Social Work Boundary Issues in the Digital Age

Reflections of an Ethics Expert

Authors

  • Frederic Reamer Rhode Island College

DOI:

https://doi.org/10.18060/26358

Keywords:

dual relationships, ethics, technology, values, professional boundaries

Abstract

Throughout social work’s history, practitioners have faced challenging boundary issues. Boundary issues occur when social workers encounter actual or potential conflicts between their professional duties and their social, sexual, religious, collegial, or business relationships. Today's social workers face a wide range of boundary challenges that are unprecedented because of practitioners’ and clients’ widespread use of digital and other forms of internet-enabled technologies. This article presents a typology of boundary-related challenges arising out of social workers’ and clients' use of technology; reviews and applies emerging ethical and practice standards; and discusses risk-management protocols designed to protect clients and social workers. The author offers practical recommendations to protect clients and practitioners, including compliance with state-of-the-art ethics standards related to technology use and development of a comprehensive social media policy.

References

Association of Social Work Boards. (2015). Model regulatory standards for technology and social work practice. https://www.aswb.org/wp-content/uploads/2015/03/ASWB-Model-Regulatory-Standards-for-Technology-and-Social-Work-Practice.pdf

Banks, S., Cai, T., de Jonge, E., Shears, J., Shum, M., Sobocan, A., Strom, K., Truell, R., Uriz, M., & Weinberg, M. (2020). Practising ethically during COVID-19: Social work challenges and responses. International Social Work, 63, 569-583. https://doi.org/10.1177/0020872820949614

Barak, A., & Grohol, J. M. (2011). Current and future trends in Internet-supported mental health interventions. Journal of Technology in Human Services, 29, 155-196. https://doi.org/10.1080/15228835.2011.616939

Barglow, P. (2005). Self-disclosure in psychotherapy. American Journal of Psychotherapy, 59, 83-99. https://doi.org/10.1176/appi.psychotherapy.2005.59.2.83

Barsky, A. (2017). Social work practice and technology: Ethical issues and policy responses. Journal of Technology in Human Services, 35, 8-19. https://doi.org/10.1080/15228835.2017.1277906

Bograd, M. (1993). The duel over dual relationships. California Therapist, 5, 7-16.

Brodsky, A. M. (1986). The distressed psychologist: Sexual intimacies and exploitation. In R. R. Kilburg, P. E. Nathan, & R. W. Thoreson (Eds.), Professionals in distress: Issues, syndromes, and solutions in psychology (pp. 153-171). American Psychological Association. https://doi.org/10.1037/10056-008

Celenza, A. (2007). Sexual boundary violations: Therapeutic, supervisory, and academic contexts. Aronson.

Chester, A., & Glass, C. A. (2006). Online counseling: A descriptive analysis of therapy services on the internet. British Journal of Guidance and Counseling, 34, 145-160. https://doi.org/10.1080/03069880600583170

Drum, K. B., & Littleton, H. L. (2014). Therapeutic boundaries in telepsychology: Unique issues and best practice recommendations. Professional Psychology: Research and Practice, 45, 309-315. https://doi.org/10.1037/a0036127

Epstein, R. (1994). Keeping boundaries: Maintaining safety and integrity in the psychotherapeutic process. American Psychiatric Press.

Farber, B. A. (2006). Self-disclosure in psychotherapy: Patient, therapist, and supervisory perspectives. Guilford.

Finn, J. (2006). An exploratory study of email use by direct service social workers. Journal of Technology in Human Services, 24, 1-20. https://doi.org/10.1300/J017v24n04_01

Freddolino, P., Earle, M., & Hampson, R. (2022). Lessons from the field during a pandemic: Students’ views of ethics in e-therapy. Social Work Education. https://doi.org/10.1080/02615479.2022.2142550

Gabbard, G. O. (1996). Lessons to be learned from the study of boundary violations. American Journal of Psychotherapy, 50, 311-321. https://doi.org/ 10.1176/appi.psychotherapy.1996.50.3.311

Graffeo, I., & La Barbera, D. (2009). Cybertherapy meets Facebook, blogger, and second life: An Italian experience. Annual Review of Cybertherapy and Telemedicine, 7, 108-112.

Gutheil, T. G. (1989). Borderline personality disorder, boundary violations, and patient-therapist sex: Medicolegal pitfalls. American Journal of Psychiatry, 146, 597-602. https://doi.org/10.1176/ajp.146.5.597

Gutheil, T. G., & Simon, R. I. (1995). Between the chair and the door: Boundary issues in the therapeutic "transition zone." Harvard Review of Psychiatry, 2, 336-340. https://doi.org/10.3109/10673229509017154

Gutheil, T. G., & Simon, R. I. (2005). E-mails, extra-therapeutic contact, and early boundary problems: The internet as a "slippery slope." Psychiatric Annals, 35, 952-960. https://doi.org/10.3928/00485713-20051201-02

Herlihy, B. & Corey, G. (2015). Boundary issues in counseling: Multiple roles and responsibilities (3rd ed.). American Counseling Association. https://doi.org/10.1002/9781119221586

Javaid, M. (2023, March 14). Your therapist is on TikTok: Will your therapy session end up their too? Washington Post. https://www.washingtonpost.com/wellness/2023/03/10/tiktok-therapists-consent-forms-social-media-anonymity-identity/

Kanani, K., & Regehr, C. (2003). Clinical, ethical, and legal issues in e-therapy. Families in Society 84, 155-62. https://doi.org/10.1606/1044-3894.98

Kilburg, R. R., Kaslow, F. W., & VandenBos, G. R. (1988). Professionals in distress. Hospital and Community Psychiatry, 39(7), 723-725. https://doi.org/10.1176/ps.39.7.723

Knox, S., & Hill, C. E. (2003). Therapist self-disclosure: Research-based suggestions for practitioners. Journal of Clinical Psychology, 59, 529-540. https://doi.org/10.1002/jclp.10157

Kolmes, K. (2010). Developing my private practice social media policy. Independent Practitioner, 30, 140-42.

Kolmes, K., & Taube, D. O. (2016). Client discovery of psychotherapist personal information online. Professional Psychology: Research and Practice, 47, 147-154. https://doi.org/10.1037/pro0000065

LaMendola, W. (2010). Social work and social presence in an online world. Journal of Technology in Human Services 28, 108-19. https://doi.org/10.1080/15228831003759562

Lannin, D. G., & Scott, N. A. (2013). Social networking ethics: Developing best practices for the new small world. Professional Psychology: Research and Practice, 44(3), 135-141. https://doi.org/10.1037/a0031794

Lazarus, A. A., & Zur, O. (Eds.). (2002). Dual relationships and psychotherapy. Springer.

Menon, G. M., & Miller-Cribbs, J. (2002). Online social work practice: Issues and guidelines for the profession. Advances in Social Work, 3, 104-116. https://doi.org/10.18060/34

Midkiff, D., & Wyatt, W. J. (2008). Ethical issues in the provision of online mental health services (etherapy). Journal of Technology in Human Services, 26(2/4), 310-332. https://doi.org/10.1080/15228830802096994

Mossman, D. (2012). Facebook: Social networking meets professional duty. Current Psychiatry, 11, 34-37.

National Association of Social Workers. (2017). NASW Code of ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, and Clinical Social Work Association. (2017). NASW, ASWB, CSWE and CSWA standards for technology in social work practice. https://www.socialworkers.org/Practice/NASW-Practice-Standards-Guidelines/Standards-for-Technology-in-Social-Work-Practice

Pascoe, K. (2021). Considerations for integrating technology into social work practice: A content analysis of nine professional social work associations’ codes of ethics. International Social Work. https://doi.org/10.1177/0020872820980833

Peterson, M. R. (1992). At personal risk: Boundary violations in professional-client relationships. W. W. Norton.

Pope, K. S., & Bouhoutsos, J. (1986). Sexual intimacy between therapists and patient. Praeger.

Reamer, F. G. (2003). Boundary issues in social work: Managing dual relationships. Social Work, 48, 121-133. https://doi.org/10.1093/sw/48.1.121

Reamer, F. G. (2015). Risk management in social work: Preventing professional malpractice, liability, and disciplinary action. Columbia University Press. https://doi.org/10.7312/ream16782

Reamer, F. G. (2017). Evolving ethical standards in the digital age. Australian Social Work, 70, 148-159. https://doi.org/10.1080/0312407X.2016.1146314

Reamer, F. G. (2021a). Boundary issues and dual relationships in the human services (2nd ed.). Columbia University Press. https://doi.org/10.7312/ream19402

Reamer, F. G. (2021b). Ethics and risk management in online and distance social work. Cognella.

Reamer, F. G. (2023). Risk management in the behavioral health professions: A practical guide to preventing malpractice and licensing-board complaints. Columbia University Press. https://doi.org/10.7312/ream20830

Recupero, P. R., & Reamer, F. G. (2018). The Internet and forensic ethics. In E. Griffith (Ed.), Ethics challenges in forensic psychiatry and psychology practice (pp. 208-222). Columbia University Press. https://doi.org/10.7312/grif18330-014

Roberts, J. R. (2005). Transparency and self-disclosure in family therapy: Dangers and possibilities. Family Process, 44, 45-63. https://doi.org/10.1111/j.1545-5300.2005.00041.x

Santhiveeran, J. (2009). Compliance of social work e-therapy websites to the NASW code of ethics. Social Work in Health Care, 48, 1-13. https://doi.org/10.1080/00981380802231216

Schoener, G. R. (1995). Assessment of professionals who have engaged in boundary violations. Psychiatric Annals, 25, 95-99. https://doi.org/10.3928/0048-5713-19950201-08

Simon, R. I. (1992). Treatment boundary violations: Clinical, ethical, and legal considerations. Bulletin of the American Academy of Psychiatry and the Law, 20, 269-288.

Simon, R. I. (1995). The natural history of therapist sexual misconduct: Identification and prevention. Psychiatric Annals, 25, 90-94. https://doi.org/10.3928/0048-5713-19950201-07

Sonnenstuhl, W. J. (1989). Reaching the impaired professional: Applying findings from organizational and occupational research. Journal of Drug Issues, 19, 533-539. https://doi.org/10.1177/002204268901900407

Stricker. G., & Fisher, M. (Eds.). (1990). Self-disclosure in the therapeutic relationship. Plenum. https://doi.org/10.1007/978-1-4899-3582-3

Syme, G. (2003). Dual relationships in counselling and psychotherapy. Sage.

U.S. Department of Health and Human Services (2021, January 20). Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency. https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

VandenBos, G. R., & Duthie, R. F. (1986). Confronting and supporting colleagues in distress. In R. R. Kilburg, P. E. Nathan, & R. W. Thoreson (Eds.), Professionals in distress: Issues, syndromes, and solutions in psychology (pp. 211-231). American Psychological Association. https://doi.org/10.1037/10056-011

Zur, O. (2007). Boundaries in psychotherapy: Ethical and clinical explorations. American Psychological Association. https://doi.org/10.1037/11563-000

Zur, O. (Ed.). (2017). Multiple relationships in psychotherapy and counseling: Unavoidable, common, and mandatory dual relations in therapy. Routledge. https://doi.org/10.1037/11563-000

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Published

2024-01-30