Many psychiatrists of, ahem, a certain age (say, over 30) have been caught by surprise by the reach of online and social media. With the explosion in use of the Internet, e-mail, Google, Facebook, Twitter, LinkedIn, and many other ways to find out information about someone, there’s no such thing as privacy any more. That creates a new set of modern problems for psychiatrists who walk a fine line between building a therapeutic alliance with patients and keeping a professional distance.
I sat in on a fascinating group discussion at the annual meeting of the American College of Psychiatrists to hear how professionals are grappling with these issues. Look for a more detailed report soon in Clinical Psychiatry News. What surprised me is that even some very young psychiatrists who grew up so immersed in online and social media that they seem like part of the natural environment have been surprised by the professional ramifications of the long reach that these tools give to patients.
Some of the challenges are old problems in a new form, it seems. Setting limits on patients’ e-mail contact with psychiatrists is similar to setting limits on phone contact in some ways, but magnified. The Internet and e-mail can be both helpful and problematic in their work, psychiatrists said. The biggest potential land mines are in the social media. What happens when a patient wants to “Friend” a psychiatrist who is on Facebook? No matter how the psychiatrist responds, there’s grist for the psychoanalytic mill. Transference becomes a bigger issue. Even using the highest privacy settings, non-Friend visitors to your page can glean information about you, your “Friends,” and potentially your family. Perhaps not surprisingly, only a handful of psychiatrists in the room said they were on Facebook. And Internet dating? Look out.
Does that mean psychiatrists must be technological hermits, never to enjoy the interconnectedness that social media supply to everyone else in society?
These are all weighty questions that usually have no right or wrong answer. The American Association of Directors of Psychiatry Residency Training (AADPRT) just released new curricula to guide psychiatrists-in-training in discussing these issues, so that they can anticipate the potential consequences of the decisions they make about use of online tools and social media. See my full story for details.
The curricula are available only to AADPRT members, though some of the resources in them may be made available to the general public in the future, said AADPRT President Dr. Sheldon Benjamin. Meanwhile, you can hear him discuss these topics in an AADPRT podcast interview with Dr. Sandra M. DeJong, chair of the Association’s Task Force on Professionalism and the Internet.
I’d love to hear from clinicians of any specialty who are reading this (but especially psychiatrists) — do you use social media? Are they worth the potential professional problems? And will you Friend me? Leave a comment, and let us know.
— Sherry Boschert