Many of our readers reacted with surprise to Monday’s post (“Facebook connects your clients, even if you don’t use Facebook”). It certainly reinforces the idea that if you are not actively and regularly working to protect the confidentiality of your clients on social media, you may not be doing enough.
In testimony to Congress the week before last, Facebook CEO Mark Zuckerberg made a point of emphasizing that if you’re a Facebook user, you own your information. This is meant to reassure users, but it is more than a little misleading. “Your information” is what you personally have uploaded to Facebook. You do not own what other people have uploaded about you. That’s what has privacy advocates so concerned. It’s also why even therapists who don’t use Facebook should be worried about the client confidentiality risks that the company poses.
Therapists and counselors have been expressing concern for some time now that Facebook can “out” their clients to other clients, even when the therapist or counselor has not done anything to facilitate the connection. It can happen even when the therapist or counselor doesn’t use Facebook. Thanks to some good reporting by Gizmodo Media, we now have a better understanding of how that happens. We also now know just how little you can do to stop it.
The whole article “How Facebook figures out everyone you’ve ever met” is really worth your time. Here, I’ll just share some of the pieces most relevant to counselors, therapists, and other mental health professionals. For us, if even just a few of your clients use Facebook, the likelihood of keeping all your therapeutic relationships truly confidential is near zero.
Many therapists and counselors maintain their electronic health records through the site TherapyNotes. (TherapyNotes and this blog are unrelated.) Last week, TherapyNotes was down for several days following the discovery of a ransomware virus on one of their servers. [Update 7/6: They’ve put that link behind a login wall. Here’s a cached version.] If you use TherapyNotes for your records, you may be wondering what to do now.
I am part of several online groups for psychotherapists, on Facebook and elsewhere. We talk about ethics, about theories, and sometimes about cases (without identifying details, of course, to protect confidentiality). Most of the time, when people say something that isn’t right, the collective wisdom of the group corrects the error. That’s one of many positives of social media: It allows professionals all over the world to share information and hold each other to high standards of knowledge and behavior.
Sometimes, though, a myth or misstatement is so common that the collective doesn’t effectively stop it. Here are the five misstatements about legal and ethical issues that I see most often from therapists.