This document outlines OUR office policies related to use of Social Media. Please read it to understand how our therapists conduct themselves on the Internet as mental health professionals and how you can expect us to respond to various interactions that may occur between us on the Internet.
If you have any questions about anything within this document, we encourage you to bring them up when you meet with your therapist. As new technology develops and the Internet changes, there may be times when the policy needs updating. If we do so, you will be notified in writing of any policy changes and make sure that you have a copy of the updated policy.
Friending/Following/Adding as a Contact:
We maintain an online presence on several social media sites. We use our full names in most cases or the username TransformedTherapy on most of these sites so that it is clear it is one of our therapists representing the business or themselves as individuals. We do not want you to see a pseudonym and think you are following someone else only to find out later that it is one of our therapists. We don’t accept friend or contact requests either from current or former clients on any social networking site. We believe adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship and make it feel like a friendship, or a type of patronage. If you have questions about this, please bring them up when we meet and we can talk more about it.
In some rare circumstances, We have had people in our wider circles who previously followed us on social media ask to come in for psychotherapy. If we agree that meeting together does not constitute a problematic conflict of interest, We will suggest that we unfollow one another on social media (or we will at the very least unfollow you during treatment) to avoid some of the problems outlined above. We will do this to preserve the integrity of our working relationship.
We will not ever knowingly follow you on social media, although it’s possible that if you use a pseudonym, we may accidentally follow you. If this happens, you are welcome to let us know when we meet. Our reasons for not following current or former clients on social media are described above.
In addition, viewing your online activities without your explicit consent and without a specific clinical purpose could have potential negative effects on your treatment. We might learn things about you that you have chosen not to discuss in therapy. It is your right to choose what to share in our work. But if we see these things outside of our sessions, then we will have to figure out how to tell you we have become aware of these things. If there are things from your online life that you do want to share with us, we encourage you to bring them into our sessions where we can view and explore them together, during the therapy hour. The best way to do this is to print things out and bring them to your session or show them to me on your devices. Please don’t forward me emails or screenshots that involve other people as anything you send me does become part of your legal record.
Interacting:
Please do not use SMS (mobile phone text messaging) or messaging on Social Networking sites such as Twitter, Facebook, Slack, Instagram, or LinkedIn to contact your therapist. These sites are not secure and we may not read these messages in a timely fashion. Do not use Wall postings, @replies, or other means of engaging with your therapist in public online if we have an already established client/therapist relationship. Engaging with your therapist this way could compromise your confidentiality. It may also create the possibility that these exchanges become a part of your legal medical record and will need to be documented and archived in your chart.
If you need to contact me between sessions, the best way to do so is by utilizing the patient portal, by phone, or email at info@transformedtherapy.org. We prefer that we only use email for administrative issues such as changing appointment times. See the email section below for more information regarding email interactions.
We also have a blog in which moderated comments are allowed. Please don’t comment on the blog as it creates another public forum in which we may be interacting. We would much prefer that if you read something on our blog and you have a reaction to it, that we talk about it together rather than having a public exchange in the comments section.
Use of Search Engines:
It is NOT a regular part of our practice to search for clients on social media or using search engines. Extremely rare exceptions may be made during times of crisis. If we have a reason to suspect that you are in danger and you have not been in touch with us via our usual means (coming to appointments, phone, or email) there might be instances in which using a search engine to check on your recent status updates becomes necessary as part of ensuring your welfare. These are unusual situations and if we ever resort to such means, we will document it in your chart and discuss it with you when we next meet.
Again, the reason we don’t do this is because we see it as a potential breach of your privacy and the trust between us. We believe that viewing your online activities and postings can alter impressions of you and change the relationship we are mutually developing in our meetings, as described in the section on Friending/Following. It can also create confusion in regard to whether we are looking at your online activity as part of your treatment (for assessment or diagnostic purposes) or to satisfy personal curiosity.
If you do have online activity that you want your therapist to know about, please talk them about it during a session.
Discovering/Viewing Our Online Activity:
We publish a blog on our website and we sometimes post stories to Medium and other platforms. We also have a Twitter account, a LinkedIn account, a Facebook account, and an Instagram account. We have no expectation that clients will want to follow our writings or social media postings. However, if you use an easily recognizable name online and we happen to notice that you’ve followed us, we may briefly discuss it and its potential impact on our working relationship.
You may also run across our information in other settings. You may see online ads that we post, you may discover that we have friends or contacts in common on social media. You may see us quoted or published in the media or see our published writings or research. You may discover our podcasts or videos. Or you may find that we have online reviews of our psychotherapy practice.
Whether you find this information accidentally or intentionally, what is most important to us is that you feel safe and comfortable bringing it up if it has an impact on you and your feelings about our work together. We want to make it clear that it is very normal for people to be curious about their psychotherapist and some people feel shame or embarrassment about bringing these things up. But we hope to create a relationship in which you are warmly welcomed to bring up anything you learn about your therapist outside of our sessions that has an effect on your comfort in working together.
Writings About Psychotherapy:
We occasionally publish stories and academic writing that references our clinical work. When we do so, we use composite cases. We won’t be writing about your therapy. However, if the issues we are writing about seem like they may hit “close to home” for any of the people in our practice, we are only writing on issues that may be linked to general topics and common themes brought up by a broad scope of clients over many years of therapy sessions and nothing specific to your counseling sessions.
Business Review Sites:
You may find our counseling practice on sites such as Yelp, Healthgrades, Yahoo Local, Google, or other places which list businesses. Some of these sites include forums in which users rate their providers and add reviews. Many of these sites comb search engines for business listings and automatically add listings regardless of whether the business has added itself to the site. If you should find our listing on any of these sites, please know that the listing is not a request for a testimonial, rating, or endorsement from you as a client.
The American Psychological Association’s Ethics Code states under Principle 5.05 that it is unethical for psychologists to solicit testimonials: “Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.”
According to the American Counseling Association’s code of ethics section C.3. “Advertising and Soliciting Clients” C.3.a. and C.3.b. states, “Accurate Advertising When advertising or otherwise representing their services to the public, counselors identify their credentials in an accurate manner that is not false, misleading, deceptive, or fraudulent. C.3.b. Testimonials Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue infuence. Counselors discuss with clients the implications of and obtain permission for the use of any testimonial.”
Of course, you have a right to express yourself on any site you wish. But due to confidentiality, we cannot respond to any review on any of these sites whether it is positive or negative. We urge you to consider your own privacy if you choose to write a review on such a site. You should also be aware that if you are using these sites to communicate indirectly with us about your feelings about our work, there is a good possibility that we may never see it.
In our work, we hope that you will bring your feelings and reactions to our work directly into the therapy process. This can be an important part of therapy, even if you decide we are not a good fit. None of this is meant to keep you from sharing that you are in therapy with one of our therapists wherever and with whomever you like. Confidentiality means that we cannot tell people that you are our client and our Ethics Code prohibits us from requesting testimonials. But you are more than welcome to tell anyone you wish that we are your therapist or how you feel about the treatment provided to you, in any forum of your choosing.
If you do choose to write something on a business review site, keep in mind that you may be sharing personally revealing information in a public forum. Please consider creating a pseudonym that is not linked to your regular email address or friend networks for your own privacy and protection.
If you feel we have done something harmful or unethical and you do not feel comfortable discussing it with your therapist, you can always contact the Texas State Board of Examiners of Professional Counselors, which oversees licensing, and they will review the services we have provided. Note that if they open an investigation into our actions, and you have given your name, they may request your records to pursue the investigation. For complete instructions on how to file a complaint please visit: https://www.bhec.texas.gov/discipline-and-complaints/index.html
Anyone who wishes to file a complaint against a healthcare professional in Texas they may call the Health Professions Council toll-free complaint referral system: 1-800-821-3205. This automated, statewide number routes a complainant to the appropriate licensing agency.
Location-Based Services
If you have used location-based services on your mobile phone, you may wish to be aware of the privacy issues related to using these services. We do not place our practice as a check-in location on various sites such as Foursquare, Places, etc. However, if you have GPS tracking enabled on your device, it is possible that others may surmise that you are a therapy client due to regular check-ins at our office on a weekly basis. Please be aware of this risk if you are intentionally “checking in,” from our office or if you have a passive LBS app enabled on your phone. Also, if you and family members or partners use Find My Phone to track your whereabouts, and they do not know you are in therapy with us, another potential risk of them seeing your location is that they may discover you are in psychotherapy.
Email and Patient Portals
We prefer the TherapyAppointment or Headway Patient Portals and if necessary email arrange or modify appointments. For teletherapy, we may also send you handouts (or we may upload them to your client portals). Occasionally, we each may share a link to something we discussed in-session. You should be aware that all exchanged emails and communications become a part of your legal record and we keep a copy in your chart. If you choose to email us content related to your therapy sessions, note that email is not completely secure or confidential. All emails are retained in the logs of your and my Internet service providers. While it is unlikely that someone will be looking at these logs, they are, in theory, available to be read by the system administrator(s) of the Internet service provider. We utilize a HIPAA compliant email platform provided by Google Workspace. We typically reply to emails within one to two days. If you want to send me things securely, the best way is to use the secure contact form on our website, which leaves no record in your email account or upload a document to your portal.
Texting:
We do not text with clients. Our business phone is not constantly monitored for incoming text messages and any texts sent to this phone will not be received in a timely fashion. It is best to utilize the TherapyAppointment or Headway patient portal messaging system, call, or even email, even if it’s just to say you are running late.
Payment Systems:
We use practice software that uses Stripe and we bill your credit card the day of service. For those who prefer for me not to have your credit card number on file, I use IVY Pay which is a HIPAA-compliant payment processing app that allows you to respond to a text message and add your credit card. We also accept cash or checks for in-person visits.
Record-Keeping and Data Storage:
We use TherapyAppointment or Headway, HIPAA-compliant cloud-based digital health systems, to schedule appointments, track your payments and diagnosis, store your records, and provide video appointments.
We encrypt all computers so that in the event of theft or loss, the entire hard drive is encrypted and the files cannot be accessed without the encryption key. This also means that HIPAA breach notification does not apply if a device is stolen.
File Deletion and Destroying Data (see Endnote 8):
Consistent with law, all records are maintained for seven years after your last contact with us. After that point, all paper records are shredded and all electronic files are deleted. If you were under 18 years old when you met with us, the seven year countdown begins once you turn 18 years of age and at that point, files will be deleted after seven years or seven years after our last contact.
Teletherapy:
We do offer teletherapy services, and you will need to read and review our separate teletherapy consent form and we will discuss the issues in the form before we meet that way.
Conclusion:
Thank you for taking the time to review our Social Media Policy. If you have questions or concerns about any of these policies and procedures or regarding our potential interactions on the Internet, do bring them to my attention so that we can discuss them.
Endnotes:
1 Psychologists: The APA Ethics Code (2017) states: 3.05 Multiple Relationships (a) A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.
A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.
Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical.
(b) If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.(c) When psychologists are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, at the outset they clarify role expectations and the extent of confidentiality and thereafter as changes occur. (See also Standards 3.04, Avoiding Harm, and 3.07, Third-Party Requests for Services.)
Counselors: The ACA Code of Ethics (2014) states: Standard A.5.e. Personal Virtual Relationships With Current Clients: Counselors are prohibited from engaging in a personal virtual relationship with individuals with whom they have a current counseling relationship (e.g., through social and other media).
Social Workers: The NASW Code of Ethics (2017) states: Standard 1.06 (c) Conflicts of Interest: Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. (Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.)
(e) Social workers should avoid communication with clients using technology (such as social networking sites, online chat, e-mail, text messages, telephone, and video) for personal or non-work-related purposes.
(f) Social workers should be aware that posting personal information on professional Web sites or other media might cause boundary confusion, inappropriate dual relationships, or harm to clients.
(g) Social workers should be aware that personal affiliations may increase the likelihood that clients may discover the social worker’s presence on Web sites, social media, and other forms of technology. Social workers should be aware that involvement in electronic communication with groups based on race, ethnicity, language, sexual orientation, gender identity or expression, mental or physical ability, religion, immigration status, and other personal affiliations may affect their ability to work effectively with particular clients.
(h) Social workers should avoid accepting requests from or engaging in personal relationships with clients on social networking sites or other electronic media to prevent boundary confusion, inappropriate dual relationships, or harm to clients.
Marriage and Family Therapists: The AAMFT Ethics Code (2015) states: Standard 1.3 Multiple Relationships: Marriage and family therapists are aware of their influential positions with respect to clients, and they avoid exploiting the trust and dependency of such persons. Therapists, therefore, make every effort to avoid conditions and multiple relationships with clients that could impair professional judgment or increase the risk of exploitation. Such relationships include, but are not limited to, business or close personal relationships with a client or the client’s immediate family. When the risk of impairment or exploitation exists due to conditions or multiple roles, therapists document the appropriate precautions taken.
Psychiatrists: In the APA Principles of Medical Ethics (2013), Section 8.2, it notes: When the psychiatrist’s outside relationships conflict with the clinical needs of the patient, the psychiatrist must always consider the impact of such relationships and strive to resolve conflicts in a manner that the psychiatrist believes is likely to be beneficial to the patient. In Section 8.3, it states: When significant relationships exist that may conflict with patients’ clinical needs, it is especially important to inform the patient or decision maker about these relationships and potential conflicts with clinical needs.
2 Social Workers: The NASW Ethics Code (2017) states in Standard 1.06 Conflicts of Interest: (e) Social workers should avoid communication with clients using technology (such as social networking sites, online chat, e-mail, text messages, telephone, and video) for personal or non-work-related purposes. It also notes in Standard 1.06 (g) Social workers should be aware that personal affiliations may increase the likelihood that clients may discover the social worker’s presence on Web sites, social media, and other forms of technology. Social workers should be aware that involvement in electronic communication with groups based on race, ethnicity, language, sexual orientation, gender identity or expression, mental or physical ability, religion, immigration status, and other personal affiliations may affect their ability to work effectively with particular clients.
3 Psychologists: The APA Ethics Code (2017) states: 10.01 Informed Consent to Therapy (a) When obtaining informed consent to therapy as required in Standard 3.10, Informed Consent, psychologists inform clients/patients as early as is feasible in the therapeutic relationship about the nature and anticipated course of therapy, fees, involvement of third parties, and limits of confidentiality and provide sufficient opportunity for the client/patient to ask questions and receive answers. (See also Standards 4.02, Discussing the Limits of Confidentiality, and 6.04, Fees and Financial Arrangements.) (Dr. Kolmes considers the use of search engines to be an applicable “third party” worthy of describing as part of Informed Consent to Therapy.)
Counselors: The ACA Code of Ethics (2014) states in Section B Confidentiality and Privacy Counselors recognize that trust is a cornerstone of the counseling relationship. Counselors aspire to earn the trust of clients by creating an ongoing partnership, establishing and upholding appropriate boundaries, and maintaining confidentiality. Counselors communicate the parameters of confidentiality in a culturally competent manner. In addition, Standard B.1.b. Respect for Privacy states: Counselors respect the privacy of prospective and current clients. Counselors request private information from clients only when it is beneficial to the counseling process. Also, in Standard H.6.c. Client Virtual Presence: Counselors respect the privacy of their clients’ presence on social media unless given consent to view such information.
Social Workers: The NASW Ethics Code (2017) states under Standard 1.03, Informed Consent (i): Social workers should obtain client consent before conducting an electronic search on the client. Exceptions may arise when the search is for purposes of protecting the client or other people from serious, foreseeable, and imminent harm, or for other compelling professional reasons. In addition, in Standard 1.07 on Privacy and Confidentiality, it states (p): Social workers should develop and inform clients about their policies, consistent with prevailing social work ethical standards, on the use of electronic technology, including Internet-based search engines, to gather information about clients. And it also states: (q) Social workers should avoid searching or gathering client information electronically unless there are compelling professional reasons, and when appropriate, with the client’s informed consent.
Psychiatrists: The APA Commentary on Ethics in Practice for Psychiatrists (2015), notes in Topic 3.4.6 Professional Use of the Internet and Communication Technology: Innovations in internet and communications technology over the past several decades have the potential to improve access to, delivery of, and quality of psychiatric care. However, these advances may also pose potential challenges to sound and ethical practice. While each type of technology and situation requires a case-by-case analysis, psychiatrists should be aware of potential ethical challenges in its use before using the technology in providing patient care. Psychiatrists are responsible for obtaining sufficient knowledge about the technologies they employ to respect patient confidentiality and deliver competent care. Psychiatrists must be aware of their responsibility to maintain professional boundaries in their internet activities – both in respecting their patients and in establishing separation between personal and professional internet and social media presence. Before using electronic communications or other technologies in the care of patients, psychiatrists should inform patients of the parameters of this technology use, including appropriate use (e.g., administrative vs. clinical), expectations, and emergency contact procedures.
Interestingly, in Section 2 of the Principles of Medical Ethics (2013), it notes: “A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.” One might assume that being honest in all professional interactions and avoiding fraud or deception might mean that a psychiatrist should disclose to a patient that they have viewed a patient’s online activity if asked about it.
4 Counselors: The ACA Code of Ethics (2014) states H.6. Social Media H.6.a. Virtual Professional Presence: In cases where counselors wish to maintain a professional and personal presence for social media use, separate professional and personal web pages and profiles are created to clearly distinguish between the two kinds of virtual presence. H.6.b. Social Media as Part of Informed Consent: Counselors clearly explain to their clients, as part of the informed consent procedure, the benefits, limitations, and boundaries of the use of social media.
Psychiatrists: As noted in the above section, The APA Commentary on Ethics in Practice for Psychiatrists (2015), notes in Topic 3.4.6 Professional Use of the Internet and Communication Technology: Psychiatrists must be aware of their responsibility to maintain professional boundaries in their internet activities – both in respecting their patients and in establishing separation between personal and professional internet and social media presence. Before using electronic communications or other technologies in the care of patients, psychiatrists should inform patients of the parameters of this technology use, including appropriate use (e.g., administrative vs. clinical), expectations, and emergency contact procedures.
5 Psychologists: The APA Ethics Code (2017) notes 4.01 Maintaining Confidentiality: Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship. (See also Standard 2.05, Delegation of Work to Others.) Standard 4.04 Minimizing Intrusions on Privacy (a) also states: Psychologists include in written and oral reports and consultations, only information germane to the purpose for which the communication is made. (b) Psychologists discuss confidential information obtained in their work only for appropriate scientific or professional purposes and only with persons clearly concerned with such matters.
Social Workers: The NASW Ethics Code (2017) notes in Standard 1.07 on Privacy and Confidentiality, (i) Social workers should not discuss confidential information, electronically or in person, in any setting unless privacy can be ensured. Social workers should not discuss confidential
information in public or semi-public areas such as hallways, waiting rooms, elevators, and restaurants. And in Standard 1.07(r) Social workers should avoid posting any identifying or confidential information about clients on professional websites or other forms of social media.
Marriage and Family Therapists: The AAMFT Ethics Code (2015) states under Standard 2.4, Confidentiality in Non-Clinical Activities: Marriage and family therapists use client and/or clinical materials in teaching, writing, consulting, research, and public presentations only if a written waiver has been obtained in accordance with Standard 2.2, or when appropriate steps have been taken to protect client identity and confidentiality.
Counselors: The ACA Code of Ethics (2014) notes H.6.d. Use of Public Social Media: Counselors take precautions to avoid disclosing confidential information through public social media.
Psychiatrists: The APA Principles (2013) in Standard 4.3. notes Clinical and other materials used in teaching and writing must be adequately disguised in order to preserve the anonymity of the individuals involved. Also, in Section 1.1 of the APA Principles of Medical Ethics (2013), it states: A psychiatrist shall not gratify his or her own needs by exploiting the patient. The psychiatrist shall be ever vigilant about the impact that his or her conduct has upon the boundaries of the doctor-patient relationship, and thus upon the well-being of the patient. These requirements become particularly important because of the essentially private, highly personal, and sometimes intensely emotional nature of the relationship established with the psychiatrist. Section 4.11 notes: It is ethical to present a patient or former patient to a public gathering or to the news media only if the patient is fully informed of enduring loss of confidentiality, is competent, and consents in writing without coercion.
6 Psychologists: The APA Ethics Code (2017) notes in Standard 5.05 Testimonials: Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.
Counselors: The ACA Ethics Code (2014) notes: C.3.b. Testimonials: Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue influence. Counselors discuss with clients the implications of and obtain permission for the use of any testimonial.
Social Workers: The NASW Ethics Code (2017) notes: Standard 4.07 (b) Solicitations: Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client’s prior statement as a testimonial endorsement) from current clients or from other people who, because of their particular circumstances, are vulnerable to undue influence.
Clinicians in states that have their own code of ethics are advised to review your applicable ethics code to see if it makes similar statements regarding testimonials.
Psychiatrists: Although testimonials are not explicitly mentioned in The Principles of Medical Ethics: With Annotations Especially Applicable to Psychiatry (2013), it does note in section 1:1: A psychiatrist shall not gratify his or her own needs by exploiting the patient. The psychiatrist shall be ever vigilant about the impact that his or her conduct has upon the boundaries of the doctor-patient relationship, and thus upon the well-being of the patient. These requirements become particularly important because of the essentially private, highly personal, and sometimes intensely emotional nature of the relationship established with the psychiatrist.
And Section 2.2 notes: The psychiatrist should diligently guard against exploiting information furnished by the patient and should not use the unique position of power afforded him/her by the psychotherapeutic situation to influence the patient in any way not directly relevant to the treatment goals.
7 Social Workers: The NASW Ethics Code (2017) says in Privacy and Confidentiality Standard 1.07 (m): Social workers should take reasonable steps to protect the confidentiality of electronic communications, including information provided to clients or third parties. Social workers should use applicable safeguards (such as encryption, firewalls, and passwords) when using electronic communications such as e-mail, online posts, online chat sessions, mobile communication, and text messages. In the Informed Consent Standard 1.03 (e) it states: Social workers should discuss with clients the social workers’ policies concerning the use of technology in the provision of professional services.
Counselors: The ACA Code of Ethics (2014) states H.2.a. Informed Consent and Disclosure: Clients have the freedom to choose whether to use distance counseling, social media, and/or technology within the counseling process. In addition to the usual and customary protocol of informed consent between counselor and client for face-to-face counseling, the following issues, unique to the use of distance counseling, technology, and/ or social media, are addressed in the informed consent process:
• distance counseling credentials, physical location of practice, and contact information;
• risks and benefits of engaging in the use of distance counseling, technology, and/or social 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;
• possible denial of insurance benefits; and
• social media policy
8 Psychologists: The APA Ethics Code (2017) notes Standard 6.01 Documentation of Professional and Scientific Work and Maintenance of Records: Psychologists create, and to the extent the records are under their control, maintain, disseminate, store, retain, and dispose of records and data relating to their professional and scientific work in order to (1) facilitate provision of services later by them or by other professionals, (2) allow for replication of research design and analyses, (3) meet institutional requirements, (4) ensure accuracy of billing and payments, and (5) ensure compliance with law. (See also Standard 4.01, Maintaining Confidentiality.)
6.02 Maintenance, Dissemination, and Disposal of Confidential Records of Professional and Scientific Work
(a) Psychologists maintain confidentiality in creating, storing, accessing, transferring, and disposing of records under their control, whether these are written, automated, or in any other medium. (See also Standards 4.01, Maintaining Confidentiality, and 6.01, Documentation of Professional and Scientific Work and Maintenance of Records.)
Social Workers: The NASW Ethics Code (2017) notes in Standard 1.07 Privacy and Confidentiality: (n) Social workers should develop and disclose policies and procedures for notifying clients of any breach of confidential information in a timely manner. In the event of unauthorized access to client records or information, including any unauthorized access to the social worker’s electronic communication or storage systems, social workers should inform clients of such disclosures, consistent with applicable laws and professional standards.
Standard 1.08 Access to Records (a) Social workers should provide clients with reasonable access to records concerning the clients. Social workers who are concerned that clients’ access to their records could cause serious misunderstanding or harm to the client should provide assistance in interpreting the records and consultation with the client regarding the records. Social workers should limit clients’ access to their records, or portions of their records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to the client. Both clients’ requests and the rationale for withholding some or all of the record should be documented in clients’ files.
(b) Social workers should develop and inform clients about their policies, consistent with prevailing social work ethical standards, on the use of technology to provide clients with access to their records.
(c) When providing clients with access to their records, social workers should take steps to protect the confidentiality of other individuals identified or discussed in such records.
Psychiatrists: The APA Commentary on Ethics in Practice (2015) notes in Topic 3.2.1: “… The advent and expansion of the use of electronic medical records and the increasing use of care coordinators and integration of medical care present challenges to traditional notions of patient confidentiality. The need to share information and coordinate care to benefit the patient must be weighed against the patient’s need for confidentiality. Where electronic records are concerned, many hospitals inform patients of how the records will be used upon admission or upon use of the hospital system and patients sign a notice that they have been informed. The psychiatrist should exercise caution to include in notes that may be available to others only the information that would be necessary for evaluation and treatment of the patient’s condition. In addition, as part of their routine practice, psychiatrists may inform patients about the types of information that are included in the record, how the information in the record could be shared with others (with and without consent), and/or patient options for amending the record.”
Also, in Section 4.1 of the APA Principles of Medical Ethics: Psychiatric records, including even the identification of a person as a patient, must be protected with extreme care. Confidentiality is essential to psychiatric treatment. This is based in part on the special nature of psychiatric therapy as well as on the traditional ethical relationship between physician and patient. Growing concern regarding the civil rights of patients and the possible adverse effects of computerization, duplication equipment, and data banks makes the dissemination of confidential information an increasing hazard. Because of the sensitive and private nature of the information with which the psychiatrist deals, he or she must be circumspect in the information that he or she chooses to disclose to others about a patient. The welfare of the patient must be a continuing consideration.
Counselors: The ACA Code of Ethics (2014) notes in Standard B.6 Records and Documentation: B.6.h. Storage and Disposal After Termination: Counselors store records following termination of services to ensure reasonable future access, maintain records in accordance with federal and state laws and statutes such as licensure laws and policies governing records, and dispose of client records and other sensitive materials in a manner that
protects client confidentiality. Counselors apply careful discretion and deliberation before destroying records that may be needed by a court of law, such as notes on child abuse, suicide, sexual harassment, or violence.
Marriage and Family Therapists: The AAMFT Code of Ethics (2015) notes in Standard 2.3 Client Access to Records: Marriage and family therapists provide clients with reasonable access to records concerning the clients. When providing couple, family, or group treatment, the therapist does not provide access to records without a written authorization from each individual competent to execute a waiver. Marriage and family therapists limit client’s access to their records only in exceptional circumstances when they are concerned, based on compelling evidence, that such access could cause serious harm to the client. The client’s request and the rationale for withholding some or all of the record should be documented in the client’s file. Marriage and family therapists take steps to protect the confidentiality of other individuals identified in client records.
Standard 6.4 Technology and Documentation explains: Therapists and supervisors are to ensure that all documentation containing identifying or otherwise sensitive information which is electronically stored and/or transferred is done using technology that adhere to standards of best practices related to confidentiality and quality of services, and that meet applicable laws. Clients and supervisees are to be made aware in writing of the limitations and protections offered by the therapist’s or supervisor’s technology.
References
American Association for Marriage and Family Therapists (2015). Code of Ethics. Retrieved from
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