Pause Before Posting About Work On Social Media Pages (part 2)

Guest post by Kimberly Sandstrom, MFTI

We all have days where we need to let out a little steam about a difficult day at work. Social media is not the place to do it.

In the first post on this topic, my goal was to bring awareness to our community about the hazards of posting personally about clients. Although our clients may not see our personal posts (see Julie Hanks Digital Dual Relationship Dilemmas), our own personal communities will, and our reputation is built on that community.

While my personal profiles are private, my extended friendship community and family I am connected with on these sites, trust me and my ability to keep things confidential for their referrals What I portray on my personal and professional sites will reflect the reputation I have as a therapist.

Does this mean we cannot post anything at all about the work we do on our personal accounts? Certainly not! My heart is for fostering a safe environment for consumers so they will feel comfortable sharing with us in the intimate space of our offices, and assurance that their stories will be kept contained within the walls of our office. Here are some tips to protecting not only yourself but our therapeutic community at large when posting about your therapeutic work.

Think before you post

Ask yourself these questions: If my client saw this, would they like what I posted about them? Is this fostering a positive message about my therapeutic community? What are my motives for posting this (i.e., vent frustration, draw others to me through humor, etc.)? Am I venting my frustration in a way that protects my client and my reputation? Would it be better if I shared this with another colleague privately?

Keep your posts about work general and positive

After a recent couples intensive weekend, my co-facilitator and I were so blessed to see the positive transformation in the couples that attended our workshop. It inspired us. I posted on my personal Facebook profile, “So blessed to watch couples transform their relationships over this weekend at the couples retreat. I love my job!”  Nothing specific about what conversations took place. If one of the participants to read this, it would most likely reflect their own positive experience of the weekend. Occasionally, I have asked for permission from clients to share their inspiring story or something they have written (poem, inspiring reflection) in a blog or to post on my professional social media sites, and again, I keep the information general and positive. And I make sure it is in a place they can see this posted (even though I do not accept former or current clients on these sites—they are open to the public to view).

Develop safe relationships with like-minded colleagues in your own community

We all have funny and frustrating stories from work—no matter what profession we are in. Developing relationships with other therapists in your community can provide you with a group that follows the same values of confidentiality that you do. You can vent your day to them, share funny stories (without giving identifying information about your clients, of course!), and explore your own triggers and countertransference in confidence, instead of publicly.

Have grace with fellow clinicians who may violate this gray area

If you feel inclined, send them a private message with your concerns about their post. If it is done with a spirit of helpfulness, gentleness, and affirms their good intention, they will most likely be grateful.  If, after reading this, you realize that you may have posted something about a client that qualifies as negative or comical, have mercy on yourself! We are human, fallible and worthy of lots of grace in the uncharted territory of social media etiquette!

Kimberly Sandstrom is a Marriage & Family Therapist Intern and Relationship Educator, Supervised by Kathryn de Bruin, LMFT, working in private practice in San Diego, CA. Married for 24 years, she and her husband are raising three daughters, two of whom are now adults.  She works with couples, and families to create emotionally safe and enduring connections in their most cherished relationships.

social media image (c) CanStockPhoto

Why I 'Broke Up' With Managed Care (Part 2)

Several months ago I wrote a post titled, "Why I Broke Up With Managed Care" that stirred up some passionate discussion! While I understand that it's not the route for every private practitioner, I have continued to build a private practice free of managed care and recently hired my 12th therapist.

While we don't bill insurance directly, we do give a superbill to clients so they can seek reimbursement from their health insurance so they can still use their benefits. As I've continued to write this blog, I've come across several therapists who have also "broke up" with managed care and asked them why they decided to build a fee-for-service therapy practice. Here's what they had to say:

Increased Reimbursement Rate

I've been in private practice for over 15 years. So, I experienced the first major transition of health care to "managed" care. I had friends and colleagues who began working in the managed care industry, and it quickly became clear to me that despite all the rhetoric about the necessity for evidenced-based care (which can be a very useful model of care), managed mental health care was really about making corporate the work of individual psychotherapists.

I also did the math. The last time I checked, insurance reimbursement was the average rate charged by psychotherapists in the 1980s. Today, I can afford to have two additional office hours available for new clients, by taking just one fee-for-service patient. This also allows me more discretion in seeing clients who are needing a low fee. Will Courtenay, PhD, LCSW "The Men's Doc"

Control Over Therapeutic Work

I wanted the freedom to determine, along with parents, the course and length of treatment and felt managed care would impede on that. Pam Dyson, LPC, RPT

My training is in social work, which is the source of the old adage "start where the client is at." That's my barometer for treatment, not where an insurance company believes my client and I should start or end our work. Will Courtenay, PhD, LCSW "The Men's Doc"

Increased Client Commitment to Therapeutic Process

Being a Christian counselor, by law I cannot bill insurance, even if I could I think private pay gives each person responsibility in the therapeutic efforts. When people  have to pay it makes them take their  therapy more seriously. Natalie Davis

No Diagnosis Required

My services are specialized in that I will work with children as young as three, something many therapists in my area will not do. The problems child clients present with are often not clinical but rooted in the parent-child relationship. I feel strongly that young children do not need a diagnosis on their permanent health record. Pam Dyson, LPC, RPT

More Time With Clients (Less Time Doing Paperwork)

I had worked in a managed care setting in the past, and I decided that in my practice that I want to avoid the incredible amount of paperwork, defending sessions, and over-diagnosing.  I also think it provides clients with more privacy. Sara Levitsky, LMSW, Birmingham Counseling For Women

Paperwork was the other major decision (in building a fee-for-service practice). I put a great deal of time and energy into my work with clients outside of our scheduled hours, including receiving professional consultation on a consistent basis. I have no time or patience for administrative busywork. Will Courtenay, PhD, LCSW "The Men's Doc"

More Flexibility To Offer Reduced Fees

Like Dr. Courtenay mentioned earlier in this article, when his practice is doing well financially, he has more (not less) time to devote to seeing clients at a reduced fee. I have found the same to be true. As my practice grows I am able to offer more free community workshops and do more pro bono work.

Do you run a fee-for-service mental health therapy practice? What led to your decision?