In the past few years we’ve seen mental health and therapy content explode online. As the stigma towards therapy decreases, people are using social media to share the beauty that can come out of sitting down with a professional and talking.
Among those sharing videos, are therapists and counsellors who want to reach a wider audience.
As someone who has been in therapy, being able to watch content linked to anxiety has helped and encouraged me to continue to do the internal work. And let’s face it, accessing therapy can be both arduous and expensive – especially if you’re early in your career or you’re facing long NHS waiting lists – so these videos are a way for people to start work on themselves today, without paying a hefty fee.
However, there’s been recent debate around how therapists are using social media. There’s a big difference between a therapist who shares five tips for coping with anxiety – and a therapist who retells their client’s life story for likes. (And no, I won’t be sharing examples of the latter).
Increasingly, it feels like it’s becoming normalised for therapists to speak about their clients in their social media, which has made people wonder how ethical this is.
“Therapists are not supposed to be using their clients to become influencers,” one therapist (@QueeringPsych) said on Twitter.
“Sharing helpful info (without generalising or diagnosing strangers) is great. Making your clients wonder if you’re gonna talk about them affects the relationship,” he added.
Therapists aren’t the only ones using social media to speak about their profession. American nurses recently came under fire after sharing their patient ‘icks’ on TikTok.
No job is perfect and being a nurse is a demanding job. But where is the line between raising awareness of the challenges of your profession and speaking about real-life patients? Does it matter if they’re unnamed? Or does it still cross a line?
Vuma Phiri, who is a 25-year-old paralegal from Western Australia, thinks the content therapists make is starting to go overboard.
“There are certain client-facing careers that need to avoid speaking about the people who come to see them because they visit you at their most vulnerable. It’s unethical to use their vulnerability to go viral,” Phiri says.
However, she shares that she’s benefitted from therapy content but mainly the therapists who give general advice without mentioning their clients’ experiences.
“You can definitely reach your audience well by giving out advice based on your knowledge rather than specifically speaking on those who come see you,” she says.
Phiri also says she’d be angry if her therapist used her story for a viral video. “The security I feel signing a confidentiality agreement would be breached by you speaking about me online on an app as far reaching as TikTok, even if I was anonymised.”
Crystal*, who has been going to therapy for some years, understands how these videos can help others, but “when its explicitly prefaced and explained as the story of a particular person, I think it’s invasive and an informal violation of trust,” she says.
She explains that she would feel violated if her therapist shared her story online. “How can I be baring my soul and telling a professional things that even my close family and friends don’t know and they’re using it as gist online for engagement?” asks the 24-year-old painter from London. “Even though only I would know it was about me, I would feel quite exposed.”
She adds that she’s never found hearing people’s personal stories in this context helpful. “It feels like entertainment and the focus is always on how juicy the story is rather than the healing/resolution/lesson to be learned,” Crystal adds.
Caroline Jesper, who’s head of professional standards at the British Association for Counselling and Psychotherapy’s (BACP), believes social media channels can be a great way to connect and communicate with people, and for therapists, it can be a good way to network with other professionals.
“However, it’s important therapists keep in mind their ethical values and principles while doing so,” she tells HuffPost UK.
“They shouldn’t breach confidentiality or publish anything on social media which could identify a client. They should also be aware that even when anonymising aspects of their client work, a client may see this and recognise themselves in being said. This would be a breach of trust in the therapeutic relationship.”
Are therapists allowed to speak about clients online?
Counselling Directory member Jennifer Warwick shares that there’s been some healthy debate amongst therapists about how, or if, they should use social media.
“Some stay well away, while others see it as a way of connecting and engaging with people,” Warwick says. “It’s a way of showing ourselves as being human and relatable.”
Therapists in the UK are bound by ethical guidelines set out by the governing boards, such as the BACP, so in theory this should prevent people crossing a line.
“Client confidentiality and privacy are key, so we need to make sure that no information that might identify the client is used,” Warwick explains.
“The BACP even have specific guidance for its members, which includes how social media relates to its ethical framework, maintaining clients’ privacy and confidentiality, as well as appropriate boundaries.”
But if you’re viewing this kind of content on TikTok – or you’re in therapy yourself – how can you judge when a therapist has shared too much?
“It’s vital for therapists to tread very carefully around this and not to share any identifiable information about clients, past or current.” Warwick adds.
“Imagine seeing a post from your therapist and thinking ‘they’re talking about me!’ even without them giving a name or location.”
She emphasis on the the importance of a health relationship between therapists and clients. “It makes no sense to have a client or potential client feel that we might not be safe to work with when they see us posting about a current client.
“It can however be helpful to talk about general themes or issues on social media that we work with, as this helps clients find the right therapist for them.”
Should therapists ask their clients if they can speak about them online?
“It’s definitely good to set boundaries with clients around social media use, for example, not responding to DMs or accepting friend requests,” Warwick says.
“Ideally, this would be stated as part of the therapist’s social media and also as part of the agreements made when starting with a client.”
“It might be good to discuss with a client how we use social media, to be there to answer any questions they might have and put their minds at ease so they know we are bound by ethical guidelines in our work, which protects our clients’ privacy and confidentiality.”
If you have concerns about your therapist, the BACP advises trying to speak to your therapist first to try to resolve the issue directly with them. But if you think confidentiality has been breached, you can make a formal complaint.
Help and support:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).
- CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.