Facebook: Ethical and Clinical Considerations

By: Traci Bartley Young, LCSW

Facebook permeates everyday social chatter, whether someone is sending a request to join or a friend is posting pictures of family. I had a recent discussion with a friend who joined Facebook as a way to market her growing business and to network. As a social worker, I am always looking at ways to network and thinking about new technologies that may enhance client functioning. The more I considered Facebook and social networking sites in general, the more I realized the ethical implications for social workers who use these sites and the possible clinical impact for our clients. This is by no means an exhaustive discussion of all the things one must consider before using a site, nor does it address all of the ways such use could affect clients. This article is intended to be a snapshot of a few issues social workers should contemplate with regard to social networking sites. The NASW Code of Ethics (1999) will be used as a reference, citing particular standards that provide a guide for each ethical issue.

4.03 Private Conduct

Social workers should not permit their private conduct to interfere with their ability to fulfill their professional responsibility.

    Social workers are valued members of their communities and often are looked to as role models. Many of us play very public roles. If your profile on a social networking site reflects a persona different from the one you portray at work or in the community, maybe you should reconsider its content. Co-workers, people you network with, and clients utilize these sites and may be looking to see if you use them, as well. If your profile could negatively affect your image as a social worker, it will interfere with your ability to do your job. Additionally, potential employers may be looking on these sites. If you are new to the profession, you will want to represent yourself in the best light possible.

    Another issue for clinicians to consider is how their membership on a social networking site may affect potential or current clients. Consider for a moment anxious clients who see you, their social worker, as a reliable nurturer. Upon perusing their favorite social networking site, they search for your name. You have posted pictures of your most recent vacation, and what the clients discover is far different from the comforting support they seek weekly. How may this discovery affect your relationship? Or consider new clients who are curious about you and look you up before your first session. Will the information they encounter affect their desire to seek help or their ability to form a positive relationship with you? Although many of the sites allow you to adjust your security settings, this does not prevent other “friends” from posting or “tagging” pictures of you.

    Finally, social workers should avoid personal use of these sites on agency time. It may, however, be acceptable to use social networking sites to network professionally. And increasingly, agencies are using sites for various forms of outreach. Social workers may even be asked to post on behalf of the agency. All agencies have different policies, but in general, using social networking sites for personal use should be avoided at work. This could affect your time management and mental focus, and interfere with professional responsibilities.

1.07 (a) Privacy and Confidentiality

Social workers should respect clients’ right to privacy. Social workers should not solicit private information from clients unless it is essential to providing services or conducting social work evaluation or research....

    Conversely, have you ever considered looking up a client on a social networking site? Let’s say you are seeing a new client, and during the assessment something does not add up. Later in the day, you become curious about the client’s private life and consider checking to see if he or she has a profile on Facebook or MySpace. Stop right there. All clients have a right to their privacy, to their own lives, and to the content of their own social networking sites. If something does not makes sense about the client and you need more information, there are far more direct ways of gathering that information. Additionally, how might the information you find on the Web affect your view of, and relationship with, that particular client? If you absolutely feel that all the answers to your questions lie in the social networking site, perhaps you could ask the client to share that site with you and you could look at it together. If used in a responsible and straight-forward way, blogs, Web pages, and social networking sites could be powerful shared tools for assessment or therapeutic means.

    One may argue that information posted on social networking sites is public information and that anyone has the right to access what is posted. This assumption is correct; however, social workers should consider the intention behind any search for information. Social workers will want to question whether the search honors the client’s right to privacy and private life outside of services before beginning to search. Social workers should also question whether the search for information is “essential to providing services.” Additionally, social workers have an obligation to behave in a trustworthy manner toward clients. Searching for information regarding a client without the client’s knowledge may not be perceived as trustworthy.

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.

    Confirm or ignore? What if you get a request from a client to network? Clearly, this could be a case in which a dual relationship could form. Thus, it should be avoided. Issues of privacy and confidentiality could also arise if you were to allow a client into a social network that consisted of family and friends. In addition, you have your own privacy and boundary issues to consider. Social workers, both for themselves and their clients, should be able to leave their work at their practice or place of employment. It is the healthy choice for all involved. But what, then, is the correct response? Do you just deny the client without a follow-up? As a social worker, you would want to follow up with that client in person and reiterate the concept of multiple relations, boundaries, and even confidentiality. It may even be a helpful opportunity to discuss healthy boundaries with that particular client.

    Have you ever wondered what happened to that past client? I know that I often think of former clients and question how they are doing. What about using a social networking site as a way to follow up with them? I believe the same rules apply as above. Who would benefit from this follow-up? If it were a genuine client follow-up, it would have been discussed and agreed upon at termination. If not, social workers would have to remember to respect all clients’ privacy—even those long progressed from our care.

Clinical Considerations

    Clinically speaking, social networking sites present a host of considerations for social workers. Increasingly, our clients will be accessing and using these sites daily. It will be a whole other realm in which our clients function and possibly carry on relationships. Social workers should anticipate both the positives and negatives to this sort of activity for our clients. In some respects, clients may discover much needed support. Online support groups exist for virtually any issue. Clients can also join causes they feel passionate about. Facebook has hundreds of such groups.

    Although connecting with old friends can be enjoyable, the inevitable and sometimes painful “walk down memory lane” may also bring to light stressful issues for clients. Facebook can include a rejection factor if a client reaches out to someone else and is not accepted into that person’s social network. There also can be unanticipated social pressures, such as unhealthy social comparison, when a client joins a networking site. Social networking is a new way in which individuals relate with one another. Relationships in this realm are more two dimensional, and it is unclear how this type of communication may affect clients’ ability to relate with others. This is by no means an exhaustive discussion on the clinical implications of social networking. It is a call to social workers to familiarize themselves with these sites, how they function, and possible ways the sites may affect clients who are utilizing them.

Conclusion

    Social networking sites present opportunities and challenges for social workers. Professionally speaking, these sites may be beneficial to social workers using them for networking purposes. Professional sites such as http://www.linkedin.com boast 30 million professionals as users. The National Association of Social Workers and The New Social Worker have their own Facebook profiles. Social workers may even use these sites to promote private practices or business. It is important, however, to separate personal networking from professional. And even considering the ethical issues discussed above, the sites do seem to maintain a very positive, upbeat, and secure environment.

    Social workers have a growing presence on many social networking sites, but as a profession, we may not be utilizing these sites to their fullest potential yet. This may not be a bad thing. Social work is a profession based on relationships. I believe that functional and healthy relationships occur best face-to-face and in real time. And yet, a technological world is the world in which we live. As social workers we should be aware of all of its obstacles and embrace all that it has to offer.

References

National Association of Social Workers. (1999). NASW Code of Ethics. Washington, DC: Author.

Traci Bartley Young, LCSW, graduated from the University of Oklahoma School of Social Work. She has practiced social work both nationally and internationally. Traci resides in Tampa, Florida with her family and is a social work consultant.