Professional Boundaries and Social Media

BACKGROUND 

Blair is an occupational therapist who owns a private practice in hand therapy and has a large Instagram following. Blair uses a professional account, which is open to the public, to advocate and educate followers on health care topics related to occupational therapy. The large following has provided opportunities to be a guest on health podcasts and other platforms.

Blair is scheduled to meet a new client, who indicated on the intake form they heard about this practice through social media. On the day of assessment, the client mentions that they have been following Blair’s Instagram account for a year now and during the visit, continuously brings up Blair’s social media presence, including some personal information gathered from a recent interview. After the appointment, Blair notices a private message in his inbox from this client and a request to follow his personal Instagram account, which is private. 

This client is scheduled for a follow-up visit next week. Blair has some concerns about the potential impact his social media presence may have on this therapeutic relationship. Blair recognizes there may be some potential boundary crossings if the follow request is accepted. He also understands it is his responsibility to uphold professionalism both in his online and real-life presence. Blair goes to the College Standards and Resources webpage to review College materials and make sure he understands his professional responsibilities and how best to manage this situation. 

CONSIDERATIONS  

  • Blair reviews the Use of Social Media document and the Standards for Professional Boundaries.

  • He decides to contact a College Practice Consultant to clarify expectations around the friend request from a client.

  • Blair realizes that he may not have considered all the privacy settings on the social media platform and unknowingly disclosed personal information that may impact his professional interactions with clients. 


OUTCOME

  • After discussing with the Practice Consultant and reviewing the COTO resources, Blair understands that the lines between public and private, and personal and professional, are easily blurred on social media. Blair chooses to decline the follow request from the client on the private personal account.
  • Blair takes a closer look at the settings of the social media accounts and starts with changing the username and increasing privacy settings. Blair also ensures there are no links from his personal account to the professional account, for example, tagged photos or mentions in comments.
  • Blair reviewed all the previous content on the public professional Instagram account and realized that the interviews and podcasts revealed some personal information. Blair contacted the creators and kindly asked them to remove or edit these parts out for professional reasons.
  • To further enhance his practice, Blair develops a social media policy to share with his clients. 

The following week, the client is scheduled for their follow-up visit. Blair takes this opportunity to talk with the client, explaining that accepting the request or private messaging blurs professional boundaries and does not align with ethical practice. As not all social media platforms may be secure, Blair also talks about the risk of privacy breaches of personal health information. He states the best way to contact him moving forward is to use the work email address or call the business line to book an appointment. 

CONCLUSION

There are many benefits to using social media in occupational therapy practice. Occupational therapists must be alert to interactions on social media that may blur professional and personal lines. Occupational therapists must protect client confidentiality and always maintain professional boundaries. Developing or referring to a social media policy can assist in discussions with clients about the appropriate use of social media.   


REFERENCES 

CONTACT

If you have any questions about this case, or have any ideas or requests for future cases, contact the Practice Resource Service: 1.800.890.6570/416.214.1177x240 or practice@coto.org.

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