Occupational therapists in private practice have the added responsibility of managing their business practice.
When promoting their practice, occupational therapists should be mindful about how and what they advertise and be aware of how certain marketing strategies may be viewed by the public.
Advertising by occupational therapists has always been subject to rules. These rules are found in the General Regulation under the Occupational Therapy Act. That regulation states:
An advertisement with respect to a member’s practice shall contain only factual and verifiable information that a reasonable person would consider relevant to choosing an occupational therapist.
While some occupational therapists may think posting client photos, including those of pediatric clients, is acceptable, this practice can be of particular concern. The use of client photos has been the subject of reports to the College by members of the public.
While using the image of a paediatric client is not strictly prohibited, because an image of a child can be considered personal and identifiable health information, full and informed consent must first be obtained from the child and/or their parent or substitute decision maker.
When it comes to posting a child client’s image on a website, a blog, or a business’ social media, full and informed consent includes a robust discussion around the potential risks.
The child or their substitute decision maker should understand the following implications before consenting to the publication of their/the child’s image. It is the occupational therapist’s responsibility to ensure they understand the following:
- Misuse of Images: Once an image is online, it can be copied, altered, or redistributed without control. This includes risks of:
- AI-generated image manipulation
- Use in inappropriate or exploitative contexts
- Identification by individuals with harmful intent.
- Privacy Violations: Children have the right to privacy. Unauthorized sharing of their images can infringe on this right, which has the potential for harm to the child.
- Unintended Testimonial Use: Client photos showing a child engaging positively with a service may be interpreted as a testimonial, which raises ethical concerns—especially if the child is a current client. The use of testimonials is prohibited under a regulation of the Occupational Therapy Act.
- Digital Permanence: Even in “private” or “closed” groups, screenshots and downloads can make content permanent and widely shareable. This digital permanence raises other considerations that may not be so obvious at first, including:
- Loss of future autonomy – children lose the ability to shape their own identity and decide what parts of their lives are public.
- Risk of future discrimination or embarrassment – content shared today may be harmless in context but could be misinterpreted, mocked, or misused in future social, educational, or professional settings. This includes images that reveal health conditions, emotional states, or personal struggles.
- Inability to erase content – Once online, content is difficult or impossible to fully remove. Even if deleted from the original source, it may have been copied, archived, or shared elsewhere.
- Risk of cybersecurity breaches – despite security measures and policies, private or closed groups can be breached.
To ensure full and informed consent, parents and/or guardians, or the child should have the following outlined and explained to them verbally and reinforced in writing:
- Purpose of Use: Clearly explain why the image is being used, for example, marketing, education, internal documentation.
- Where It Will Appear: Specify platforms, for example, website, social media, newsletters.
- Duration of Use: Indicate how long the image will be used or stored.
- Risks Involved: Outline the potential for misuse, loss of control, and permanence of digital content – as outlined above.
- Right to Withdraw: Inform them they can revoke consent at any time and explain the process for doing so.
- No Guarantee of Control: Acknowledge that once shared online, the organization cannot fully control how the image is used or shared by others.
- Security Measures: Describe how the image will be stored and protected, for example, not on personal devices, encrypted storage.
It is also important to note that seeking consent from any client for the use of their image may also raise concerns around professional boundaries. Occupational therapists are in a position of power with their clients, and clients may feel pressured to say ‘yes’ to the use of their image because they want to keep receiving the services they find so helpful.
The College encourages occupational therapists to reflect on how they advertise their practice and consider ways in which they can accurately provide information about the benefit of their services, while exhibiting the utmost professionalism and ensuring continuing confidence in the profession.