[Counselor_Educ] Article from Mental Health Academy - Ethical Use of Social Media in Mental Health Practice

[Bhat, Christine]

Ethical Use of Social Media in Mental Health Practice



This article shows how confidentiality and boundaries in social media must be proactively maintained, as ethical awareness online extends core ethical principles.

Introduction

In a world where connection happens at the speed of a swipe, social media has become both a bridge and a boundary for mental health professionals. In this article we explore how to navigate that terrain with integrity, compassion, and clarity.

Online presence shapes professional identity, so we look into how you can distinguish between personal and professional roles in digital environments. We explain how you can preserve confidentiality and trust in digital spaces. We offer a rationale for developing a social media policy consistent with professional codes of ethics. And we show you how to evaluate the influence of your digital footprint on therapeutic relationships and public trust.

Ultimately, it is about how you can cultivate digital mindfulness - the ability to engage online with the same care, empathy, and professionalism that define your work offline. You may hear us say throughout this series: ethical social media use is not about silence; it's about showing up thoughtfully, with heart, in the global conversation on mental health.

The digital mirror: Why social media matters in mental health practice

Social media has transformed from a casual pastime into a powerful arena for professional presence and public engagement. For mental health practitioners, platforms like LinkedIn, Instagram, and even TikTok now function as spaces for education, advocacy, networking, and destigmatization. Research indicates that clients increasingly expect to find information about their clinicians online (Campbell et al., 2016). This visibility can strengthen credibility, signal approachability, and extend the reach of mental health literacy initiatives. Yet, it also requires ethical discernment to balance openness with professional responsibility.

The digital mirror metaphor captures the dual nature of this visibility. On one hand, it reflects professional identity and values outward to the world, allowing practitioners to model compassion, authenticity, and evidence-based thinking. On the other, it reflects back - revealing personal details, opinions, and moments that may be interpreted through a professional lens. Even when accounts are set to "private," algorithms and cross-platform exposure make total invisibility unrealistic (Tunick, Mednick, & Conroy, 2011). The result is a blurred boundary between the personal self and the professional self that clients, colleagues, and the public all observe and evaluate.

>From an ethical standpoint, this raises questions about fidelity, beneficence, and integrity - principles that underpin the professional codes of conduct across psychology, counselling, and social work (Australian Psychological Society [APS], 2023; National Association of Social Workers [NASW], 2021). A well-intentioned post celebrating personal growth could, if interpreted as advice or self-disclosure, inadvertently affect a client's perception of the therapeutic relationship. Likewise, engaging in heated online debates or commenting on politically charged issues risks undermining perceptions of neutrality and safety (Zur, 2025b). The challenge, then, is not withdrawal from the digital space, but thoughtful participation guided by ethical awareness.

Social media also amplifies the public dimension of professional ethics. Mental health practitioners are uniquely positioned to correct misinformation, promote mental health literacy, and advocate for systemic change. Studies show that responsible online engagement by clinicians can reduce stigma and increase help-seeking behaviors (Naslund et al., 2020). However, the same platforms that facilitate advocacy also encourage impulsivity and emotional expression - traits that can collide with ethical restraint. Every "like," comment, or post contributes to an ongoing digital footprint that clients and the public may interpret as part of professional identity (Kolmes, 2012; Kolmes & Taube, 2016).

Ultimately, ethical engagement on social media is not about self-censorship - it's about reflective self-presentation. Clinicians should ask: Does this post align with my professional values? Could it be misconstrued as clinical advice or boundary crossing? Ethical mindfulness, rather than avoidance, allows practitioners to harness social media's potential for good while safeguarding client trust and professional integrity. As the digital mirror reflects both intention and impact, the most ethical stance is one of visibility with vigilance - an approach that humanises mental health professionals while maintaining the sacred boundaries of care.

Professional vs personal identity online

In an era where one's social presence can feel as vital as one's professional credentials, mental health practitioners face a subtle but persistent question: Where does the therapist end and the private citizen begin? Even with privacy settings and pseudonyms, the line between personal and professional identity online is rarely watertight. Research shows that clients can - and often do - search for their therapists online, whether out of curiosity or anxiety (Zur et al, 2009; White & Hanley, 2023; Baier, 2019). What they find can influence trust, perceived competence, and even therapeutic outcomes.

The blurred boundary

A "private" photo shared with friends can easily be shared again, re-captioned, or appear in algorithmic suggestions far beyond its intended audience. This visibility turns casual expression into professional communication, whether one intends it or not. As Kolmes and Taube (2016) note, digital footprints persist long after deletion, and clients' interpretations of those footprints may differ dramatically from the therapist's intent. Thus, every online trace becomes a kind of professional disclosure.

Ethical implications

Two ethical principles - fidelity and autonomy - are especially relevant. Fidelity obliges professionals to uphold trust and to act in ways consistent with the client's welfare (APS, 2023). When a practitioner's online persona appears inconsistent with therapeutic values - for instance, by sharing politically charged or judgmental posts - clients may experience a rupture in that trust. Autonomy, meanwhile, demands respect for the client's right to self-determination. When therapists share personal stories or opinions online, they must consider whether such disclosures could subtly shape a client's choices or expectations.

Even "positive" self-disclosures, like fitness milestones or personal resilience stories, can blur the clinician-client power dynamic. Studies indicate that clients who view self-disclosing therapist content may develop unrealistic familiarity or expectations of reciprocal intimacy (White & Hanley, 2023; Baier, 2019). Online authenticity is valuable - but only insofar as it serves client welfare rather than therapist expression.

Strategies for integrity

To that end, we propose several strategies to maintain high ethical standards for keeping your professional persona separate from your personal one:

Separate spaces. Maintain distinct professional and personal accounts if possible, using the professional one solely for education, advocacy, and verified information.

No client content - ever. Even anonymized anecdotes or "composite" cases risk re-identification and are discouraged by professional guidelines (NASW, 2021).

Regular self-audit. Search your name periodically, review tagged content, and update privacy settings. Seeing yourself through a client's eyes can be revelatory.

Pause before posting. Ask: Would this align with my in-session values? Could it be misconstrued as clinical advice?

These small acts of vigilance sustain professional congruence - the alignment between what one teaches, practices, and models. Digital transparency is not inherently unethical; it becomes so when it erodes the safety and neutrality essential to therapeutic work. Maintaining professional identity online is less about constructing a polished façade and more about practicing mindful authenticity - being recognizably human without compromising professional ethics.

Boundaries and dual relationships in social media contexts

If there's one domain where the digital world loves to test a therapist's resolve, it's in the realm of boundaries. The same platforms that connect us globally can, with one friendly click, blur the delicate lines between professional, personal, and even commercial relationships. On social media, dual relationships aren't always intentional - but they are almost always traceable.

The subtle slide into dual roles

A client sends a friend request, follows a professional page, or "likes" a therapist's photo. What begins as an innocent gesture of appreciation can shift relational dynamics in ways both parties may not immediately grasp. As Zur (2025a) notes, even passive visibility - like a client scrolling through a therapist's family vacation photos - can create a sense of unwarranted intimacy or familiarity. Once that occurs, the therapist's neutrality may be compromised, and the therapeutic frame can quietly erode.

Ethical risks

We might ask, what do we risk as mental health professionals when seemingly innocent disclosures send us down the slippery slope toward dual roles and compromised ethical integrity? The consequences seem large for the "small sin" of, say, a therapist's "like" of a third-party post or the post of a therapist's single picture:

Loss of therapeutic neutrality. Even the perception of personal closeness can influence transference and countertransference.

Breach of confidentiality. If clients comment publicly on professional pages, their identity as therapy recipients becomes exposed.

Role confusion. The social media environment can create expectations of availability beyond clinical boundaries - clients may message for advice or reassurance between sessions (Henretty & Levitt, 2010).

Ethical frameworks universally stress that the responsibility for maintaining boundaries lies with the professional, not the client (APS, 2023; NASW, 2021). Digital platforms merely multiply the opportunities to test that responsibility.

Professional responses

The most effective safeguard is clarity before crisis. Social media policies should be introduced at intake, explaining that therapists do not accept friend or follow requests, nor communicate via direct messages for therapeutic purposes. When such requests occur, a polite but firm declination paired with a brief rationale (e.g., confidentiality protection) preserves rapport while upholding standards.

Professional or organizational pages can still serve as educational spaces, sharing mental health resources without individual interaction. For practitioners in small or culturally tight-knit communities, absolute separation may be impractical; in those cases, transparency and supervision become essential tools for ethical navigation (Reamer, 2018; 2021).

Cultural sensitivity

In rural or minority settings, community overlap is often unavoidable. Ethical practice in these contexts means adopting a stance of informed boundary negotiation - acknowledging connections, discussing implications openly, and documenting boundary decisions. Ethical flexibility, grounded in reflection and consultation, replaces rigid rules with relational responsibility.

Key principle

Boundaries are not barriers; they are containers of trust. In digital spaces where immediacy is prized, restraint can feel countercultural - but it remains the cornerstone of professional integrity. Saying "no" online is sometimes the most therapeutic act of all.

Ethical communication and public engagement

Social media gives mental health professionals an unprecedented platform for public education, advocacy, and destigmatization. Clinicians can amplify accurate information and counter mental health myths with immediacy and reach that previous generations could only dream of. Yet paradoxically, the same communication tools that can advance public good can also expose professionals to ethical risk if used without care.

The therapist as public educator

When practitioners share insights about anxiety, relationships, or trauma-informed care online, they are engaging in what Reamer (2017) calls digital social work - a fusion of public education and professional ethics. This engagement can promote beneficence and justice, helping underserved populations access reliable mental health knowledge. However, the online audience is not a classroom; it is a fluid, global crowd where context collapses. A post intended as psychoeducation can be interpreted as personal advice, a diagnostic statement, or even therapeutic direction.

To safeguard against misunderstanding, clinicians should distinguish clearly between general information and professional services. Including brief disclaimers ("This content is for general educational purposes only") helps manage expectations and protects client autonomy (Kolmes, 2012). Transparency is not only ethical - it is protective.

Managing risks and misinformation

Ethical challenges multiply in the comment sections. Followers may share sensitive personal stories, seek direct guidance, or challenge professional opinions. Responding publicly may appear compassionate, but it can inadvertently confirm clinical relationships or offer unsupervised advice. Best practice is to redirect such exchanges to appropriate channels: a private message clarifying boundaries, or a standard response directing individuals to crisis or referral services (Tunick et al., 2011).

The professional also bears a duty to combat misinformation responsibly. As Patel et al. (2020) note, false or sensationalized mental health content circulates widely online, and silence can perpetuate harm. Ethical engagement means correcting inaccuracies without shaming, diagnosing, or engaging in online conflict. Tone matters as much as content; professionalism must extend to digital discourse.

Balancing advocacy and neutrality

Advocacy is central to mental health ethics - but it can blur into partisanship if not grounded in shared professional principles. Posting about social justice, diversity, or policy issues aligns with professional codes that emphasize fairness and inclusion (APS, 2023). However, emotional or polarizing language risks alienating clients with differing beliefs. Ethical communication requires self-awareness: Is this post promoting well-being and understanding, or simply expressing frustration?

Ethical communication in practice

Four guidelines clarify how mental health professionals can communicate online with high ethical standards. You can:


  *   Verify the accuracy and source of all shared content.
  *   Disclose your credentials and scope of practice clearly.
  *   Avoid commenting on trending clinical cases or celebrities' mental health.
  *   Engage in public dialogue respectfully, avoiding diagnostic language outside the therapy context.

Each post becomes a microcosm of professional ethics - visible, permanent, and influential. The idea is not to be silent, but to use your voice with purpose.

Marketing, self-promotion and transparency

In the digital age, mental health professionals are no longer just clinicians - they are also brands. Websites, blogs, and social media profiles function as virtual storefronts, and the line between sharing expertise and selling oneself has never been thinner. Ethical marketing in this landscape isn't about modesty; it's about honesty, clarity, and respect for client autonomy.

The ethics of visibility

Marketing is not inherently unethical. In fact, transparency about one's services, credentials, and specializations can empower clients to make informed choices, aligning with the ethical principle of autonomy (APS, 2023). Problems arise when marketing tactics exaggerate, manipulate, or blur the distinction between information and persuasion. The "attention economy" rewards emotional storytelling and grand claims - but mental health professionals must resist the temptation to equate visibility with value.

As Reamer (2021, 2018b) observes, digital self-promotion carries the risk of commodifying care. When therapy is framed as a purchasable product rather than a collaborative process, the client's vulnerability can become a marketing tool. Ethical marketing therefore demands both authenticity and restraint: practitioners must describe what they do accurately, avoiding any implication of guaranteed outcomes or "quick fixes."

Advertising standards and professional codes

Most professional associations, including the APS and the American Counseling Association, provide explicit guidance on advertising and testimonials. These codes prohibit:


  *   False or misleading claims about success rates or client outcomes.
  *   Testimonials or endorsements that could reveal a therapeutic relationship.
  *   Use of confidential client information, even if anonymized, for promotional purposes.

Even subtle breaches - such as clients voluntarily posting glowing reviews - can compromise confidentiality and create pressure for reciprocity. The ethical response is not to solicit such endorsements but to educate clients about why professionals cannot "like," "share," or respond publicly to such posts (Practice Edge. 2024).

Social proof and the digital halo

Metrics like likes, shares, and follower counts can easily morph into a proxy for competence. Yet research shows that clients may equate social popularity with clinical effectiveness (Care Learning, 2025; Mikal et al., 2016). This "digital halo effect" can distort perceptions and create unrealistic expectations before therapy even begins. Ethical transparency involves helping potential clients understand that online presence signals accessibility, not superiority. Practitioners can still market ethically by focusing on values and process rather than promises.

The integrity of self-representation

Ethical marketing is ultimately an extension of professional integrity. It invites practitioners to replace persuasion with clarity, and image-building with education. Transparency doesn't weaken credibility; it strengthens it by aligning public messaging with professional truth. In a world where algorithms reward exaggeration, maintaining honesty becomes a radical ethical act.

Creating a personal or organizational social media policy

Social media may be dynamic and ever-changing, but ethics are timeless. The most effective way to navigate this shifting landscape is to translate ethical principles into a living document - a personal or organizational social media policy. Rather than a bureaucratic chore, this policy serves as a map for digital professionalism: one that helps clinicians avoid ethical pitfalls and maintain alignment with their values, even when the online world moves fast.

Why a policy matters

Without clear boundaries, digital engagement can quickly become reactive. A comment here, a shared post there - and suddenly a therapist's feed becomes a confusing mix of professional insights, personal reflections, and inadvertent disclosures. A well-designed policy acts as a compass rather than a cage. It protects confidentiality, supports consistency, and communicates professionalism to clients, colleagues, and the public (Kolmes, 2012; Reamer, 2021, 2018b).

Moreover, written policies demonstrate due diligence. If an ethical complaint ever arises, being able to show that a clinician or organization had a proactive policy in place can significantly mitigate risk (APS, 2023).

Core components of an ethical social media policy

Purpose and scope. Clarify what the policy covers - for example, all professional online activity including websites, social media, blogs, and networking platforms. Define who it applies to (individual practitioners, team members, interns, etc.).

Professional boundaries. Clearly state that therapists will not accept client friend or follow requests, nor communicate about therapy through social media. Specify that all therapeutic contact occurs through approved, secure channels only.

Content guidelines. Outline the types of material suitable for posting. Educational resources, advocacy campaigns, or evidence-based insights are encouraged; client cases, even anonymized, are off-limits. Include rules about not commenting on clinical news stories or public figures' mental health.

Privacy and data handling. Describe how comments, messages, or tagged content will be managed. For example: "Messages received via social media will not be read or responded to; clients should contact the clinic/me directly via phone or email."

Review and revision. Digital ethics evolve quickly. Commit to reviewing the policy annually or when major platform or legal changes occur. This prevents the policy from gathering dust and ensures it reflects both current technology and best practice.

A quick-start template (for the weary but willing clinician)

If you want a one-line anchor to start your policy, try this:

"I use social media to promote mental health awareness and share professional resources, not to provide therapy or personal advice. I protect client confidentiality by maintaining clear boundaries and avoiding personal interactions online."

Even a short statement like this, visible on a website or professional page, sets a tone of transparency and trust.

>From information to ethical presence

Social media moves fast; ethical reflection moves slow. Professionals who thrive online are not necessarily the most active, but the most intentional. Reflection transforms impulsive clicks into ethical choices. As Reamer (2021) notes, online professionalism depends less on policies alone and more on cultivating a mindset of digital mindfulness - remaining conscious of how each post, comment, or "like" might ripple outward.

This is the art of ethical congruence: ensuring that the professional self-portrayed online aligns with the therapeutic self that clients meet in session. When congruence is present, the digital persona becomes an extension of therapeutic integrity rather than a distortion of it (Kolmes, 2012).

We advise regular reflection on where the line is drawn between professional advocacy and personal self-expression, what emotional tone is used, and whose voices are being amplified if communication is to be ethical. Such reflection nurtures awareness, as you engage a living conversation between values and evolving technologies.

The reflective loop

Clinicians can integrate reflection into their professional rhythm through brief, consistent habits, such as monthly check-ins, peer supervision, and boundary journaling about situations that feel ethically "sticky". In the digital realm, every click is an opportunity for micro-reflection - a small, deliberate moment of professional mindfulness.

Integration

When clinicians integrate ethical reflection into their online presence, they embody digital integrity rather than perform it. Ethical social media use is not about fear of mistakes; it's about commitment to responsible visibility - showing up authentically, thoughtfully, and compassionately in a space that often rewards the opposite.

The ultimate goal is balance: to engage with courage, communicate with care, and let one's digital footprint mirror the same professionalism that guides every therapeutic moment.

Conclusion

Ethical social-media practice is not about retreating from the digital world; it is about entering it with eyes open and purpose clear. Each post, each click, each moment of online visibility becomes part of a professional narrative - one that speaks as loudly as any therapy room ever could. We have seen that ethics online are simply ethics, amplified. Social media offers opportunity: connection, education, advocacy. But it also demands restraint: discernment, transparency, humility.

The clinician who practices digital mindfulness - who pauses, reflects, and chooses words with care - models to clients what healthy engagement can look like in a noisy age. Ultimately, ethical social-media use is an act of professional compassion. It protects clients from harm, honours the dignity of the profession, and preserves the credibility of every voice that speaks for mental health.

Key takeaways


  *   Ethical awareness online extends core clinical principles into public space.
  *   Confidentiality and boundaries in social media must be proactively maintained, not assumed.
  *   Transparency in social media builds credibility; exaggeration erodes it.
  *   Reflection transforms online activity in social media, blogging, and networking sites into ethical action.
  *   Every post reflects both the individual and the profession as a whole.

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~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Christine Suniti Bhat (she/her), PhD, LPC, LSC (OH)
Professor, Department of Counseling & Higher Education
The Patton College of Education
OHIO University, Athens, OH 45701

Past-President, American Counseling Association, 2025-2026
Fellow, American Counseling Association
Fellow, Association for Specialists in Group Work

Office: Patton Hall, 432F
Phone: 740-593-4425; Email: bhatc at ohio.edu<mailto:bhatc at ohio.edu>
Website: https://www.ohio.edu/education/bhatc
Media: https://www.ohio.edu/experts/expert/christine-suniti-bhat

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