Google and Facebook raise new issues for therapists and their clients

... Across the country, therapists are facing similar situations and conflicted feelings. When Huremovic, director of psychosomatic medicine services at Nassau University Medical Center in New York, recounted his vignette last year at an American Psychiatric Association meeting and asked whether others would have read the suicidal man's blog, his audience responded with resounding calls -- of both "yes!" and "no!" One thing was clear: How and when a therapist should use the Internet -- and even whether he or she should -- are questions subject to vigorous debate.

"We are just beginning to understand what ethical issues the Internet is raising," says Stephen Behnke, ethics director for the American Psychological Association. "To write rules that allow our field to grow and develop and yet prevent [patient] harm at the same time: That's the challenge."

In fact, the tremendous availability online of personal information threatens to alter what has been an almost sacred relationship between therapist and patient. Traditionally, therapists obtained information about a patient through face-to-face dialogue. If outside information was needed, the therapist would obtain the patient's consent to speak with family members or a previous mental-health practitioner. At the same time, patients traditionally knew little about their therapists outside the consulting room. Now, with the click of a mouse, tech-savvy therapists and patients are challenging the old rules and raising serious questions about how much each should know about the other and where lines should be drawn.

Among the questions under debate:

Should a therapist review the Web site of a patient or conduct an online search without that patient's consent?

Is it appropriate for a therapist to put personal details about himself on a blog or Web site or to join Facebook or other social networks?

What are the risks of having patients and therapists interact online?

Neither the American Psychiatric Association nor the American Psychological Association has rules specifically governing therapists' online behavior, but ethics advisers with the psychiatric association maintain that online searches are not wrong -- as long as they're done in the patient's interest and not out of therapist curiosity. ...

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