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Do You Know Your Therapist’s Social Media Policy?

Understanding Therapy Consent Forms

We continue our series on informed consents for treatment in therapy with the discussion of social media policies. If you want to read more about informed consent for treatment check out our previous blogs here.

Over the past few years there has been a significant increase in the amount of therapists in the social media space. Whether a therapist is on Facebook, Instagram, or even TikTok, they probably have some form of a social media policy in place to protect you and themselves from a breach in boundaries.

So what exactly is a social media policy, and why is it important?

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A social media policy is a layer of legal/ethical understanding put into place in order to protect the therapeutic relationship between a client and their therapist. Therapists will often list this policy on their social media pages, in an informed consent, or through a verbal acknowledgement in session. This policy often looks something like this:

What a Social Media Policy looks like…

“In order to prevent breaches in confidentiality and the creation of any dual relationships, the therapist will not accept any “friend requests” or “follows” on any social media platform by any current or former client. If following a business account associated with the therapist, the therapist highly recommends to not engage in comments or direct messaging through these social media platforms as these are not regularly monitored and may put your confidentiality at risk of being breached. The therapist may not reply to any contacts made through various social media platforms. Do not use these platforms to request emergency resources.”

You may also see a version of these policies listed as “disclaimers” on a therapist’s social media accounts. These disclaimers often describe how to engage appropriately with these social media pages, expectations of interactions, ways to maintain confidentiality, and resources in case there is an emergency that needs immediate attention. Reading these policies and disclaimers is an important part of being informed as you enter into a therapy space.

Ultimately, these social media policies are in place to prevent the forming of dual relationships. Dual relationships are an ethical concern for mental health professionals, as it can deteriorate the professional relationship formed with a client. The professional and therapeutic relationship formed between a therapist and client should be the ONLY relationship formed between a therapist and client. Therapists should not form business relationships, friendships, or romantic relationships with their clients due to the risk of harming the client’s therapeutic progress and degrading a therapist’s professional lens when treating a patient. Therapist’s should always prioritize your growth and what is most therapeutically helpful.

If you aren’t sure if your therapist has a social media policy, always feel free to ask, so as not to cross a boundary that is ultimately in place for the betterment of your therapeutic work. For therapists, always be clear about what boundaries are in place to protect your client’s confidentiality and therapeutic process.

peace love happiness, Lee

What are the Limits to Confidentiality in Therapy?

Understanding Therapy Consent Forms Series

Reading over the consent for treatment is such an important step in starting therapy services. We continue our discussion today with the topic of limits to confidentiality in therapy. (Feel free to check out our previous discussions on “No Secrets” policies and the benefits of therapy.)

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Most of those outside of the mental health field find confidentiality and therapists to be one in the same. These two things feel synonymous as therapists are only second to lawyers when it comes to professionals who hold secrets for their clients. However, those within the mental health field know that confidentiality is actually our second most important priority. This is due to limits of confidentiality in therapy treatment.

Certain professionals are bound to codes of law & ethics. Doctors and therapists have similar codes when it comes to confidentiality. HIPAA laws require healthcare workers to protect a client’s private health information. Unlike lawyers (who practice attorney-client privilege), healthcare workers are required to breach confidentiality when it comes to safety concerns for clients.

So what exactly are the “limits to confidentiality”? Well, for therapists the limits include four things:

  1. Suspicion of child abuse (any person under 18 years of age) of any kind (physical, sexual, verbal, neglect, etc.)
  2. Suspicion of elder* abuse (any person over 65 years of age) of any kind (physical, sexual, financial, verbal, neglect, etc.). *This can also be applied to those with disabilities of any age.
  3. A credible threat to harm oneself
  4. A credible threat to harm someone else

Therapists are obligated to act on these four things because the #1 most important priority in therapy is the safety of a client and those around them. Therapists will report these things either in the moment, if it is time sensitive, or at the very latest within 36 hours of the disclosure of these occurrences.

We ultimately report these disclosures to authority figures such as the local police or child/adult protective services in order to increase the safety of those involved. If it is a suicidal or homicidal threat, the police will be called to escort the client to a hospital setting to get psychiatric care, and/or the threatened party will be notified for their safety. If it is a safety issue concerning a child, elder, or someone who is disabled, the appropriate protective services agency will be notified so they can reach out to those involved and provide appropriate resources to keep the family safe. This is why you may be asked your address at the beginning of every teletherapy session, so if an emergency arises your therapist can send the appropriate people to assist you in your time of need.

“Limits to confidentiality” is ultimately about safety. No therapist wants to see a client in harms way, or others in harms way due to a mental health crisis. So when you are beginning therapy there is no need to be surprised by your therapist mentioning these limits at the onset of treatment.

simplee therapy sign off. Peace, love, happiness, Lee.

Physical Health tied to Mental Wellness: 5 Ways to Reduce Stress in Your Day-to-Day Life

I recently experienced what so many of my clients come into session concerned about…physical aches and pains.

I woke up one morning with an aching pain in my jaw. It was like having a migraine in my mouth all day long. I tried to think back over the last few days…what had I been doing differently that could have caused this? After some self reflection and figuring out what the pain exactly was, I realized stress was the culprit. I had gotten to a place of extreme stress from working two jobs, being a mom, and managing all the calendars my household had to keep track of. I had begun clenching my teeth while I slept, which caused me to wake up in pain.

The solution to this pain? Physical therapy, mouth guards at night, and pain medication. Um…I don’t know about you, but none of that sounded like a solution or appealing in any way. They sounded more like management, than a cure.

So many of my clients come into session expressing symptoms of depression or anxiety or general stress, then will make a passing comment about chronic back pain, or chest tightness, or other physical ailments that they have been getting evaluated at a physician. They never tie the experience of physical health to their mental health however.

Disclaimer: I am not a physician, and you should always seek out medical professionals to have any physical health symptoms evaluated. This is in no way a replacement for medical assistance/ advice.

Minority women especially, are more likely to experience mental health concerns as physical symptoms in the body. These aches and pains are almost always directly related to your level of stress. In my personal experience, consciously working on reducing my stress enabled me to reduce my jaw pain to zero.

Now this does not mean medical intervention isn’t helpful, but it can work hand in hand with mental health interventions. Utilizing various coping strategies to reduce stress can assist in a speedy recovery.

Here are my top 5 coping strategies for managing stress:

  • 1. Mindfulness Breathing

  • Mindfulness breathing is a tool that can be utilized at any moment in your day and requires nothing more than the ability to breathe. Pausing in a moment of stress to take a deep inhale and slow exhale allows for your body to experience a sense of calm. It slows down your heart rate and reduces the idea that your body needs to go into “fight or flight” mode. If you want some assistance in practicing this technique try searching for “Guided Mindfulness Breathing” on YouTube, or download the “Calm” app on your mobile device.
  • 2. Journaling

    Journaling can be a great way to get thoughts out of your head and practice letting go of stress. Writing about your emotions whether it be grief, anger, joy, or a plethora of other emotions allows you to release these thoughts and reflect on how they are affecting you. An important aspect of journaling however is practicing to write about gratitude. Expressing gratitude for various aspects of your life provides balance to the challenges and emotions that occur on a daily basis. Nobody wants a book of sorrow, so incorporate both the good and bad.

    3. Skincare Routine

    This may seem frivalous, but hear me out. A regular skincare routine not only benefits your skin, but it gives you time to yourself. Depending on the type of skincare routine you implement (it could be as simple as rubbing some lotion on or as complex as a multi-step regimen) you can give yourself 2-30 minutes of “me time”. Being intentional about this time each day guarantees that you take a break and attend to your own needs even if only for a few minutes.

    4. Low-Impact Exercises

    Depending on your physical symptoms and with approval from your physician, try low- impact exercises such as walking or yoga. Walking is such an underrated exercise regimen. Taking time on your lunch break or before/after work to take a walk outside allows for more time in the sun, increased blood flow, and an overall mood boost. This physical activity kills two birds with one stone as it benefits your physical and mental health at the same time.

    5. Sleep Hygiene

    Last, but certainly not least, ensure you are getting enough sleep. How you feel when you wake up determines how well you’ll manage your stress throughout your day. The National Sleep Foundation recommends adults get 7-9 hours of sleep each night. Take a look at your daily schedule. Where is time wasted? And what could be moved around to create room for a decent bedtime? Also, take a look into what you are sleeping on. Maybe that futon from college isn’t cutting it anymore, or your mattress could use a new topper for support. Nobody has ever applauded themselves for having a late night and waking up groggy in the morning. Elevate this basic need to ensure a brighter day ahead.

    All these coping strategies can be used on a day-to-day basis to reduce the stress that is likely contributing to those physical ailments. Incorporating and practicing these stress-reducing skills will allow you to live a happier and healthier life. And if these things aren’t enough, try attending therapy!

    Cheaters: Why They Do It & How to Prevent It

    So you are in a “committed” relationship (or so you thought), but you have a nagging feeling that something isn’t right. Something is wrong. You start to dig for clues as to what is possibly going on, and slowly (but surely) drive yourself crazy wondering, “are they cheating??” Well I bet there is another question you haven’t asked yourself…”have I been meeting my partner’s needs?” Yep. I bet you haven’t taken a second to think “why would my partner cheat?”

    I wonder why you haven’t asked this question because there is only one reason why people cheat. Yes, one. Here’s the big, top secret reason…their needs are not being met.

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    That’s it. Every person needs certain things to be fulfilled. These things could be love, sex, passion, compassion, security, generosity, time, affection, and an assortment of other things. More often than not people wind up in a relationship where their partner cannot satisfy ALL of their needs. Now this is the point where you are probably thinking, “well if your needs aren’t being met, just break up with the person!” Relationships aren’t that simple. Imagine this…

    If our emotional needs looked more like our physical needs such as food, water, & shelter, how would things pan out? Imagine you were in a relationship where your partner is providing 2 out of 3 (water & shelter), but they were starving you. No food. You have dropped hints that you are hungry, maybe even straight up asked for food, but were denied 90% of the time. Then you come across someone who is offering up a feast on a silver platter. What are you going to do?

    A. Go home to your water & shelter and continue starving?

    B. Leave your whole life behind with only a guarantee of food (none of the water or shelter)?

    C. Or are you going to try and sneak enough food to meet your needs, then go home to a reliable source of water and shelter?

    Let’s be honest with ourselves, the last choice makes the most sense. Now putting this back into the emotional sense…when you partner with someone because they meet most of your needs, there is a risk that the needs that aren’t being met will be met somewhere else. The other option is to learn to live without that additional need, but that is often easier said than done.

    Now, you may be wondering “how do I prevent cheating from happening in my relationship?” Great question. Before I answer, I must remind you that relationships are SELFLESS acts. That means at any given point in a relationship you should be trying to meet the needs of your partner, while effectively communicating your needs as well.

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    The best way to prevent cheating is by utilizing the time you spend as a single person figuring out how you can meet your own needs. This allows you the time and energy when you enter a relationship to focus on how you can meet your partners needs. Because again, relationships are not about you! They are about having a mutual understanding that you will support one another. If you can figure out your own needs, then you will want to be with someone who has done the same, and neither of you will be looking for a partner to complete them. Because you are a WHOLE person. No one can “complete” you.

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    Here’s the trickier part. If you are already in a relationship and feel your needs aren’t being met, then you have to learn what it is you need, and teach yourself/partner how to meet that need. You cannot just say “I need your attention more.” You have to educate your partner on how they can give you more attention. Give them the who/what/when/where/why/how you learned in grade school. For example, if your need is sexual intimacy:

    Who needs to be meeting this need? Obviously it takes two to tango, so your partner needs to be involved in meeting this need.

    What is the need EXACTLY? Be clear. Is this need about actual sex, or is this need about general physical touch? Does foreplay meet this need? Would you like to kiss & hug more often? This is not just a single sentence answer. Go into detail.

    When is the appropriate time to meet this need? Everyone has a preference, but also when is it feasible to meet this need? Maybe kids are in the house so babysitters have to be arranged. Or maybe this is a need that needs to be met more than just once a month. When would you ideally like to meet this need? Be open to some compromise in the process.

    Where is the appropriate place to meet this need? The bedroom, a hotel, the shower? Hey, whatever floats your boat.

    Why is this need important to you? This may be the most important question. This is where you help your partner and teach your partner the reason behind the need. Maybe you feel like there is a general lack of intimacy, or maybe you feel insecure about how you look and want to feel desired by your partner. Again, not a place for a one sentence answer. Be descriptive.

    How can your partner support this need? Explain what role you would like them to play in supporting this need. If they can initiate sex more often or if they can provide compliments that make you feel sexy. Whatever it is, help your partner figure out how they can be supportive.

    No matter what your need is, utilize these questions to effectively communicate to your partner how you two can work as a team to meet each others’ needs. A relationship is about support and giving. Taking preventative steps to care for your partner can help reduce the likelihood of having to take drastic measures to put a relationship back together. And at the end of the day if you are finding it difficult to have these conversations, make a therapy appointment! Therapy is a great place to learn how to communicate effectively and efficiently.

    sign off

    Why I have a Waiting List: What To Do in the Meantime

    I know. You came here to schedule an appointment, but you saw I had a waiting list. You got yourself pumped up for starting therapy and were disappointed. I sincerely apologize. I created a waiting list so I know who to reach out to when an appointment opens up. I do not encourage rushing people through their therapeutic process, so as I help my current clients, I will try to leave you with some ideas on how to utilize your time and start the therapy process before your first appointment!

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    Photo by Fabrizio Verrecchia on Pexels.com

    Start Journaling

    One way to document your emotions, events in your life, or just ideas and to-do lists is by keeping a daily or weekly journal. The first question I ask all my clients is, “what brings you into therapy?” If you keep a record of how you have been feeling, you will have collected all the data necessary to answer this question. The therapeutic process would have started before you even walk in the door, and you’ll feel prepared for the work that happens in the therapy room.

    Do some Self Care

    If you are willing to dedicate an hour a week to therapy that means you have an hour in your schedule already to do some self care. Take that time now to schedule something just for you. Self care can look like taking a walk around the park, lake, or by the beach. It could be spending some time doing something creative like painting, coloring, or knitting. It could mean practicing mindfulness or meditation in a peaceful setting you create just for yourself (candles, mood lights, and white noise machines welcome!). Self care could also look like setting up a coffee date with some of your favorite people every week. Whatever you choose to do with your time make it all about self love!

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    Photo by rawpixel.com on Pexels.com

    Talk to your Support Network

    Maybe you can’t grab coffee every week, but maybe you can incorporate some other form of communication. Write a letter to an old friend or to someone you never got to say how you really feel too. Call up a sibling and laugh about old shenanigans or vent about your crazy parents. Join a book club or support group that helps you learn how to open up about your thoughts. Or just carve out time for you and your partner to connect every week. Who ever you give that time to, make sure it is spent with those that will add to your life instead of take away from it.

    Try Something New

    You thought therapy would be a new adventure for you to take. Why not try something else new and different from your normal routine? Being uncomfortable is a skill you will definitely utilize in therapy, so might as well practice now. Whether that is a new restaurant in town or a new hobby, get outside of your comfort zone and try something that the new you could really dive into!

    Reach out to one of the Referrals Provided

    If waiting isn’t something you are open to, please utilize one of the referrals emailed to you after adding your name to the waiting list. You could also call the following numbers to get resources more quickly!

    Mental Health Resources: 2-1-1

    Access & Crisis Line (San Diego): 1-888-724-7240

    Crisis Text Line: Text “HOME” to 741741

    National Suicide Prevention Lifeline: 1-800-273-8255

     

    I hope to see you soon along your path to wellness!