Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

1. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace Keely Kolmes, Psy.D., Private Practice Daniel Taube, J.D., Ph.D., California School of Professional Psychology at Alliant International University

2. These are the major findings from our study. We will be writing up an article that we hope to publish in which we will go into greater detail. Please see the last slide for author contact information. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

3. Recruitment • Participants: N = 227 • Age range: 23 - 80 • Biological Sex: • 74% female • 26% male • 0.4% genderqueer • Sexual orientation: • 78% heterosexual • 8% bisexual • 8% lesbian • 6% gay • 2% queer • Recruitment method: • Internet-based convenience sample • Inclusion criteria: • Have been a provider of psychotherapy services • Utilize the Internet Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

4. Demographic Information • 89% were Caucasian, 3% were African American, 3% were Latino/Hispanic, 3% were bi-racial, 2 percent were Asian American, 2% were Native American, and 3% described themselves as “other.” • 90% were people without disabilities, and 10% had visual, orthopedic, auditory, cognitive or other disabilities. • The largest group (47%) earned between $30,000 and $70,000 per year. 12% earned less than $30,000, and 21% earned more than $70,000. • Participants were from 15 states within the US; 44% resided in California, and 7% resided outside of the United States. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

5. Services, training and licensure • 93% were currently providing therapy services. • 32% were in training: the bulk (68%) were not. • For those in training, 68% were seeking a doctoral degree in psychology, 17% a marriage and family therapy degree, and 13% counseling or other degrees. Only 1% were clinical social workers. • 64% were licensed, with most (59%) holding psychology, professional counselor (16%), clinical social work (12%) or marriage and family therapy licenses (10%). Two percent were psychiatrists. • 58% were providing online or e-therapy services, though most were providing such services for 5 hours or less per week (82%). • 79% had provided online services to a total of 10 or fewer clients. Some 11% had provided online services to 36 or more clients. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

6. Predominant theoretical orientation Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

7. Discovery of current client information on the Internet • 28% of therapists accidentally discovered information about current clients. The rest did not. • 48% of therapists intentionally sought information on current clients in non-crisis situations, without client awareness. • 47% discussed in treatment the client information they found on the internet--whether intentionally or accidentally. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

8. Sites on which Discovery was Made Accidental discovery of current clients (participants could choose more than one site):70% found information on Facebook, 19% on Google, 14% on LinkedIn, 11% on Shared email lists, 11% on Blogs, 6% on Twitter, 3% on Dating sites, 3% on MySpace, and 6% on Other sites. Intentional Discovery of current clients (participants could choose more than one site):76% found information on Google, 40% on Facebook, 8% on LInkedIn, 2% on a Blog, 2% on Dating Sites, 2% on Twitter, 1% on Yelp, and 14% on Other Sites. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

9. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

10. Crisis situations: • 8% of these clinicians intentionally searched for information about current clients on the Internet in a crisis situation. • Of those clinicians, 53% found information that was useful in resolving the crisis. (Examples included contact information, incarceration status, address for safety check by police, suicidal intent expressed on Facebook.) Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

11. Discovering information about a terminated client on the Internet • 23% accidentally found such information • 24% intentionally sought such information When intentionally seeking information about terminated clients, clinicians looked for such things as arrests, accidents, death, criminal history, outcome of legal action, accomplishments, whether clients reached life goals, general updates and well-being. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

12. Clients finding therapist information on the Internet • 28% of clinicians in this sample had a client find information about them on the internet. • 49% had a client request that they visit a client blog or social networking page on the web. • 63% of those clinicians honored that request. • 23% had had clients “fan,” “friend” or “follow” them. • Of those clinicians, 53% discussed that contact in treatment. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

13. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

14. Purpose of Client requests for Therapist to Visit Their Site • Client wanted therapist to view artwork, writing, or other personal information on a site. • Client wanted therapist to read feelings expressed on a blog. • Client wanted therapist to better know client as a full and complete person. • Client wanted therapist to see client’s family/friends. • Client wanted therapist to provide feedback on a public interaction. Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace

15. Thank you so much for participating in our research and for visiting our site for results. If you have any questions, please feel free to contact us. Keely Kolmes, Psy.D. can be reached at drkkolmes@hushmail.com Results: http://www.drkkolmes.com/research Dan Taube, J.D., Ph.D., can be reached at dtaube@alliant.edu Results: http://www.snurl.com/n64nv Findings on Therapist-Client Interactions on the Internet: Boundary Considerations in Cyberspace