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.
- Describe why therapist online visibility is a clinical, ethical, and informed consent issue within the current digital landscape.
- 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).
- 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.
- 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.
- Apply the CARE Framework (Clarity, Accountability, Responsibility, Engaging Sustainably) to ethical decision-making regarding online presence and social media content.
- Develop a written social media policy appropriate for clinical practice, including platform-specific considerations and informed consent language.
- Develop a sustainable process for reviewing your online activity, boundaries, informed consent language, and social media policy in clinical practice.
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.
Complete all 7 modules, pass the 20-question post-test with 80% or higher, submit the evaluation, and generate the certificate.
Unlimited attempts. Missed questions are shown with educational feedback after each attempt. No lockout period.
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.
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.
The Digital Landscape for Clinicians
How online visibility shapes client trust, boundaries, and expectations
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.
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.
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.
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.
Reviews, tags, comments, and mentions you do not control. Clients may see these first and assess them as heavily as anything you post yourself.
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.
Online Help-Seeking and Client Evaluation
What prospective clients are doing online before they become clients
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.
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.
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
Ethical Risks in Digital Spaces
Understanding the clinical and ethical terrain through the professional literature and real scenarios
Before you can apply an ethical decision-making framework for posting online, you need to be able to name what's realistically at stake.
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)
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)
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)
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)
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)
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)
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)
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)
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 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)
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
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.
What Participants Shared
A structured exploration of the original dissertation data: quantitative findings, qualitative themes, and clinical implications
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.
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.
Click the tabs below to explore the dissertation quantitative findings, the qualitative themes, and the clinical implications.
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.
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.
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.
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.
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.
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.
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.
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.
Applying CARE to Real Clinical Scenarios
Practice the CARE ethical decision-making framework across five realistic scenarios with immediate, detailed feedback
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.
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?
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?
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?
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.
Policy and Boundary Implementation
Building the policies and protocols that protect you, your clients, and your practice
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.
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.
Integration for Ethical Online Practice
Translating this course into policy review, informed consent updates, boundary maintenance, and sustainable clinical decision-making.
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.
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.
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.
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.
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Your Certificate of Completion
3 hours of ethics-focused instruction | Social Media Ethics for Therapists
Enter Certificate Information
Course Disclosures and Information
Required disclosures for continuing education provider review and participant transparency
3 hours of ethics-focused instruction.
Ethics.
Complete all 7 modules, pass the 20-question post-test with 80% or higher, submit the evaluation, and generate the certificate.
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.
Intermediate. Participants are expected to have foundational knowledge of professional ethical codes and general social media familiarity. No prior research training is required.
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.
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.
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.
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.
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.
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. 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.
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.