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Therapists and the Web: A Brave New World

Clinical Update
By Zur Institute

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Therapists and the Web: A Brave New World

Explore the emerging and complex ethical, clinical and legal issues that are involved in telehealth, digital ethics and other aspects of psychotherapy and the Internet

Therapists who came of age before the digital era - and their younger counterparts - are thrust into situations that no school provided training for.


There is not one week that I do not get requests to consult on issues such as:

  • My suicidal teenage clients want to text me. I'm uncomfortable with this even thought I know it is probably the only way to reach them and communicate with them.
  • A borderline client found my home address online - I feel unsafe!
  • An ex-client is posting damaging Yelp reviews of me under multiple fake profiles! It's hurting my business.
  • My clients are highly functional and stable, and some want to be Facebook friends. How should I respond?
  • New clients sometimes Google me before the first session and find out sensitive information about my family. It's odd to need to answer to inquiries from virtual strangers who are coming to me for help. . .
  • I just got an e-mail from a potential client who wants to engage in Avatar Therapy. Is it ethical?
  • I work late hours and at times, I am the only one in the building. As a woman therapist I feel vulnerable and got into the habit of Googling new male clients to help me feel safer. Is it right?
  • A client e-mailed me at 2 am with the short note, "Doc, I can't take it any more!!!" Now, I can't reach them. Is this worth reporting, or were they simply venting, which is so easy to do online?

Digital ethics and social conduct online is a thriving new arena, with complexities far beyond what anyone could have imagined ten years ago. The above scenarios can apply to many, if not most, therapists. For those who practice telehealth (also called e-counseling or tele-mental-health) online via Skype or avatar, or conduct phone or e-mail therapy, the issues become even more layered and interesting.


We offer courses on the growing and valuable field of Digital Ethics and Psychology of the Internet:

You can order TeleHealth courses as a 26-unit certificate for the discounted price of $162.


What's covered in the discussion of digital boundaries?

  • Online self disclosure and transparency
  • Clients Googling therapists
  • Therapists Googling clients
  • Communicating with clients via cell phone, e-mail, text, chats, video-conferencing or Skype
  • The important role of informed consent in digital ethics
  • Texting or cell phone calls during sessions
  • Social networking with clients, such as interacting on Facebook
  • Negative posts by clients of their therapists and digital harassment
  • Record-keeping of e-communication
  • Office policies on social media



Proper conduct online is a current issue for everyone in this technological era and therapists have a special obligation to act ethically online. Issues, such as confidentiality, become less straightforward and more complex in online communication. To protect yourself and your clients from harm, we encourage education, exploration and collaboration on these new and important emerging issues.


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