I chose the following case from Reamer’s article:
“A social worker in a substance use disorders treatment program was in recovery and participated actively in an online support group. Occasionally, the social worker posted details about her own recovery. She discovered that one of her clients, who was also in recovery, gained access to this online support group and read several of the social worker’s postings about the practitioner’s personal life.”
I mainly chose this case because it hits so close to home and is something that I am concerned about as I pursue work in this field. A common mantra from my recovery community is that “no one can pour from an empty cup.” In short this means that in order to be of assistance to others you must first ensure that you are getting the support you need for your own recovery. This is very much a put your mask on before helping others put theirs on. This becomes very tricky since the recovery community is very tight-knit but also transient in the way that people hop from meeting to meeting. Although to be fair, I am not aware of very many recovery groups that “post” anything. There are facebook groups where individuals may post that they are celebrating a birthday or something that they are struggling with, but I am not sure that there are very many examples of people posting personal information that could be “used” against them. Unless the social worker is posting about how they are deeply struggling with their recovery or have recently had a return to use that they have not disclosed to their employer, I am not sure where this could lead to issues. However, that feels like an even scarier position to be in since there can be all sorts of different ways this could turn into a mess. For example, if the client’s treatment is part of a court order program then anything personal may be used as a means of ensuring that the social worker feels compelled to report positively about the client’s progress. This is an exceptionally unlikely scenario, but it is still possible.
The easiest remedy would be for the social worker to ask a moderator to remove their posts, or remove said posts themselves and have a discussion about it with the client. Unfortunately, it is not possible to tell someone that they cannot go to a particular meeting no matter your status as a professional or regular person in recovery so the social worker would need to find a group elsewhere if the client wants to continue to engage with the group.
The boundary dynamic that I chose was that of intimacy mostly because of the importance of keeping anything that can even be considered inappropriate in check to ensure maximum safety of all involved in the therapeutic process. The article that I read outlined the variety of intimate actions that can be considered misconduct from those that are overt such as sexual advances, smaller (but still weird) things such as using particular names for clients that are not the legal or accepted name (sweetie, dearest, and others). What I found most interesting was how the use of some less formal means of communication could lead to a blurring of professional and personal relationships (Strom-Gowried, p. 444) which could lead to unintended (or intended violations of ethics). One cited source in the article, Berliner, found that “most of the sexual misconduct cases involved private practitioners” (1989, p. 70) and research on psychiatrists has indicated that 88% of the sexual violations were between male therapists and female patients, followed by male psychiatrists and male patients (7.6%), with female psychiatrists and female patients comprising only 1.4% of the cases (Gartrell et al., 1986). This clearly shows the reality that in this area men tend to make up the lion’s share of “bad actors” which is why it is so important to me to keep focused on maintaining professional boundaries across all mediums of communication, digital or otherwise. This is not just to be beyond reproach and avoid these situations happening at all, but also to try and lead by example that other men in the field might do better.
Not being an avid social media user and doing my very best to wipe any digital footprint I may have left, I still think that it is vital to start with concrete rules and understanding in place. Not only does this help a client better understand how to set and maintain boundaries, but also gives you a reasonable defense if accusations are leveled despite the best efforts and appropriate boundary maintenance. You cannot stop individuals from searching out information, but you can create a safety net for yourself.
References
Berliner, A. K. (1989). Misconduct in social work practice. Social Work. https://doi.org/10.1093/sw/34.1.69
Gartrell, N., Herman, J., Olarte, S., Feldstein, M., & Localio, R. (1986). Psychiatrist-patient sexual contact: Results of a national survey. I: Prevalence. American Journal of Psychiatry, 143(9), 1126–1131. https://doi.org/10.1176/ajp.143.9.1126
Strom-Gottfried, K. (1999). Professional boundaries: An analysis of violations by social workers. Families in Society: The Journal of Contemporary Social Services, 80(5), 439–449. https://doi.org/10.1606/1044-3894.1473
Great post!! I would have to agree that as a social worker there is a deep responsibility to yourself to maintain self-care and making yourself a priority. I always love the example of ‘Securing your mask before helping someone else’. I don’t think that you have to compromise who you are and what you’re going through in order to remain ethical and professional as a social worker. I was wondering the same thing about online forumns for recovery and support. I know of support groups and meetings to be in person. There maybe some issues with privacy and not being fully connected with others on a personal level with an online support group. As we continue to advance in technology, to include telehealth, resources, and other support forumns, I can imagine that there will be policies and laws to protect the privacy of the clients and participants.