Digital Boundaries: Managing Therapist-Client Communication in the Online Age

The boundary between work and life has become a permeable one for many, if not most, people as we’ve gained the ability to be constantly online and connected. For therapy the muddying of the distinction between work and daily life has introduced some complicated questions. The choices a therapist faces regarding how they communicate with, and relate to, clients outside of work hours have big implications for providing care, because appropriate boundaries are fundamental to successful talk therapy.

For talk therapy to work, a therapist has to discuss a client’s most deeply personal matters with them, but must remain at all times an objective professional concerned with guiding the client to a better self-understanding, not an emotionally-invested confidant. The client has to feel comfortable discussing these things, and expects thoughtful, informed honesty from the therapist that might challenge them in a way someone closer would not, as well as meticulous confidentiality.

The way we live our lives online, and the tools out there that facilitate easy communication, even as they make some elements of therapy more convenient, can lead therapists and clients, often unconsciously and accidentally, to interact in ways that subtly rewrite these roles, compromising the boundaries success relies on. But the following tips for managing therapist-client communication in the online age, can make sure that both clinician and client strike the right balance, getting the most out of today’s communication technology without crossing lines that should not be crossed.

Set The Precedent For Texting And Email

There’s no doubt text messaging is convenient. Some find it easier than talking, and some therapists find that it makes sense to receive last-minute cancellations, or even dispense a limited amount of advice, via text message. But this can be a slippery slope.

Texting is, after all, something we do with our friends and family. Communicating person-to-person with a client via text can feel, well, personal. It sets up an expectation of access to a therapist’s personal time, and can also make it easy to slip into a more casual, and less professional, demeanor which wouldn’t happen in a face-to-face session. This shift in tone can compromise therapy’s effectiveness.

Email can also cause problems if used too casually. While it might feel less direct and more professional than texting, answering your client emails at 4 AM can give the impression that you’re always available. This can create difficulties down the line, even if it feels helpful (or like a useful way to spend your insomniac hours).

Therapists should put a lot of thought into what access they allow clients outside of sessions. If you don’t have a robust administrative staff, you can consider implementing tech solutions that handle some off-hours tasks, like scheduling and cancellations, via text or email, so that you don’t personally field those text messages.

Telehealth Counseling is Not an Invitation Over

If texting and email have blurred the lines between the personal and the professional, that’s nothing compared to what telehealth is doing. These days clients might be sitting in their living room or even bedroom during a video call, and you could likewise be sitting where you usually have your coffee.

But a casual environment encourages a casual sensibility, and this can create subtle misunderstandings and misaligned expectations. Therapists are wise to consider this, adjust their environment accordingly, and suggest clients do likewise to the extent possible, in the following ways;

• For therapists: Conduct virtual counseling sessions from a space you’ve cultivated to look professional, and no more (or less) personally revealing than an office.
• For clients: It’s a bigger ask, since therapy is a service they’re utilizing and not one they’re hosting, but if clients can set space aside that feels more structured and dedicated to therapy than, say, their bedroom, it will keep video-based virtual counseling sessions feeling like therapy should. 

Think Before You Post!

How we communicate about clients today has been as disrupted by technology as how we communicate with them. For many people in general now, it feels natural to go online and vent in some online social media forum after a rough day. But doing this can put mental health practitioners in a precarious position.

When you are considering whether to post online, be it somewhere that feels relatively anonymous or not, think. Think not just of the legal confidentiality you must adhere to, but the baseline ethics of the profession. Ask yourself, if a client stumbled onto your post and identified themselves in it, or somehow discovered you were putting things told in confidence up for public judgment, how would they feel? How would it impact your ability to provide them care?

This does not mean that you can never discuss professional matters online, just remember that the ease of online communication should never lull you into loosening your standards of professionalism and privacy.

Keep Boundaries in Mind With Onboarding

If this advice seems reasonable, you might find that following it can be easier said than done. In the field, setting and maintaining boundaries might push against your instinct to be helpful for clients. You can find yourself far down an unproductive, stressful path before you know it.

But there is a tool that can help therapists set the right tone.

Virtual therapy onboarding solutions, which give both clients and clinicians expert-created video content to walk them through everything they need to know about therapy, can contain segments on setting boundaries for both sides of the therapy relationship.

These micro-trainings can be easily accessed at any point in the therapeutic relationship, and so can serve as both an introduction to and a reminder about what is appropriate online communication and what is not.

Having clear, well-established practices for communication boundaries outside the office puts clinicians and clients on the same page without any sense of judgment on either end. It lets everyone benefit from the convenience the online world gives us, without compromising therapy’s effectiveness. So to help keep digital boundaries in mind and therapy running smoothly, implement onboarding!