3 hours of ethics-focused instruction

Social Media Ethics
for Therapists

Meeting Clients Where They're @

This course helps therapists understand how social media shapes client trust, help-seeking, and the therapeutic relationship before the first session. Grounded in original dissertation research, it gives clinicians a practical framework for evaluating professional online activity in a way that is intentional, ethical, and protective of both the client and the clinician.

Course at a Glance
3.0
ethics-focused instruction
7
Modules
20
Question Post-Test
80%
Passing Score
Unlimited
Attempts
Certificate
Issued upon completion
🎓
Dr. Markyse Bernadin, PhD, LCSW
Mental Retune | mentalretune.com
📊
Original Dissertation Research
Barry University, 2024 (n=177)
After completing this course, participants will be able to:
  1. Describe why therapist online visibility is a clinical, ethical, and informed consent issue within the current digital landscape.
  2. Explain how clients use social media and other information and communication technology to understand symptoms, evaluate fit, and decide whether to seek care, drawing on original dissertation research (Bernadin, 2024).
  3. Identify key ethical risks in digital spaces, including boundary violations, dual relationships, confidentiality concerns, and parasocial dynamics, as informed by NASW, ACA, and AAMFT ethical standards.
  4. Analyze original research findings on client perceptions of clinician social media behavior, including directiveness preferences, help-seeking attitudes, and the non-significance of demographic predictors.
  5. Apply the CARE Framework (Clarity, Accountability, Responsibility, Engaging Sustainably) to ethical decision-making regarding online presence and social media content.
  6. Develop a written social media policy appropriate for clinical practice, including platform-specific considerations and informed consent language.
  7. Develop a sustainable process for reviewing your online activity, boundaries, informed consent language, and social media policy in clinical practice.
Dr. Markyse Bernadin, PhD, LCSW

Dr. Markyse Bernadin is a licensed clinical social worker, doctoral researcher, and the founder of Mental Retune, a private practice based in North Miami, Florida. She earned her Doctor of Philosophy from Barry University (2024), where her dissertation examined client perceptions of mental health clinicians on social media, research that forms the empirical foundation of this course.

Dr. Bernadin's clinical and academic work sits at the intersection of digital ethics, therapeutic relationship formation, and professional identity. She has designed this course, planned its instructional objectives, and is responsible for ongoing content evaluation and revision. She holds expertise in social media ethics as a psychotherapist navigating digital spaces and as a researcher who has studied the client experience within them.

Contact: ready@mentalretune.com

This course is grounded in original doctoral dissertation research (Bernadin, 2024) and supplemented by professional ethical standards and peer-reviewed literature. Dissertation findings are labeled "Dissertation Finding" and reflect empirical results from a study of n=177 participants. Literature-informed concepts and instructor interpretations are clearly distinguished from empirical findings throughout the course.

Use of AI. AI assistance was used for formatting, editing, and accessibility support. Course content, clinical interpretation, research application, and final review were completed by the instructor.

Completion Requirements

Complete all 7 modules, pass the 20-question post-test with 80% or higher, submit the evaluation, and generate the certificate.

Post-Test Policy

Unlimited attempts. Missed questions are shown with educational feedback after each attempt. No lockout period.

Attendance & Completion Tracking

When all requirements are met, a completion record is submitted to Mental Retune's administrative recordkeeping system. Certificate of completion is awarded only after all requirements are met and the record is successfully saved.

Record Retention

Mental Retune maintains CE completion records, including participant name, email, license number, completion date, post-test score, evaluation confirmation, certificate ID, and instructional hours completed, for a minimum of six years through its administrative recordkeeping system.

Module 1 of 7

The Digital Landscape for Clinicians

How online visibility shapes client trust, boundaries, and expectations

⏱ 20 minutes
Exposure Audit + Visibility Spectrum
Your online presence starts the therapeutic relationship.

Many clients and prospective clients may look you up before they schedule, and they may continue viewing your content while therapy is active. What they find can shape how they understand you, what they expect from therapy, and what they feel safe enough to share.

That makes social media more than just a public communication tool. Social media is now part of clinical practice and relevant to ethical considerations. Your online presence can influence the conditions that support treatment, including trust, expectations, disclosure, and informed consent, which means it belongs in your informed consent process and social media policy before confusion or harm occurs.

Consider what each part of your online presence reveals about your practice.

🪪 Your Professional Footprint

Directory profiles, your website, license records, and the concerns you say you treat. Clients may use these to judge legitimacy and fit before they call.

👤 Your Personal Life

Photos, family, location, beliefs, and lifestyle that surface through personal or blended accounts. Clients may read your values and infer your ability to relate to them.

🗣️ Your Clinical Voice

The posts, videos, and opinions you publish about mental health. Clients may infer your style, your stance, and how you might treat them from how you speak publicly.

🔁 What Others Post

Reviews, tags, comments, and mentions you do not control. Clients may see these first and assess them as heavily as anything you post yourself.

Literature-Informed Concept

Whatever you publish functions as a form of professional self-disclosure. In person, you decide how much of yourself to reveal; online, those same decisions are made through what you post, share, and leave visible. Some clinicians choose a neutral, minimally disclosing presence, while others use selective self-disclosure to model and normalize healthy coping. Both can be ethical. What matters is that the choice is deliberate, shaped by your theoretical orientation, your client population, and your professional boundaries, rather than left to default. The guiding question for any disclosure is whether it stays privacy-protective and connected to client welfare.

Drude, K. P., Messer-Engel, K., & O'Neil, D. (2021). The development of social media guidelines for psychologists and for regulatory use. Journal of Technology in Behavioral Science, 6, 388–396. https://doi.org/10.1007/s41347-020-00176-1

National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, & Clinical Social Work Association. (2017). Standards for technology in social work practice. National Association of Social Workers.

White, E., & Hanley, T. (2023). Therapist + social media = mental health influencer? Considering the research focusing upon key ethical issues around the use of social media by therapists. Counselling and Psychotherapy Research, 23(1), 1–5. https://doi.org/10.1002/capr.12577

Wu, K. S., & Sonne, J. L. (2021). Therapist boundary crossings in the digital age: Psychologists' practice frequencies and perceptions of ethicality. Professional Psychology: Research and Practice, 52(4), 419–427. https://doi.org/10.1037/pro0000407

Kolmes, K. (2017). Digital and social media multiple relationships on the internet. In O. Zur (Ed.), Multiple relationships in psychotherapy and counseling: Unavoidable, common, and mandatory dual relations in therapy (pp. 185–195). Routledge/Taylor & Francis Group.

Johnsen, C., & Ding, H. T. (2021). Therapist self-disclosure: Let's tackle the elephant in the room. Clinical Child Psychology and Psychiatry, 26(2), 443–450.

Drag the slider to explore the clinical and ethical implications at each level of online visibility.

Fully Private
Selective
Fully Public
Selective Presence: Some professional content, carefully curated. Strength: balances accessibility with control over what is visible. Limitation: partial visibility can read as inconsistent unless the curation is deliberate.
Why can a therapist's online activity raise clinical and ethical issues?
How visible are you online right now, and which parts of that visibility reflect a deliberate clinical choice versus something that happened by default?
Responses are stored locally and never transmitted.
Module 2 of 7

Online Help-Seeking and Client Evaluation

What prospective clients are doing online before they become clients

⏱ 25 minutes

Help-seeking does not begin at the first appointment. For many clients, it begins privately through information and communication technology (ICT): search engines, directories, social media, online reviews, mental health content, and peer conversations. People use the internet to better understand health concerns, reduce uncertainty, and decide whether professional help feels safe or relevant. This matters because many people who experience mental health concerns also face barriers to care, including stigma, family beliefs, limited mental health literacy, cost, transportation, wait times, cultural mistrust, and concerns about privacy.

By the time someone contacts you, they may have already encountered your website, directory profile, or social media and asked themselves: Can this person understand me? Will my privacy be protected? Do they seem competent with what I am facing? Do they appear culturally responsive? Would I feel safe enough to disclose here?

Click each stage to understand the help-seeking journey and what may happen before clients contact you.

Stage 1 / Awareness
Something Feels Wrong
Before a client contacts a therapist, they may have already encountered mental health content online or on social media. That content can shape their understanding of therapy, their expectations of a therapist, and their sense of whether help is available for someone like them.
Stage 2 / Research
Googling, Scrolling, and Vetting
Many clients may research potential therapists before first contact. The online content they find can either reassure or amplify the ambivalence many bring to help-seeking.
Stage 3 / Pre-Treatment Evaluation
Forming Impressions Before First Contact
What clients find online shapes their expectations, trust level, and readiness to disclose during consultation or first session.
Stage 4 / Active Treatment
Ongoing Awareness
Clients in active treatment may continue following their therapist and viewing their therapist's content. Without a social media policy in informed consent, clients don't have expectations for what they encounter, and you won't have a structure for addressing it therapeutically.
Stage 5 / Post-Treatment
The Relationship That Does Not Fully End
Former clients may follow therapists online indefinitely. Without intentional boundary policies, a closed therapeutic relationship becomes an ongoing one-way connection.

Online behavior does not automatically become a clinical issue. It becomes clinically relevant when it affects trust, boundaries, safety, confidentiality, or the therapeutic relationship. Flip each card to see the clinical response.

📸
Following or viewing therapist content
Flip for clinical response
Clarify boundaries and explore meaning if it enters treatment.
💬
Sending DMs
Flip for clinical response
Redirect to approved communication channels and document the contact if clinically relevant.
🗨️
Commenting on public content
Flip for clinical response
Avoid confirming the therapeutic relationship publicly and address confidentiality risk if needed.
❤️
Using posts for coping between sessions
Flip for clinical response
Discuss whether the client is relying on public content as informal support outside the treatment plan.
🔔
Turning on notifications or closely monitoring content
Flip for clinical response
Explore attachment, dependency, reassurance-seeking, or parasocial dynamics if clinically relevant.
🔍
Discovering therapist personal information
Flip for clinical response
Hold space for the client to process the impact on trust, comfort, and expectations.
Literature-Informed Concept

When prospective clients evaluate your online presence, they are often weighing more than personality. They may be reading for professional experience and training, fit with their presenting concern, perceived competence, and cultural responsiveness. Practical signals matter too: reviews and testimonials, accessibility, office location, and whether you take their insurance. Alongside these, clients form personal and professional impressions that shape whether reaching out feels safe. None of this is a clinical assessment on the client's part. It is pre-treatment evaluation, and it often decides whether a first contact happens at all.

Ellis, D. M., Guastello, A. D., Anderson, P. L., & McNamara, J. P. H. (2019). How racially concordant therapists and culturally responsive online profiles impact treatment-seeking among Black and White Americans. Practice Innovations, 4(2), 75–87. https://doi.org/10.1037/pri0000084

Han, X., Lin, Y., Han, W., Liao, K., & Mei, K. (2024). Effect of negative online reviews and physician responses on health consumers' choice: Experimental study. Journal of Medical Internet Research, 26, e46713. https://doi.org/10.2196/46713

Kozikowski, A., Morton-Rias, D., Mauldin, S., Jeffery, C., Kavanaugh, K., & Barnhill, G. (2022). Choosing a provider: What factors matter most to consumers and patients? Journal of Patient Experience, 9, 23743735221074175. https://doi.org/10.1177/23743735221074175

Sadusky, A., Yared, H., Patrick, P., & Berger, E. (2024). A systematic review of clients' perspectives on the cultural and racial awareness and responsiveness of mental health practitioners. Culture & Psychology, 30(3), 567–605. https://doi.org/10.1177/1354067X231156600

The dissertation that informs this course found a mean help-seeking attitude score of 3.90 on a 7-point scale. What does this finding most directly suggest for clinical practice?
When a client arrives for a first session, what online impressions might they already be carrying into the room?
Module 3 of 7

Ethical Risks in Digital Spaces

Understanding the clinical and ethical terrain through the professional literature and real scenarios

⏱ 30 minutes

Before you can apply an ethical decision-making framework for posting online, you need to be able to name what's realistically at stake.

🌊
Boundary Confusion
When repeated digital exposures blur the clinical frame.

One post may not create a problem on its own, but repeated exposure can change how a client understands you, relates to you, or feels in session. When clients begin seeing pieces of your life, personality, opinions, or availability outside the therapy room, it may blur the professional dynamic.

Citation: Reamer (2023)

🔄
Online Dual Relationships
Holding both a therapeutic and a public-facing role at once.

When a therapist's clinical role overlaps with another public-facing role, such as educator, content creator, business owner, or community member. A second relational context may form outside the therapy room by a client following, messaging, commenting, or interacting with you in a public space.

Citation: Smith, Jones, & Hunter (2023)

🔍
Unintentional Self-Disclosure
Personal information surfacing online without intending it to.

Online self-disclosure is not limited to what you choose to say directly. Clients may learn about your personal life, beliefs, relationships, location, or emotions through posts, likes, tags, comments, or your content being shared beyond your intended audience. Once that information is seen, it can become part of how the client experiences you in therapy.

Citation: Haimson et al. (2021)

🧲
Parasocial Dynamics
A one-sided sense of closeness a client may develop toward you.

When repeated exposure to a therapist's online content creates a sense of closeness or familiarity that is not mutual in the same way as the therapeutic relationship. Over time, clients may feel more connected to the therapist, expect more access, or bring assumptions into treatment based on what they have seen online.

Citation: Hoffner & Bond (2022)

🔒
Confidentiality Risks
Signals that can inadvertently reveal who is, or may be, a client.

Risks can emerge when online interactions make a private clinical relationship more visible than the client intended. Follows, comments, tags, shared connections, location data, or public replies can create clues that allow others to infer a client's connection to the therapist.

Citation: van der Boon et al. (2024)

💬
Direct Messages
Private messaging outside documented, HIPAA-compliant channels.

Clients may send DMs for scheduling, disclosure, crisis contact, or reassurance, even when the platform is not appropriate for those purposes. A clear policy helps define what happens when clients contact you there.

Citation: Soubra et al. (2022)

📱
Out-of-Session Contact
Any therapist-client interaction happening outside the session.

Any therapist-client interaction that occurs outside the therapy session. Online, this can happen through follows, likes, comments, DMs, story views, or shared digital spaces. Even small interactions can shape what the client expects from you and how they experience the clinical relationship.

Citation: Giuffrida et al. (2024)

Reviews and Testimonials
Public feedback that raises distinct confidentiality questions.

Responding to a review may confirm a clinical relationship, even when the response is brief. Asking clients for testimonials can also place pressure on them to publicly support the therapist or practice.

Citation: Placona & Rathert (2022); Mahar et al. (2022)

🚧
Content Boundary Risk
Content that can change how a client experiences your role.

What you post online may affect the clinical relationship. Content involving strong opinions, intoxication, sexual material, hostility, or highly private disclosures may affect trust, safety, or a client's willingness to be open in session.

Citation: Dalton et al. (2026)

🏷️
Social Class and Lifestyle Disclosure
Posts that unintentionally signal wealth, status, or lifestyle.

Social media may reveal information about money, status, access, or daily life that may affect how a client sees the therapist. Posts about travel, luxury, housing, relationships, or professional success can unintentionally create distance or comparison. When these differences become visible, therapists may need to consider how they shape trust, safety, and what clients feel able to share.

Citation: Engstrom et al. (2024)

🛰️
Client-Profile Discovery
Coming across a client's profile without ever searching for it.

A client's post may appear through mutual connections, platform suggestions, comments, tags, or your own feed. Even when you did not search for it, seeing client content outside the therapy room can raise questions about privacy, safety, documentation, and whether it should be addressed in session.

Citation: Ryan-Blackwell et al. (2024)

Soubra, R., Hasan, I., Ftouni, L., Saab, A., & Shaarani, I. (2022). Future healthcare providers and professionalism on social media: A cross-sectional study. BMC Medical Ethics, 23, Article 4. https://doi.org/10.1186/s12910-022-00742-7

Smith, K. M., Jones, A., & Hunter, E. A. (2023). Navigating the multidimensionality of social media presence: Ethical considerations and recommendations for psychologists. Ethics & Behavior, 33(1), 18–36. https://doi.org/10.1080/10508422.2021.1977935

Haimson, O. L., Liu, T., Zhang, B. Z., & Corvite, S. (2021). The online authenticity paradox: What being "authentic" on social media means, and barriers to achieving it. Proceedings of the ACM on Human-Computer Interaction, 5(CSCW2), Article 423. https://doi.org/10.1145/3479567

Hoffner, C. A., & Bond, B. J. (2022). Parasocial relationships, social media, & well-being. Current Opinion in Psychology, 45, Article 101306. https://doi.org/10.1016/j.copsyc.2022.101306

van der Boon, R. M. A., Camm, A. J., Aguiar, C., Biasin, E., Breithardt, G., Bueno, H., Drossart, I., Hoppe, N., Kamenjasevic, E., Ladeiras-Lopes, R., McGreavy, P., Lanzer, P., Vidal-Perez, R., & Bruining, N. (2024). Risks and benefits of sharing patient information on social media: A digital dilemma. European Heart Journal - Digital Health, 5(3), 199–207. https://doi.org/10.1093/ehjdh/ztae009

Placona, A. M., & Rathert, C. (2022). Are online patient reviews associated with health care outcomes? A systematic review of the literature. Medical Care Research and Review, 79(1), 3–16. https://doi.org/10.1177/10775587211014534

Giuffrida, A., Saia-Owenby, C., Andriano, C., Beall, D., Bailey-Classen, A., Buchanan, P., Budwany, R., Desai, M. J., Comer, A., Dudas, A., Francio, V. T., Grace, W., Gill, B., Grunch, B., Goldblum, A., Garcia, R. A., Lee, D. W., Lavender, C., Lawandy, M., et al. (2024). Social media behavior guidelines for healthcare professionals: An American Society of Pain and Neuroscience NEURON Project. Journal of Pain Research, 17, 3587–3599. https://doi.org/10.2147/JPR.S488590

Reamer, F. G. (2023). Social work boundary issues in the digital age: Reflections of an ethics expert. Advances in Social Work, 23(2). https://doi.org/10.18060/26358

Dalton, C., Sarwar, Z., Garwe, T., & Hunter, C. J. (2026). Evaluating perceptions of social media professionalism by healthcare workers. Digital Health, 12, Article 20552076251411281. https://doi.org/10.1177/20552076251411281

Engstrom, H. R., Laurin, K., Kay, N. R., & Human, L. J. (2024). Socioeconomic status and meta-perceptions: How markers of culture and rank predict beliefs about how others see us. Personality and Social Psychology Bulletin, 50(9), 1386–1407. https://doi.org/10.1177/01461672231171435

Mahar, P. D., Panaccio, D. C. A., Dean, J. M., Farmer, C. C., Pang, S. C., & Kevat, D. A. S. (2022). Managing negative online reviews: Considerations for doctors. Australian Journal of General Practice, 51(8), 568–570. https://doi.org/10.31128/AJGP-10-21-6215

Literature-Informed Concept

Ethical social media use is not only about avoiding boundary violations. The same duties that govern the rest of your practice apply online: to promote client wellbeing (beneficence) and to avoid doing harm (nonmaleficence). These duties surface in concrete moments. You might accidentally discover a client's content and feel unsure whether it rises to mandated reporting. You might wonder whether to raise alarming online material with a client or leave it alone. In each case, the responsible path usually runs through consultation, careful documentation, and attention to the client's privacy, while staying aware that a client may feel shame, embarrassment, or anger if they learn you saw something. Holding both duties at once, doing good and avoiding harm, is the heart of ethical digital practice.

Ryan-Blackwell, G., Jackson, J., & Haider, S. (2024). When and in what circumstances is patient-targeted Googling acceptable for health and social care professionals? A narrative review and thematic analysis. Health Informatics Journal, 30(3), 1–14. https://doi.org/10.1177/14604582241285756

The following scenarios help you explore ethical dilemmas that can arise when you use social media. Choose the best response and receive immediate feedback.

Scenario A
The Late-Night Post
Dr. Reyes posts at 11pm: "Compassion fatigue is real. Some days I wonder if I chose the right field." A current client sees it the next morning and arrives visibly distressed, asking: "Are you okay? Are you going to stop being my therapist?"
What is the most clinically and ethically sound response?
Scenario B
The Online Review
A counselor discovers a 1-star Google review: "This therapist abandoned me when I needed help most." She suspects it is from a former client whose treatment ended six months ago after a difficult session. The review is affecting referrals.
Which response best balances ethical obligations, clinical integrity, and professional reputation?
Scenario C
The Viral Post
A therapist's post about anxiety goes unexpectedly viral with 200,000 shares. In the comments, a current client and the therapist's cousin appear to be connecting with each other and making plans to meet, not knowing how they're both connected to the therapist.
What does this most directly illustrate, and what is the immediate clinical priority?
Which risk is most present in your online presence right now, and what is one boundary or policy change you can implement this week?
Module 4 of 7. Dissertation Findings

What Participants Shared

A structured exploration of the original dissertation data: quantitative findings, qualitative themes, and clinical implications

🔬 Barry University, 2024 (n=177)
📊 C-NIP + MHSAS instruments
⏱ ~35 minutes
Research Transparency Statement

Research findings presented in this module are drawn from the instructor's doctoral dissertation (Bernadin, 2024). Findings labeled as Dissertation Finding represent empirical results from that study. Instruments used include the Mental Help Seeking Attitudes Scale (MHSAS) and the Cooper–Norcross Inventory of Preferences (C-NIP), adapted for this study. Clinical interpretations and practice recommendations represent the instructor's professional application of those findings and are labeled accordingly.

177
Completed responses
Online survey, 2024
69%
Preferred clinician directiveness
C-NIP measure
68%
Preferred emotional intensity
C-NIP measure
3.90
Mean help-seeking attitude score
Out of 7.0 (MHSAS: Mental Help Seeking Attitudes Scale)

For a qualitative perspective of participant preferences, this study asked participants which types of content they would prefer to see from a therapist that they follow on social media.

Open-ended survey responses, sized by frequency. Dissertation data, 2024.
Word cloud of participant responses describing what clients find encouraging in clinician online content, with 'Encouraging' and 'Educational' as the most frequent terms

Click the tabs below to explore the dissertation quantitative findings, the qualitative themes, and the clinical implications.

Scale 1: Directiveness Preference (C-NIP)
Therapist directiveness vs. no strong preference vs. client directiveness. n=177
80%60%40%20% 69%Therapist Directiveness 28%No Strong Preference 3%Client Directiveness
Scale 2: Emotional Intensity Preference (C-NIP)
Emotional intensity vs. no strong preference vs. emotional reserve. n=177
80%60%40%20% 68%Emotional Intensity 24%No Strong Preference 8%Emotional Reserve
Scale 3: Orientation Preference (C-NIP)
Past orientation vs. no strong preference vs. present orientation. Near-equal three-way split. n=177
40%30%20% ~34%Past Orientation ~33%No Strong Preference ~33%Present Orientation
Scale 4: Disposition Preference (C-NIP)
Warm support vs. no strong preference vs. focused challenge. n=177
80%60%40%20% 43%No Strong Preference 29%Warm Support 28%Focused Challenge

In summary, participants in this sample preferred clinician directiveness and emotional intensity in the online therapeutic relationship, while showing no dominant preference regarding session orientation or therapist disposition. This leaves room for therapists' personal style.

Dissertation Finding: Client Preferences and Demographics
Across the sample (n=177), participants showed a strong preference for clinician directiveness (69%) and emotional intensity (68%), while orientation and disposition each showed no dominant preference. Race, age generation, and gender identity were not statistically significant predictors of these preferences. F=1.008, p=.441.
Clinical Interpretation
More clients in this sample wanted a therapist who is engaged, direct, and emotionally present rather than neutral. But which client wants that cannot be predicted from demographic category. Preference is individual, not demographic.
Ethical Implication
Ask instead of assume. Use informed consent and direct conversation, not demographic guesswork, to learn what a specific client prefers.
📌

These six themes are synthesized from the qualitative findings of the dissertation that informs this course. They represent patterns identified in participant responses, not verbatim categories from the original analysis. Each is labeled as a Dissertation Finding and should be understood as a thematic summary, not a direct quotation or statistical result.

🎭 Authenticity and RelatabilityHighest Frequency Pattern
Dissertation Finding
Participants generally valued authentic self-presentation balanced with professionalism. Clinician content perceived as performative or lacking genuine engagement was viewed less favorably.
Clinical Interpretation
Clients in the sample were not seeking curated perfection. They responded to content that read as genuine, which suggests authenticity and professional boundaries can coexist rather than compete.
Ethical Implication
Consider how a post balances relational honesty with the professional frame. Content can be personal in tone without disclosing material that shifts focus away from the client.
📚 Educational and Practical ContentHigh Frequency Pattern
Dissertation Finding
Participants tended to favor applied, skill-oriented content over general awareness messaging. Practical utility was a consistent factor in how clinician content was evaluated.
Clinical Interpretation
Psychoeducational and skills-based content appears to be valued by prospective and current clients, which supports its use as part of an ethical online presence.
Ethical Implication
Watch for content that mirrors in-session interventions closely enough to function as informal treatment. Frame educational content as general information, not individualized care.
🌍 Cultural Sensitivity and RepresentationSignificant Pattern
Dissertation Finding
For some participants, particularly those from marginalized communities, a clinician's online presence was described as one factor in evaluating potential fit and cultural responsiveness prior to direct contact.
Clinical Interpretation
Online content may function as an early, informal signal of cultural responsiveness before a client ever reaches out, particularly for clients who have had difficulty finding responsive care elsewhere.
Ethical Implication
Consider how your online presence reflects cultural humility and responsiveness, while recognizing this is one factor among many in a client's decision to seek care.
🌱 Personal Development and GrowthPresent Pattern
Dissertation Finding
Participants tended to respond positively to content addressing growth, change, and lived experience. Content that normalized difficulty while modeling healthy coping was rated as meaningful.
Clinical Interpretation
Content drawing on lived experience or personal growth may resonate with clients navigating similar difficulty, but it also places the clinician's own narrative in a public space.
Ethical Implication
Before sharing personal growth content, consider whether it serves client wellbeing or shifts relational focus toward the therapist's story. When in doubt, keep the client's needs at the center.
💡 Emotional Management ToolsPresent Pattern
Dissertation Finding
Some participants reported independently using clinician-generated content for support between sessions. This behavior was not clinically sanctioned and raises considerations regarding boundaries and informed consent.
Clinical Interpretation
Clients may treat public content as an informal coping resource outside the treatment plan, without the clinician's awareness or agreement.
Ethical Implication
Address between-session content use directly in informed consent and social media policy, including how to raise it if you notice it happening.
🔨 Real-World ApplicationPresent Pattern
Dissertation Finding
Content connecting clinical concepts to everyday experience was rated more engaging and useful than abstract or theoretically framed material.
Clinical Interpretation
Applied, situation-specific content may be more effective at reaching prospective clients, but that same specificity increases the risk a post could feel targeted at a current client's disclosed situation.
Ethical Implication
When writing applied examples, generalize enough that no current client could reasonably see themselves depicted in the scenario.

The quantitative and qualitative findings above point toward a few broader practice takeaways. These are not new data points. They are the synthesis this module builds toward.

Ask instead of assume

Demographics (race, age generation, gender identity) did not significantly predict client preference across the C-NIP scales in this sample (F=1.008, p=.441). Content and engagement decisions are better grounded in what an individual client tells you than in assumptions based on demographic category.

Visibility can shape access

A mean help-seeking attitude score of 3.90/7.0 suggests ambivalence about seeking care is common. For some participants, especially those from marginalized communities, a clinician's online presence functioned as an early signal of fit and cultural responsiveness before first contact.

Authenticity needs a clinical frame

Participants valued genuine, human content over polished or performative posts, but authenticity is not a substitute for professional boundaries. The two can coexist when personal tone stays within a clear ethical frame.

Educational content is not treatment

Skills-based, applied content was consistently valued, but content that mirrors in-session work, or that is specific enough for a client to see themselves in it, blurs the line between public education and individualized care.

Between-session use needs policy language

Some participants described using clinician content as informal support between sessions. This use is not clinically sanctioned by default. It belongs in informed consent and social media policy, not left as an unaddressed gap.

What do you assume clients and prospective clients want from your online presence, and how can you check those assumptions before building content around them?
Module 5 of 7. CARE Framework Application

Applying CARE to Real Clinical Scenarios

Practice the CARE ethical decision-making framework across five realistic scenarios with immediate, detailed feedback

🎯 5 scenarios
💬 Step-by-step feedback
⏱ ~35 minutes

Instructor-Developed Framework. The CARE Framework (Clarity, Accountability, Responsibility, Engaging Sustainably) was developed by the instructor as an applied ethical decision-making model for digital clinical practice. It is not a published instrument or established model from the existing literature. It is designed to translate professional ethical codes into a practical pre-publication review process.

C
Clarity
A
Accountability
R
Responsibility
E
Engaging Sustainably
C: Clarity

Clarity of intent and professional role. Before posting, ask: What is my purpose? Am I acting as clinician, educator, content creator, or private person? Is my intention aligned with my professional obligations?

A: Accountability

Accountability to ethical codes and professional standards. Before posting, ask: Does this align with NASW/ACA/AAMFT guidelines? Could it create a dual relationship, boundary violation, or confidentiality concern?

R: Responsibility

Responsibility to client welfare. Before posting, ask: How might a current or former client interpret this content? Could it harm, confuse, or compromise anyone in or formerly in a clinical relationship with me?

E: Engaging Sustainably

Building a digital practice maintainable over a clinical career without ethical drift. Ask yourself: Is this a pattern I can sustain consistently? Does this strategy protect my longevity and wellbeing?

🧭

Directions: Select a scenario from the list. You'll move through four guided questions using the CARE Framework. Choose the strongest response, read the feedback, and continue to the next question. This activity is for practice only and does not affect your final score.

Which part of the CARE Framework do you already tend to consider, and which part do you need to be more intentional about?
Module 6 of 7

Policy and Boundary Implementation

Building the policies and protocols that protect you, your clients, and your practice

⏱ 25 minutes
Dissertation Finding
The dissertation that informs this course found that participants reported engaging with therapist social media content before and during treatment. Reported uses included evaluating potential fit, assessing perceived competence, and using content for emotional support between sessions. These are participant-reported behaviors, not universal conclusions.
Clinical Interpretation
None of this requires a social media policy to happen. Without one, clinicians have no framework for addressing it therapeutically when clients bring it into the room.
Ethical Implication
A social media policy is not only a liability document. It is also a clinical tool that enables transparent, consent-based conversations about digital contact before it becomes a problem.
Professional Code Anchor

The practices covered in this module are not standalone best practices. They are grounded in ethical duties reflected across professional codes and technology practice standards, including confidentiality, informed consent, boundaries and dual relationships, consultation when uncertain, documentation, and client welfare. A written social media policy helps translate these ethical duties into clear, practice-specific expectations for online contact, public interaction, and digital boundaries.

Click each platform to explore specific clinical and ethical risk examples.

📸
Instagram
High Risk
Personal and professional blending, story visibility, DMs, follow requests, and algorithmic amplification all create complex boundary terrain. Requires explicit policy for follow requests, DM responses, and story content.
🎵
TikTok
High Risk
Duets, stitches, and comment sections create uncontrolled interaction surfaces. The algorithm surfaces content to unexpected audiences. Short format encourages oversimplification of clinical concepts.
💼
LinkedIn
Medium Risk
Professional context reduces personal disclosure risk. Connection requests from clients, former clients, and supervisees create dual-role dynamics. Posts about clinical work may inadvertently identify clients.
🐦
X / Twitter
High Risk
Public by default, rapid reposting, and replies from unknown parties create high context collapse risk. Political and social commentary is particularly vulnerable to misattribution and reputational harm.
🎬
YouTube
Medium Risk
Long-form content allows for nuance and clinical framing. Main concerns: parasocial depth from extended content, comment sections, and channel membership features that create extended relationship dynamics.
👥
Facebook
Medium Risk
Groups, friend requests from clients, and tagging create complex boundary situations. Personal pages are often less curated. Consider separate personal and professional pages with documented policies for each.

Check each element to track your social media policy coverage. A robust therapist social media policy may address these 24 areas. Because participants reported evaluating fit, perceiving competence, and using content for support before and during treatment, each element below turns one of those realities into something you can disclose, document, and discuss with clients.

Policy Coverage
0/24
Purpose and Scope
A statement of purpose explaining why the policy exists and to whom it applies (current, former, and prospective clients)
A list of all platforms the clinician maintains a presence on, including personal accounts clients may encounter
Friend and Follow Requests
Clear guidance on whether you accept follow or friend requests from current clients, former clients, or prospective clients
What you will do if a client requests connection and your clinical rationale
How to handle discovering that a client is already following a personal account
Direct Messages and Online Communication
Whether you will respond to DMs on social platforms
How to contact you in an emergency (not via social media)
Your documentation process if a client contacts you via social media
Content and Self-Disclosure
Your approach to personal versus professional content on social platforms
How you handle content that clients may encounter that relates to clinical themes
Your policy on discussing clinical work in any form on social media
Reviews and Testimonials
Whether and how you respond to online reviews
Your policy on requesting or using client testimonials
Discovery and Search
What you will and will not search for regarding clients online
How you handle information you discover about a client online
Documentation requirements for any online search related to a client
What you do if you accidentally discover a client's content online, including when you consult and how you document it
How you handle a safety concern, such as possible risk of harm, that surfaces through online content
Account Separation and Privacy
Keeping personal and professional accounts separate and distinct from your clinical presence
Using separate email addresses for professional accounts versus personal or leisure apps, such as dating and marketplace apps
Reducing searchability, or using a pseudonym for personal accounts, where appropriate to your safety and context
How you manage contact syncing and "people you may know" suggestions that could surface clients or reveal connections
Policy Review and Updates
How often you will review and update the policy
How clients will be informed of changes to the policy
Based on your policy builder results, which policy area needs your attention first? What is one realistic step you can take this month to strengthen it?
Module 7 of 7

Integration for Ethical Online Practice

Translating this course into policy review, informed consent updates, boundary maintenance, and sustainable clinical decision-making.

⏱ 10 minutes

This final module is about what you will actually change. Use the prompts below to turn the course into specific, time-bound commitments you can sustain.

Identify specific steps you can take to strengthen your informed consent, social media policy, documentation, consultation, and boundaries online. Your responses are saved in this browser session.

This Week
One thing I will do in the next 7 days
This Month
One thing I will implement in the next 30 days
This Quarter
One practice I will sustain for the next 90 days
One part of my online presence I will approach more intentionally after this course is...
Consider sharing this commitment with a supervisor, consultant, or trusted colleague for accountability.

Ethical practice conditions online can change over time. Every 90 days, review what clients can see, how they can contact you, and whether your informed consent language and social media policy still match your actual online behavior.

1
🖼️ Review the Frame
Re-read your current social media policy and informed consent language.
Confirm they still match what you actually do online.
2
🔍 Scan the Platforms
Review each platform you are active on.
Note any new features, such as DMs, stories, comments, tags, reviews, or contact options, that need a boundary decision.
Check whether any new accounts or content have appeared that clients could encounter, including personal or blended accounts.
3
🛡️ Protect the Boundary
Confirm your privacy setup is still in place: separate professional and personal accounts, separate emails, and contact-syncing limits.
Review how you handled any client follow requests, DMs, reviews, or accidental discoveries this quarter.
Note whether consultation and documentation occurred when needed.
4
🎯 Retune the Rhythm
Run one recent or planned post through the CARE Framework as a spot check.
Identify one sustainability adjustment that protects your time, wellbeing, and consistency for the next 90 days.
Your Commitment
My next 90-day retune date is:
One thing I will review first is:
🔬
Research Foundation
The dissertation findings are a foundation, not a ceiling. This environment is evolving rapidly and requires ongoing learning, policy revision, and supervisory reflection.
🧭
CARE Is Durable
The CARE framework applies to new platforms, emerging technologies, and clinical situations not yet documented in research. It is designed to travel with you.
Ongoing Commitment
Ethical digital practice is not a one-time decision. It is a recurring act of intentionality, made every time you decide whether, what, and how to post.
🌱
Visibility Has a Pace
Having an online presence does not mean becoming a content creator who posts all the time. Ethical visibility is about choosing a sustainable rhythm that fits your capacity, your boundaries, and your career as a therapist.
Course Assessment

Post-Test

20 questions | 80% passing threshold (16/20) | Unlimited attempts

📋

Score 80% or higher (16 of 20) to pass. You may retake the post-test as many times as needed. After each attempt, missed questions are shown with educational feedback so you can learn and try again.

Course Evaluation

Tell Us How We Did

Your feedback helps improve this course. Required to unlock your certificate.

🎯

Achievement of Learning Objectives. Please rate how much this course helped you learn each skill below. 1 = Not at all, 3 = Somewhat, 5 = Very much.

1. After taking this course, I understand why a therapist's online presence can affect client trust, boundaries, confidentiality, and informed consent.
2. After taking this course, I understand how clients may use social media, websites, online reviews, and search results to decide whether a therapist feels safe, credible, and appropriate for them.
3. After taking this course, I can recognize common social media ethics risks, including DMs, comments, follows, reviews, boundaries, dual relationships, and confidentiality concerns.
4. After taking this course, I understand why therapist social media content should be intentional, professionally appropriate, and connected to client welfare.
5. After taking this course, I can use the CARE Framework to think through ethical decisions before posting, responding, or engaging online.
6. After taking this course, I can identify what should be included in a clear social media policy for a therapy practice.
7. After taking this course, I can review my online activity, boundaries, informed consent language, and social media policy in a sustainable way.
📋

Course Quality. (1 = Strongly Disagree, 5 = Strongly Agree)

8. The course content was clear, practical, and relevant to therapists using social media.
9. The interactive activities helped me apply what I learned.
10. What part of the course was most useful?
11. What could improve the course?
Course Complete

Your Certificate of Completion

3 hours of ethics-focused instruction | Social Media Ethics for Therapists

Enter Certificate Information

CE Compliance

Course Disclosures and Information

Required disclosures for continuing education provider review and participant transparency

Approval Status: This course is currently pending approval and should not be advertised as approved continuing education until approval is granted by the appropriate approving body.
🎓 Course Completion
3 hours of ethics-focused instruction
🏷️ Course Category
Ethics
👥 Target Audience
Licensed mental health professionals and graduate-level trainees
📈 Instructional Level
Intermediate
✅ Completion Requirements
Complete all 7 modules, pass the 20-question post-test with 80% or higher, submit the evaluation, and generate the certificate
📝 Post-Test Policy
80% or higher required (16 of 20); unlimited retakes allowed
Course Completion

3 hours of ethics-focused instruction.

Course Category

Ethics.

Completion Requirements

Complete all 7 modules, pass the 20-question post-test with 80% or higher, submit the evaluation, and generate the certificate.

Target Audience

This course is intended for licensed mental health professionals, including therapists, social workers, counselors, marriage and family therapists, psychologists, and other licensed mental health clinicians, as well as graduate-level trainees interested in ethical social media use.

Instructional Level

Intermediate. Participants are expected to have foundational knowledge of professional ethical codes and general social media familiarity. No prior research training is required.

Conflict of Interest and Financial Disclosure

The instructor/provider receives course registration revenue. The instructor reports no external financial relationships, sponsorships, product placements, commercial support, or third-party funding related to the development or delivery of this course. No products or services are promoted as part of the educational content.

Grievance Policy

Questions, concerns, or grievances regarding course content, completion requirements, certificates, or accessibility may be directed to Mental Retune at ready@mentalretune.com. All inquiries will be reviewed and responded to within a reasonable timeframe.

Accessibility Statement

Reasonable efforts will be made to accommodate participants with accessibility needs. This course is self-paced with no time limit. Participants requiring accommodations should contact the provider at ready@mentalretune.com.

Record Retention

Mental Retune maintains CE completion records, including participant name, email, license number, completion date, post-test score, evaluation confirmation, certificate ID, and instructional hours completed, for a minimum of six years through its administrative recordkeeping system.

Administrative Recordkeeping

Completion records are generated when a participant completes all course requirements, passes the post-test, submits the required evaluation ratings, and generates a certificate. The completion record is submitted to Mental Retune's administrative recordkeeping system for CE documentation and retained according to CE provider requirements.

Attendance and Completion Tracking

When all requirements are met, a completion record is submitted to Mental Retune's administrative recordkeeping system. Certificate of completion is awarded only after all requirements are met and the record is successfully saved.

Dr. Markyse Bernadin, PhD, LCSW

Dr. Bernadin is a licensed clinical social worker and the founder of Mental Retune, a private practice based in North Miami, Florida. She earned her Doctor of Philosophy from Barry University (2024), where her dissertation examined client perceptions of mental health clinicians on social media. She has designed this course, planned its instructional objectives, and is responsible for ongoing content evaluation and revision. She holds expertise in social media ethics as both a practitioner and a researcher who has studied the client experience within digital clinical contexts.

This course is grounded in original doctoral dissertation research (Bernadin, 2024) and supplemented by professional ethical standards and peer-reviewed literature. Dissertation findings are labeled "Dissertation Finding" and represent empirical results from a study of n=177 participants. Literature-informed concepts and instructor interpretations are clearly distinguished from empirical findings throughout the course. The CARE Framework (Clarity, Accountability, Responsibility, Engaging Sustainably) was developed by the instructor as an applied ethical decision-making model and is not a published instrument from the existing literature.

Use of AI. AI assistance was used for formatting, editing, and accessibility support. Course content, clinical interpretation, research application, and final review were completed by the instructor.

Bibliography

References

Dissertation research, professional ethical codes, and literature sources informing this course

Bernadin, M. (2024). Meeting clients where they're @: Evidenced-based practices for the online therapeutic relationship [Doctoral dissertation, Barry University]. ProQuest Dissertations & Theses.

Note: All references to dissertation findings in this course (n=177, instruments MHSAS and C-NIP, directiveness preference data, demographic non-significance findings, and thematic findings) are drawn from this primary source and are labeled as such throughout the course.

American Association for Marriage and Family Therapy. (2015). AAMFT code of ethics. https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx

American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf

National Association of Social Workers. (2021). NASW code of ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics

National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, & Clinical Social Work Association. (2017). NASW, ASWB, CSWE, & CSWA standards for technology in social work practice. NASW Press.

Peer-reviewed literature and measures from current professional sources, including the instruments used in the dissertation that informs this course.

Cooper, M., & Norcross, J. C. (2016). A brief, multidimensional measure of clients' therapy preferences: The Cooper-Norcross Inventory of Preferences (C-NIP). International Journal of Clinical and Health Psychology, 16(1), 87–98. https://doi.org/10.1016/j.ijchp.2015.08.003 [Source instrument for the C-NIP adapted for dissertation use]

Drude, K. P., Messer-Engel, K., & O'Neil, D. (2021). The development of social media guidelines for psychologists and for regulatory use. Journal of Technology in Behavioral Science, 6, 388–396. https://doi.org/10.1007/s41347-020-00176-1

Hammer, J. H., Parent, M. C., & Spiker, D. A. (2018). Mental Help Seeking Attitudes Scale (MHSAS): Development, reliability, validity, and comparison with the ATSSPH-SF and IASMHS-PO. Journal of Counseling Psychology, 65, 74–85. https://doi.org/10.1037/cou0000248 [Primary source for the MHSAS instrument used in the dissertation that informs this course]

Johnsen, C., & Ding, H. T. (2021). Therapist self-disclosure: Let's tackle the elephant in the room. Clinical Child Psychology and Psychiatry, 26(2), 443–450.

Kolmes, K. (2017). Digital and social media multiple relationships on the internet. In O. Zur (Ed.), Multiple relationships in psychotherapy and counseling: Unavoidable, common, and mandatory dual relations in therapy (pp. 185–195). Routledge/Taylor & Francis Group.

White, E., & Hanley, T. (2023). Therapist + social media = mental health influencer? Considering the research focusing upon key ethical issues around the use of social media by therapists. Counselling and Psychotherapy Research, 23(1), 1–5. https://doi.org/10.1002/capr.12577

Wu, K. S., & Sonne, J. L. (2021). Therapist boundary crossings in the digital age: Psychologists' practice frequencies and perceptions of ethicality. Professional Psychology: Research and Practice, 52(4), 419–427. https://doi.org/10.1037/pro0000407

Dalton, C., Sarwar, Z., Garwe, T., & Hunter, C. J. (2026). Evaluating perceptions of social media professionalism by healthcare workers. Digital Health, 12, Article 20552076251411281. https://doi.org/10.1177/20552076251411281

Ellis, D. M., Guastello, A. D., Anderson, P. L., & McNamara, J. P. H. (2019). How racially concordant therapists and culturally responsive online profiles impact treatment-seeking among Black and White Americans. Practice Innovations, 4(2), 75–87. https://doi.org/10.1037/pri0000084

Engstrom, H. R., Laurin, K., Kay, N. R., & Human, L. J. (2024). Socioeconomic status and meta-perceptions: How markers of culture and rank predict beliefs about how others see us. Personality and Social Psychology Bulletin, 50(9), 1386–1407. https://doi.org/10.1177/01461672231171435

Giuffrida, A., Saia-Owenby, C., Andriano, C., Beall, D., Bailey-Classen, A., Buchanan, P., Budwany, R., Desai, M. J., Comer, A., Dudas, A., Francio, V. T., Grace, W., Gill, B., Grunch, B., Goldblum, A., Garcia, R. A., Lee, D. W., Lavender, C., Lawandy, M., et al. (2024). Social media behavior guidelines for healthcare professionals: An American Society of Pain and Neuroscience NEURON Project. Journal of Pain Research, 17, 3587–3599. https://doi.org/10.2147/JPR.S488590

Haimson, O. L., Liu, T., Zhang, B. Z., & Corvite, S. (2021). The online authenticity paradox: What being "authentic" on social media means, and barriers to achieving it. Proceedings of the ACM on Human-Computer Interaction, 5(CSCW2), Article 423. https://doi.org/10.1145/3479567

Han, X., Lin, Y., Han, W., Liao, K., & Mei, K. (2024). Effect of negative online reviews and physician responses on health consumers' choice: Experimental study. Journal of Medical Internet Research, 26, e46713. https://doi.org/10.2196/46713

Hoffner, C. A., & Bond, B. J. (2022). Parasocial relationships, social media, & well-being. Current Opinion in Psychology, 45, Article 101306. https://doi.org/10.1016/j.copsyc.2022.101306

Kozikowski, A., Morton-Rias, D., Mauldin, S., Jeffery, C., Kavanaugh, K., & Barnhill, G. (2022). Choosing a provider: What factors matter most to consumers and patients? Journal of Patient Experience, 9, 23743735221074175. https://doi.org/10.1177/23743735221074175

Mahar, P. D., Panaccio, D. C. A., Dean, J. M., Farmer, C. C., Pang, S. C., & Kevat, D. A. S. (2022). Managing negative online reviews: Considerations for doctors. Australian Journal of General Practice, 51(8), 568–570. https://doi.org/10.31128/AJGP-10-21-6215

Placona, A. M., & Rathert, C. (2022). Are online patient reviews associated with health care outcomes? A systematic review of the literature. Medical Care Research and Review, 79(1), 3–16. https://doi.org/10.1177/10775587211014534

Reamer, F. G. (2023). Social work boundary issues in the digital age: Reflections of an ethics expert. Advances in Social Work, 23(2). https://doi.org/10.18060/26358

Ryan-Blackwell, G., Jackson, J., & Haider, S. (2024). When and in what circumstances is patient-targeted Googling acceptable for health and social care professionals? A narrative review and thematic analysis. Health Informatics Journal, 30(3), 1–14. https://doi.org/10.1177/14604582241285756

Sadusky, A., Yared, H., Patrick, P., & Berger, E. (2024). A systematic review of clients' perspectives on the cultural and racial awareness and responsiveness of mental health practitioners. Culture & Psychology, 30(3), 567–605. https://doi.org/10.1177/1354067X231156600

Smith, K. M., Jones, A., & Hunter, E. A. (2023). Navigating the multidimensionality of social media presence: Ethical considerations and recommendations for psychologists. Ethics & Behavior, 33(1), 18–36. https://doi.org/10.1080/10508422.2021.1977935

Soubra, R., Hasan, I., Ftouni, L., Saab, A., & Shaarani, I. (2022). Future healthcare providers and professionalism on social media: A cross-sectional study. BMC Medical Ethics, 23, Article 4. https://doi.org/10.1186/s12910-022-00742-7

van der Boon, R. M. A., Camm, A. J., Aguiar, C., Biasin, E., Breithardt, G., Bueno, H., Drossart, I., Hoppe, N., Kamenjasevic, E., Ladeiras-Lopes, R., McGreavy, P., Lanzer, P., Vidal-Perez, R., & Bruining, N. (2024). Risks and benefits of sharing patient information on social media: A digital dilemma. European Heart Journal - Digital Health, 5(3), 199–207. https://doi.org/10.1093/ehjdh/ztae009

Older works retained for theoretical and historical grounding of concepts referenced in the course (for example, parasocial interaction and professional boundaries). They support, rather than substitute for, the current literature above.

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191

Chou, W. S., Hunt, Y. M., Beckjord, E. B., Moser, R. P., & Hesse, B. W. (2009). Social media use in the United States: Implications for health communication. Journal of Medical Internet Research, 11(4), e48. https://doi.org/10.2196/jmir.1249

Gabbard, G. O., Kassaw, K. A., & Perez-Garcia, G. (2011). Professional boundaries in the era of the internet. Academic Psychiatry, 35(3), 168–174. https://doi.org/10.1176/appi.ap.35.3.168

Horton, D., & Wohl, R. R. (1956). Mass communication and para-social interaction. Psychiatry, 19(3), 215–229. https://doi.org/10.1080/00332747.1956.11023049

Kolmes, K. (2012). Social media in the future of professional psychology. Professional Psychology: Research and Practice, 43(6), 606–612. https://doi.org/10.1037/a0028678

Lehavot, K., Barnett, J. E., & Powers, D. (2010). Psychotherapy, professional relationships, and ethical considerations in the MySpace generation. Professional Psychology: Research and Practice, 41(2), 160–166. https://doi.org/10.1037/a0018709

Zur, O., Williams, M. H., Lehavot, K., & Knapp, S. (2009). Psychotherapist self-disclosure and transparency in the internet age. Professional Psychology: Research and Practice, 40(1), 22–30. https://doi.org/10.1037/a0014028

Note on Content Sourcing: This course distinguishes between content drawn directly from the primary dissertation (labeled "Dissertation Finding" throughout) and content informed by the broader professional literature (labeled with literature badges). Instructor interpretations and clinical applications are clearly identified as such. This bibliography reflects both categories.