Think you don’t work online? Think again. ‘I don’t really work online,’ you argue. ‘Well, maybe the odd Skype session.’ This is so often what I hear when I ask therapists if they have a digital policy. Either this or ‘Why do I need one? I don’t even have a Facebook account.’
Let me ask you this. Do you correspond with clients via email? Do you keep their contact details on a computer or smartphone? Do you use any form of social networking? Do you use videoconferencing to speak to clients or supervisees, even just once in a while? Do you use an online-based invoicing programme? Do you ever receive text messages from clients? If your answer is yes to any one of these, you need a digital policy.
Those who answer ‘no’ to all of these are in the minority, and while there’s no requirement that they ‘digify’ themselves, they still might benefit from asking themselves how aware they are of the culture in which most of their clients will be embedded.
All therapists are trained to maintain boundaries according to their modality. However, much training still teaches boundaries in the way that they existed before the internet. Our ‘always on’ world, however, invites challenges well beyond these well-practised precepts. However we try to hold a safe space in our consulting rooms, the potential for digital impingement1 is always present. That is, any kind of disruption to the self or the therapeutic dyad that emanates from the digital world. They can be independent of therapy, but for the purposes of this column, we’re looking at impingements that affect the therapeutic dyad. These include things that happen during a session, like a phone ringing, or between sessions in the form of emails, text messages, or friend requests on social media.
I came to understand digital impingement when I found out that a client of mine had Googled my name in a moment of distress. Alone at night, she was looking for a connection to me – her ‘good object’ – and as I wasn’t available, Google seemed to be the next best thing. However, what she was presented with was material about me that I’d not previously shared. Her experience of this, outside the containment of a consultation room, and in the midst of a distressed state, made me seem alien and unknown. Naturally this affected our relationship deeply. Fortunately, we were able to work through it, and I describe this experience in my paper ‘TMI in the Transference LOL: psychoanalytic reflections on Google, Social Networking and Digital Impingement’.2
Five years on, there’s little reason for therapists to be caught out by such events, and they can and should be prepared for them. I have found that by developing a digital policy, therapists take back control by identifying ambiguous boundaries that the digital world introduces, and working out how to meet them before they’re breached. This helps keep both clients and therapists safe by providing clarity about engagement outside the therapy room. While we can’t prepare for everything, we can be clear about our expectations.
You don’t have to re-invent the wheel. If you want a really good cheat, just look at my policy and adapt it to your needs: http://aaronbalick.com/ pdf/digital-policy.pdf. I didn’t invent the idea either. I cribbed mine from Keely Kolmes, who was one of the first to have such a document (borrow as you like, but it’s always good to give credit where credit’s due). When developing your policy, think of all the zones you’d like to cover – social media, text messaging, emails, video conferencing etc – and think about what would make you comfortable. So many of us use our technology passively, when we should be proactive. For example, just because you can receive client emails at the weekend, does that mean you have to respond straight away? Just because you can arrange video conferencing while you or a client is away, is that something you should do? We don’t make these decisions about our offline behaviour, so why should online choices be any different?
While we can’t all be IT experts, we should be informed about the basics of data safety online and taking precautions. Fortunately, tech questions are generally answerable if you ask the right people (ie any 12 year old) or check good resources. You can find out how to encrypt personal information and emails, register with the Information Commissioner’s Office (yes, you should), and find out which video-conferencing software is safe for use. Less answerable are questions about whether or not it’s appropriate to see a particular client by video conferencing, what to do when you receive an email full of clinical material, or if you receive a concerning text. Once your boundaries are clear on the basics, these details can be ironed out in supervision.
Deciding simple things like how long you might leave it before you respond to an email or whether or not you are contactable between sessions, and communicating this with a client, will keep both parties safe. You can design these boundaries in a way that’s authentic to your modality and personality. You can communicate these easily by making your client aware of a weblink to where they can read your policy. Give yourself room for flexibility, as you’ll adapt your policy as you grow and learn.
When running workshops on digital policies for therapists, I often find that they can carry a lot of anxiety in relation to this. However, once the details of such a policy become thinkable and contained, the anxiety decreases. You’ll find too that by getting your questions attended to and thinking through the complexity of the less black-and-white matters, you’ll be well ahead of the game in protecting yourself and your clients. You will also reduce your anxiety about working in a digital environment, while reaping the bonus of making active decisions about how you contain your practice, rather than passively responding to the digital world around you
Dr Aaron Balick is a psychotherapist, cultural theorist, author and the director of Stillpoint Spaces London, a new psychological hub for events, contemporary cultural reflection, and psychotherapy, in London.
References
1. Balick A. TMI in the transference LOL: psychoanalytic reflections on Google, social networking, and ‘virtual impingement’. Psychoanalysis, Culture and Society 2012; 17(2): 120–136.
2. Balick A. The psychodynamics of social networking: connected-up instantaneous culture and the self. London: Karnac; 2014.