Psychologists, Social Media and Digital Ethics

Kathleen Ashton, PhD, ABPP, FACHP 
Dr. Ashton is a board certified clinical health psychologist at the Cleveland Clinic, where she works in an integrated team at the Breast Center. Her clinical and research interests include psychosocial aspects of breast cancer and hereditary risk of breast cancer. Dr. Ashton serves on the APA Practice Organization Committee for the Advancement of Professional Practice. Twitter: @stress_doc

Lindsey Buckman, PsyD 
Dr. Buckman is a psychologist in private practice in Phoenix, Ariz. She is a faculty associate at Arizona State University. Dr. Buckman serves as the vice chair for the Committee for the Advancement of Professional Practice, president-elect of Div. 31, and the Diversity member at large for Div. 42. Twitter: @drBinPHX 

Vaile Wright, PhD 
Dr. Wright is director of Research and Special Projects in the Practice Directorate and a member of APA’s Stress in America team. As part of the Practice Research and Policy department, she focuses on the development and implementation of programs and policies related to expanding opportunities for professional psychology. She received her PhD in counseling psychology from the University of Illinois, Urbana-Champaign in 2007, and is licensed in the District of Columbia. Twitter: @drvailewright

Madeline Stoltz: Hello! I’m Madeline Stoltz, an intern with the Practice Communications office. For this episode of Progress Notes, I spoke with three practicing psychologists who use social media in their professional lives. You’ll hear their advice on using social media in their career, including how to ensure patient confidentiality and personal privacy. Whether you tweet daily or don’t have a single social media account, I hope you enjoy hearing insights from these three psychologists on how to better take advantage of social media if you’re interested in have an active presence online.  

Lindsey Buckman: I’m Dr. Lindsey Buckman, I am a psychologist in private practice in Phoenix, Ariz. I own my own solo practice and my specialty areas have to do with chronic medical issues, binge and compulsive over-eating, LGBTQ folks, and third-party reproductive assessments.  

Madeline Stoltz: You can find Dr. Buckman active on Twitter, as well as frequently updating her private practice’s website with her professional background and patient resources. Dr. Kathleen Ashton is also on Twitter, and also maintains a professional website, where she runs a blog on issues and advice for practicing psychologists.

Kathleen Ashton: I’m a health psychologist and clinical assistant professor at the Cleveland Clinic. And I’ve been working in the integrated care clinic here for the past 15 years.

Madeline Stoltz: Dr. Vaile Wright is the director of Research and Special Projects in the APA Practice Directorate. Before this position, she practiced at a hospital in Washington, D.C.

Vaile Wright: I was the director of Clinical Training at St. Elizabeth’s Hospital, which is an inpatient psychiatric hospital, and I also worked as a psychologist in the hospital so I worked on a unit with individuals with treatment refractory psychosis, I ran the Dialectical Behavioral Therapy group program, and I ran a research program at the hospital as well.

Madeline Stoltz: Two of the main concerns practicing psychologists often have when promoting themselves online are protecting patient confidentiality and protecting their own privacy. Because of these concerns, it’s becoming more common to include a social media policy in the informed consent process. Dr. Ashton immediately introduces this with new patients.

Kathleen Ashton: My social media policy for example says I don’t communicate over email or any forms of social media. We have a patient messaging system that’s secure through our electronic health record, so I encourage patients to use that.

Madeline Stoltz: What happens if patients accidentally break your policy and engage with you on social media? Dr. Buckman explained how she handles these situations.

Lindsey Buckman: I talk about the fact that all of our communications are meant to be confidential and if you communicate with me on social media I will not be able to communicate back and that I will not follow them and anytime that somebody tries to do that, then I immediately, once I see it, pick up the phone and explain to them that the nature of our relationship is confidential and these are the reasons why and so I won’t be communicating with you on social media.

Madeline Stoltz: Dr. Wright speaks on her experience with social media policy at the hospital, not just with patients, but with supervisors as well.

Vaile Wright: I would never friend a patient and I think the other thing that was interesting at the hospital was that we did have a contract with supervisees as well. So my trainees, the interns, the externs, the postdocs, none of them could friend their supervisors or other psychologists at the hospital until after they had left the program.

Madeline Stoltz: Dr. Wright and Dr. Buckman also raised the importance of not sharing anything from your sessions on social media, even if the post is anonymous, it’s on your private account, and seems harmless.

Vaile Wright: While I think it’s meant as a way to seek out relief or catharsis, I think it’s really important that psychologists be careful about what they post about their practice, even if it’s on a private, personalized social media account, that they’re not unintentionally breaking some sort of patient privacy.

Madeline Stoltz: Dr. Buckman agreed that psychologists need to be thoughtful about this, because even if the person isn’t named, there is still a chance they could come across it. Protecting patient privacy is incredibly important, but so is protecting your own privacy. What was the biggest recommendation they all shared?

Vaile Wright: I frequently Google myself…

Kathleen Ashton: I also would Google yourself occasionally…

Lindsey Buckman: I really advise people Googling themselves to see what’s out there, so not only what’s coming up on the initial pages, but to go on the images pages, the news pages…

Madeline Stoltz: For social media accounts, they advise being very thoughtful about the privacy settings. Dr. Ashton shared how she learned this the hard way when she created a LinkedIn account and accidentally allowed LinkedIn access to her email contacts.

Kathleen Ashton: A former patient who had gotten my email previously was the first person who joined my LinkedIn account and it took me several hours to find a way to extricate him from that account so I think when you are getting started, be careful, read the fine print about what you’re agreeing to, think about who you’re inviting, and whether that site is the right fit for you.

Madeline Stoltz: Dr. Buckman said she makes sure to set the highest possible privacy controls for her private accounts and takes some extra precautions, such as only posting about locations she was at after she’s left them, and being very careful when setting up these private accounts.

Lindsey Buckman: Now that everybody has all of their information on their phone, if they have your email address, if they have your phone number, then you’re going to pop up in whatever account that you’re using that information for in their own feeds, on their own phones. So I make sure to use email addresses and alternate phone numbers for accounts that I don’t necessarily want to have folks who are engaged with me in professional settings to have access to.

Madeline Stoltz: When it comes to public social media accounts like Twitter, they recommended only posting content that you’d be more than willing to defend. Dr. Buckman referred to social media as a sort of “billboard” but added that there are additional concerns specific to practicing psychologists.

Lindsey Buckman: Because of the nature of our work, we don’t put very much of our personal lives and interests out in our work with our patients, I think that really heightens folks’ curiosity, and so being really thoughtful about the fact that if you have things on social media, people are going to look and potentially dig down deep into your conversations with others, and just really being thoughtful with what that looks like.

Madeline Stoltz: For all three psychologists, promoting their professional presence online has opened up opportunities and new connections, which wouldn’t have been made possible without their social media.

Kathleen Ashton: I’m able to let people know of upcoming conferences and talks, new blog posts, my research. And then I also can promote other people’s research. So often at a conference, I will live-tweet about anything I think is important at the conference, which helps me connect with other people who are there, as well as get that information out to a wider group of psychologists and the public who might be interested.

Madeline Stoltz: Dr. Ashton has also been able to interact with people on social media and then meet them in person. After she moved into a new area of practice, she attended a conference she hadn’t been to before.

Kathleen Ashton: I didn’t know that a lot of people, and I was feeling a little bit like a fish out of water, and I started to chat with someone, and she suddenly became really animated, and she said, “Oh, I know you! I read your blog.” And it was so strange, it really came out of nowhere, but we really connected.

Madeline Stoltz: Dr. Wright noted that her Twitter has also helped her make connections. Journalists can easily contact her, as well as stud ents who are interested in her work.

Vaile Wright: I have done a couple different Facebook Live videos professionally. One with CNN, and then one for APA. And those were really neat experiences, but they also made me think about my relationship with Facebook a little bit. I tried not to read the comments, but I also didn’t want to “like” either of the pages, or share them on my own personal page, because then that could link back to somebody who was commenting or somebody who saw the public exponent of it. Not that I think people are paying that much attention to me, but it was just something I was more aware of, making sure that I was keeping that professional aspect of Facebook separate from my personal page.

Madeline Stoltz: Dr. Buckman has integrated her Twitter with her work in practice and said she enjoys being able to act “as a psychologist out in the world.”

Lindsey Buckman: I think one of my favorite things about Twitter is just the connections that you make that you would really in no other way have any opportunity to make. I have two young women that met each other through Twitter, met me through Twitter. They are part of the LGBT community, they have both had mental health difficulties, and have connected with me on a personal connection, but I send them things every once in a while that I think would be helpful to them, and I make sure I’m being a good example and being a good cheerleader to them. 

Madeline Stoltz: So what if you want to get more active online but don’t know where to start? Dr. Buckman said to first ask yourself what your goal is.

Lindsey Buckman: What are they looking for? What’s the outcome that they’re trying to move forward? If it’s something like referrals or expanding practice, then maybe getting on a psychologist locator would be a really nice first step because it’s easier than developing your own webpage, but has some of the same features, so people can get a sense of you and your practice and links to connect to you.

Madeline Stoltz: Dr. Ashton also had a recommendation.

Kathleen Ashton: I’d commit some time to experimenting and playing around with the site to see how it’ll work for you. Setting aside a brief 10 minutes or so a day is a good way to get started without feeling overwhelmed.

Madeline Stoltz: Both Dr. Wright and Dr. Buckman reflected on the potential of social media in the field of practicing psychology.

Vaile Wright: There’s a lot of opportunities to use social media in smart ways, to brand yourself, to market your practice, to make yourself accessible to other sort of avenues, demonstrating your expertise in these different areas.

Madeline Stoltz: Dr. Buckman discussed social media’s contributions to psychology overall.

Lindsey Buckman: Even reducing the stigma of mental illness is a huge thing that social media can do. So I think that we can really, as psychologists, use it as a great tool to get information out there, techniques that people can do at home to manage some anxiety or some other things. I think it can be really a great thing for us to embrace and work with as a profession in general.

Madeline Stoltz: That’s it for this episode! Don’t forget to subscribe to Progress Notes on iTunes and Soundcloud. If you have a Twitter, follow us @APAPractice. If you’re interested on keeping up with Dr. Buckman, Dr. Wright, or Dr. Ashton, we’ve linked their social media and websites in the show notes. Thanks for listening!