have conversations with consumers upfront about how this could affect the job search.
  • If service agencies have an office page, make the page public so that users don’t have to disclose association with a disability organization by liking a page to view updates.

The Ethics of using Distance Communication Methods:

The Commission on Rehabilitation Counselor Certification (CRCC) also outlines best practices for distance counseling and technology use. Review the CRCC Code of Ethics and consider obtaining additional training if you are interested in using distance counseling with consumers.

According to the Center for Credentialing and Education distance counseling can be defined as,

“a counseling approach that takes the best practices of traditional counseling as well as some of its own unique advantages and adapts them for delivery to clients via electronic means in order to maximize the use of technology-assistance counseling techniques. The technology-assisted methods may include tele-counseling, secure email communication, chat, videoconferencing or stand-alone software programs (Center for credentialing and education, n.d).

Below, we highlight some key ethical considerations touched on in the CRCC code of ethics.

  • Don’t practice outside your competencies – Distance technologies can be a great tool for connecting with consumers. However, if you don’t know how to use them effectively they can be frustrating and compromise the counseling relationship. In addition, people sometimes say or do things online that they would never say or do face-to-face, which can change the counseling dynamic (Suler, 2004). Learn about how behaviors might change online and how to use these changes to your advantage rather than disadvantage.
  • Consider the consumer’s skills— Not everyone will benefit from distance counseling. Think about a consumer’s abilities and access to technology before engaging in distance counseling. Don’t be afraid to discontinue its use if distance counseling isn’t working.
  • Record keeping – Emails, transcripts, recordings and instant messages become part of the counseling record.
  • Confidentiality – Distance counseling introduces a number of confidentiality concerns. Be sure to clearly communicate these risks to the consumer before using distance counseling. See email confidentiality for more information about mitigating security risks through encryption and other best practices for email confidentiality.
  • Technology failure and crises – Create a backup communication plan in the event that preferred technology fails or in case of a crises that requires immediate action.
  • Outline boundaries – Clearly communicate with consumers when you will be available and how quickly they can expect a response to an email, text message or phone call.
  • Informed Consent – Clearly address all of the points highlighted above as well as any other points relevant to your practice in your informed consent document. See the “creating an informed consent form” section below for more information.

Responding to negative review:   

The internet is an interactive environment where any user with Google or Yelp account can leave a positive or negative online review. While positive comments are generally welcome, negative comments can be difficult to address. In general, avoid deleting negative comments unless they directly violate your agency’s terms of service. The best course of action with a negative comment may be to ignore it and hope that over time positive reviews outshine negative reviews. However, if you feel a response is warranted, keep it brief and invite the reviewer to contact you privately. If you find that your agency has a negative online presence, you can apply the strategies for cleaning up a consumer’s online reputation to the agency.

Informed Consent:

An important first step when using (or not using) social media and/or distance counseling methods is to clearly define expectations in an informed consent document. During the first in-person meeting with a new consumer, discuss how you will use technology in the counseling relationship. How you decide to use social media/distance counseling is largely a personal choice dictated by the needs of the consumer, state law, and agency policy. Even if you decide not to use online communication methods, clearly state this in the informed consent form and define how you will respond to friend requests, emails or other attempts to communicate through distance technologies.

Guidelines for Creating and Informed Consent Form

There are benefits and drawbacks to using social media and distance counseling. More frequent contacts in between face-to-face meetings has been associated with improved employment outcomes (Ipsen & Goe, 2016). In addition, viewing social media posts may give the counselor valuable insight into the consumer’s situation that may enhance the counseling relationship (Daniel–Burke, 2015).

Drawbacks to social media and other distance counseling methods include risks to confidentiality and security. They can also blur the boundaries of professional relationships and create the expectation that counselors are available 24/7. Completely abstaining from using technology, however, does not avoid the problem since many confidentiality breaches are unintentional. Having a solid informed consent document can help alleviate many ethical concerns and educate the consumer about risks.

Keely Kolmes, a psychologist based in California, shared her social media informed consent document online. It is a great resource for writing an informed consent document specific to social media.

How are you going to use social media and/or distance counseling methods?

Begin the informed consent form by clearly outlining how you are going to use technology. Will you only use it to communicate in between face-to-face meetings? Or, will distance counseling methods take the place of face-to-face meetings? If yes, what platform will you use? Will you connect with consumers on social media sites?

You may decide to not use social media at all. However, you may want or need to work cooperatively with consumers to evaluate their online identity. Discuss what this will look like and consider under what circumstances you will Google their name. You may Google their name to learn about their online identity, But, there could also be situations when you Google their name because you are worried about their safety or whereabouts.

How does your agency use technology with consumers?

If your agency has any social media presence, discuss the intended purpose and how consumers can interact with that page. In addition, be sure to address your agencies policy on distance counseling (if there is one)!

Boundaries

Clearly state your expectations for interaction on social media sites and other distance counseling methods. Is it okay for consumers to directly message you on social media sites? Will you respond to email messages at 11:00 at night? If not, what is the preferred method of communication in between face-to-face meetings? Also outline when you will respond to messages so you don’t end up feeling like you are on call 24/7. If you do accept requests for connections on social media sites, will you continue with that connection once the relationship has ended?

Risks

There are risks to using social media and other technologies during a job search, particularly risks to confidentiality. Discuss how you will work to mitigate risks to confidentiality by using appropriate security settings and not making comments about consumers on your personal social media sites. Also discuss the consumer’s responsibility for maintaining their confidentiality by highlighting how their public posts, group memberships, and unencrypted email messages may disclose disability or health status.

Signature Lines

Conclude your consent document with a space for signatures for both the VR professional and the consumer.

 

Although using distance counseling methods and social media sites can be intimidating it is possible with some education and training. Check out the websites below if you are interested in learning more:

http://kristenjacoway.com/

http://www.zurinstitute.com/digitalethicscourse.html

http://drkkolmes.com/clinician-articles/#facebook

References:

Counselor-Licnese.com. (n.d.).Social media creates new opportunities for VR professionals. Retrieved from: http://www.counselor-license.com/articles/social-media-counseling.html

Center for Credentialing and Education. (n.d.) DCC Distance Credentialed Counselor. Retrieved from: http://www.cce-global.org/dcc

Daniel-Burke,R. (host). (March, 2015). Ethics and social media. Retrieved from:  https://www.counseling.org/knowledge-center/podcasts

Kolmes, K. (June 30,2012). A yelp review is no an authorization to release client information: Online reviews and confidentiality. Retrieved from: http://drkkolmes.com/2012/06/30/yelproi/

Ipsen, C. & Goe, R. (2016). Factors associated with consumer engagement and satisfaction with the Vocational Rehabilitation system. Journal of Vocational Rehabilitation, 44 (1), 85-96. Doi: 10.323/JVR-150782Zur, O. (2015).

Suller, J. (2004). The online disinhibition effect. CyberPsychology & Behavior, 7 (3), 321-326.

Zur, O. (2015) To Accept or Not to Accept? How to respond when clients send “Friend Request” to their psychotherapists or counselors on social networking sites. Retrieved from: http://www.zurinstitute.com/socialnetworking.html

 

 

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