Careless Use of Facebook Can Jeopardize Your Career

By Frances Patterson, PhD, MAC

I often am asked questions regarding the ethical issues for counselors regarding social networking, specifically Facebook. At that point I usually hear about a situation that has caused professional and personal problems for an addictions professional. In each scenario that follows names have been changed and situations modified to protect the identity of those involved.

Situation 1 – Using Social Media to Monitor Clients

Danny is a substance abuse counselor who decided to join Facebook for a specific reason: he wanted to look up clients to see if they were posting information on Facebook that would indicate they were using.

What are the Ethical Concerns?

Client autonomy: Clients in treatment have a right to choose whether to use alcohol or other drugs. As a counselor would you drive by a client’s house to see if that client is sitting on the front porch smoking a joint? Clients have a right to their personal lives outside of treatment, whether or not it is what we would choose for them.

Counseling relationship: Trust is a major component of the counseling relationship. A client could consider it a violation of that trust to “spy” on him on Facebook. Before the advent of Facebook, a counselor asked clients if they were using and conducted drug screens. Should our methods be any different today?

Do no harm: Is there the possibility that such actions could harm a client? We must always consider the possible outcomes of our actions when it involves client care. A client could possibly feel betrayed by her counselor if such “investigation” is pursued by the counselor.

Professional boundaries: One of our responsibilities as counselors is to have healthy professional boundaries. These boundaries can easily become blurred if or when we begin to intrude on the personal lives of clients outside the professional relationship. Just as we need to set appropriate boundaries with clients regarding our personal Facebook pages, we too should respect their boundaries.

Situation 2 – The Personal/Private Divide

Mary Beth was a counselor at a large addictions treatment facility. She is not in recovery from drug or alcohol addiction. She had recently returned from a vacation at the beach. A client of one of Mary Beth’s colleagues at the same facility mentioned during an individual session that he had been searching people on Facebook and found Mary Beth’s page. He stated, “I really liked those pictures of her vacation.” After the client left, his counselor looked up Mary Beth on Facebook to see what the client was referring to. To her dismay she found that Mary Beth had no security on her page and all of her information was open to anyone who came across it. Additionally, she had posted pictures of herself in a bikini, holding a beer in her hand, with a male companion who appeared to be fondling her. Mary Beth was fired from her job. The agency maintained that she was not projecting a professional image and was negatively affecting the reputation of the agency.

What are the Ethical Concerns?

Counseling relationship: What did the pictures portray to clients and colleagues who saw them on her Facebook page? We have a responsibility to safeguard the integrity of our relationship with clients. (NAADAC Code of Ethics, Principle I) Part of this safeguard is to always being aware of perceptions and how those perceptions may change the professional relationship with a client.

Professional responsibility: If Mary Beth had put the security blocks on her page which would allow only invited friends to see her page, she would have been acting more responsibly. The addiction professional recognizes that those who assume the role of assisting others to live a more responsible life take on the ethical accountability of living responsibly. The addiction professional recognizes that even in a life well-lived, harm might be done to others by works and actions. (NAADAC Code of Ethics, Principle IV)

Discretion: Mary Beth’s actions in regards to Facebook appear to be poor professional judgment. She certainly has a right to her personal life and to enjoy herself. On the other hand, professional judgment includes how we conduct ourselves in public, even in our leisure time which includes what we post on a Facebook page for all to view.

Do no harm: Although Mary Beth is not in recovery herself, the posting of the picture of her drinking may cause undue influence on clients to assume that if it is OK for a counselor to participate in these activities that it must be acceptable for them also. Or clients may believe that Mary Beth is not “practicing what she preaches”. Again, often we are talking about perceptions which may not always be reality.

Situation 3 – Information Sharing

Carla is in private practice working as a substance abuse professional. She recently joined Facebook and being a very social person, enjoys the interactions each evening with her Facebook friends. One of those friends is a counselor at a local substance abuse in-patient facility. For the past few evenings Carla has noticed that her friend has begun to post information about clients she has seen that day, funny things they have done or unusual crises they have experienced. Although her friend is not stating client names she has told others where she works.

What are the Ethical Concerns?

Confidentiality: We are to make every effort to protect the confidentiality of client information. (NAADAC Code of Ethics, Principle III) Carla’s friend has stated where she works and now she is talking about clients of that facility. She is not honoring confidentiality, even though she is not stating client identifying information. She may inadvertently be giving enough information that someone could deduce to whom she is referring. This is also a violation of client rights and their expectation that their information will be protected.

Due diligence: We are to be conscientious and careful in all of our actions when it concerns clients and our professional life. We, as professional counselors, should make every effort to avoid “gossiping” about clients. It is possible that, unbeknownst to this counselor, a client may be a “friend of a friend” on Facebook and actually can see what this counselor is posting and recognizes that the counselor is telling her story.

Legal concern: Carla is bound under 42 CFR Part 2 and HIPAA to make every reasonable effort to protect client information. This type of behavior could result in litigation.

Resolving Ethical Issues: Carla has a responsibility to go to her friend and discuss the ethical and legal concerns she has regarding her friend’s behavior. If her friend is unwilling to change that behavior, Carla next needs to seek supervision and consider her licensure reporting responsibility. (NAADAC Code of Ethics, principle VIII)

Situation 4 – Venting Frustrations

Martin has been having a difficult time at work lately. It is increasingly more stressful with an increased number of clients who are exhibiting more severe symptoms, fewer staff and fewer resources. He has recently been having disagreements with his supervisor. He has also begun to post his “venting” on his Facebook page.

What are the Ethical Concerns?

Discretion: As professionals we have an obligation to use utmost discretion in all of our professional life. Ethically, Martin would be well served to seek other supervision or peer support in his stressful situation rather than venting on his Facebook page.

Professional relationships: Martin is not building, supporting or treating his professional relationships respectfully. As professionals we are to respect other professionals by going to them when we have problems that are affecting us. I have heard many accounts of people losing their jobs as a result of airing their complaints about their jobs and employers on Facebook.

Situation 5 – Compromised Testimonials?

A 12 step focused residential treatment facility developed a Facebook page as a means of advertising. It is also a means for keeping a connection with former clients. These former clients may also write comments on their experience with the treatment program. Recently the administrator contacted former clients requesting that they post testimonials on Facebook. A counselor conducting patient aftercare was made aware of the request and was concerned about confidentiality.

What are the Ethical Concerns?

Informed consent and Confidentiality: In this situation clients need to be fully informed about the risks of posting testimonials on Facebook. If they do post voluntarily, they should be informed of the risk of confidentiality being compromised.

Due Diligence: This treatment facility, as well as the counselor who was made aware of the request, have an obligation to be diligent in the care of clients and sensitive client information.

Exploitation: Is the facility using client testimonials to help others who are suffering with addictions or are they using this to further their business and bring in revenue? The concern here is whether or not it is exploiting clients to ask them to help in marketing a program by posting personal testimonials about their treatment experience. Clients may not understand the far-reaching outcomes of this course of action. Treatment programs need to consider all aspects of their decisions to use media such as Facebook to market their programs.

Reporting

Often I hear professionals say that they hesitate to report unethical behavioral because they are friends with the person or they don’t want to hurt the other person’s career. As licensed or certified professionals, we have an ethical and legal obligation to report unethical behavior that cannot be resolved or that is such an egregious violation that it is beyond being resolved.

As technology grows and becomes more and more available, we as professionals must always consider the ramifications of our actions when using any technology, including social network sites such as Facebook. When ethics are violated, we have an obligation to address the issue and report to licensure boards when necessary.

Be true to yourself, your profession and your colleagues.

Source: http://www.naadac.org/component/content/article/48-publications/643-careless-use-of-facebook-can-jeopardize-your-career

Related Online Continuing Education (CE/CEU) Course:

2-Hour Online CEU Course

Ethics and Social Media is a 2-hour online CEU course for psychologists, counselors, social workers and MFTs. Is it useful or appropriate (or ethical or therapeutic) for a therapist and a client to share the kinds of information that are routinely posted on Social Networking Services (SNS) like Facebook, Twitter, and others? How are psychotherapists to handle “Friending” requests from clients? What are the threats to confidentiality and therapeutic boundaries that are posed by the use of social media sites, texts, or tweets in therapist-client communication? The purpose of this course is to offer psychotherapists the opportunity to examine their practices in regard to the use of social networking services in their professional relationships and communications. Included are ethics topics such as privacy and confidentiality, boundaries and multiple relationships, competence, the phenomenon of friending, informed consent, and record keeping. A final section offers recommendations and resources for the ethical use of social networking and the development of a practice social media policy. Course #20-75 | 2013 | 28 pages | 14 posttest questions

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; by the National Board of Certified Counselors (NBCC) to offer home study continuing education for NCCs (#5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the TexasBoard of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

Parents of Kids with Autism Earn Less

By Rachael Rettner, MyHealthNewsDaily Staff Writer

Adriana Lara, a mother in Hutto, Texas, is not able to work because her 5-year old son Joshua has autism. Lara must stay home to give Joshua the care he needs, and to drive him to his therapy sessions five days a week.

“It’s just impossible for me to be able to hold a job and do all these things with Josh,” Lara, 31, said. The family depends on the salary of Lara’s husband, a psychologist at a Veteran’s Affairs hospital.

Joshua’s therapies, including speech, music and occupational therapy, cost about $5,000 a month. Eighty-five percent of the cost is currently covered by a government grant, but the grant will run out this summer, and the family’s insurance policy won’t cover Joshua’s therapies, Lara said.

“We don’t know how we’re going to afford it,” Lara said. While public schools offer autism therapies, Joshua’s school does not offer the type of intensive therapies he needs, Lara said. For instance, the therapies provided by Joshua’s school are not one-on-one, Lara said.

A new study highlights the unique financial burden faced by families of children with autism, like Lara’s. The burden is particularly significant for mothers, the study finds.

On average, mothers of autistic children earn $14,755 less per year than mothers of healthy children, and $7,189 less per year than mothers of children with other health conditions (such as asthma and ADHD) that limit their ability to engage in childhood activities, according to the study.

Despite the fact that they tend to have completed more years of education, mothers of autistic children are 6 percent less likely to be employed, and they work on average 7 hours less weekly than mothers of healthy children, the researchers say.

“We don’t think that autism creates more of a strain on the family per se than other chronic conditions of childhood,” said study researcher David Mandell, associate professor of psychiatry and pediatrics at the University of Pennsylvania School of Medicine. “I think the reason these mothers are leaving the workforce is because the service system for children with autism is so fragmented,” Mandell said.

Health care and workplace policies need to recognize the full impact of autism, and alleviate costs for the families with greatest needs, the researchers concluded, writing in the March 19 issue of the journal Pediatrics.

Higher Bills, Lower Salaries

About 1 in 110 children in the United States have an autism spectrum disorder, a developmental disability that can cause language delays, impaired communication skills and social challenges, according to the Centers for Disease Control and Prevention.

The new study results are based on yearly surveys of U.S. households conducted between 2002 and 2008. The study included 64,349 families with healthy children, 2,921 families of children with other health limitations and 261 families of children with autism.

While fathers’ salaries, by themselves, were not affected by having a child with autism, total family income was, the study showed. On average, families with autistic children earned $17,763 less than families with healthy children, and $10,416 less than families with children with other health limitations.

As Lara’s story shows, having a child with autism may limit the parents’ abilities to work because these children require more care. Finding quality, specialized childcare for autistic children may be difficult and costly, the researchers say.

“A traditional daycare setting really is really not conducive,” for children with autism to thrive, said Carolyn Price, whose 7-year old son has autism. Autistic children are very sensitive to sights and sounds, and may be overwhelmed at a day care, Price said.

When Price’s son was in daycare — before he was diagnosed with autism — he would bite other children because he couldn’t cope with the environment, Price said. In addition, autistic children need one-on-one interaction that is generally not feasible at day care, Price said.

When Price’s son, also named Joshua, was young and had to be at home, she and her husband felt uncomfortable having anyone beside themselves or close friends look after him.

“It’s really challenging when you have a child with special needs, to really turn that responsibility over to someone else and feel like they are getting the best care,” Price said. Price’s husband Joel still works only part time, so he can drive his son to therapy sessions.

Financial Support

Children with autism need to be immersed in their therapies in order to benefit, Price said. Providing therapy one day a week, when a child needs five sessions, won’t have the same impact, Price said.

In 2010, Price and her husband started a non-profit organization called Imagine a Way to provide financial assistance to families with autistic children. The organization focuses trying to provide funds to support for children for two years.

While other nonprofits and government subsidies offer support to families of children with autism, it’s often comes in the form of a little bit at a time, Price said.

“There’s a recognized need for it, I just don’t think there’s a consolidated organization like Autism Speaks, that’s able to do something on a major scale,” Price said. While any source of funding is valuable, “For the magnitude of what these kids need, a little bit is just not enough,” Price said.

Pass it on:  Autism places a significant financial burden on families.

Source: http://www.myhealthnewsdaily.com/2366-autism-family-financial-burden.html

Related Articles:

• Brain Imaging Could Detect Autism Risk in Infants as Young as 6 Months (pdresources.wordpress.com)
• A Mother Struggles To Care For Her 20yr Old Autistic Son (beyondautismawareness.wordpress.com)
• I Am in Here: The Journey of a Child with Autism (childrensbooksheal.com)

 

Sleep Less, Eat More, Gain Weight

By Carrie Gann

Obesity linked to hormonal changes, lack of sleep

We’ve all heard about the importance of getting a good night’s sleep, and now scientists offer more evidence to back that up. A new study found that people who get less sleep may be inclined to eat more, move less and gain weight.

Scientists at the Mayo Clinic in Rochester, Minn., studied a group of 17 healthy volunteers between the ages 18 and 40 for a week in their homes, monitoring how much each one typically slept and ate. Then, they brought the volunteers into  the clinic’s research lab for eight days: Half of the volunteers were allowed to sleep according to their usual pattern, and the other half got only two-thirds of their usual shut-eye.

All  the volunteers were allowed to eat as much food as they wanted from the hospital cafeteria or from outside the research center. The researchers also measured how much energy each volunteer  expended each day.

The sleep-deprived participants wolfed down an average of 549 calories beyond their usual intake but burned no more calories than their well-rested peers.

“A lot of people have this idea that if they’re up late, working hard, they’re burning more energy. But we found no change in how much they moved when sleep deprived,” said Dr. Andrew Calvin, lead author of the study and an assistant professor of medicine at the Mayo Clinic. “They’re consuming an additional 549 calories per day, but not burning any of them off.”

Those  excess of unburned calories is a surefire way to gain weight, which numerous studies have connected to a variety of chronic health problems.

The volunteers who got less sleep also had higher levels of  leptin, a hormone that suppresses appetite, and lower levels of ghrelin, a hormone that stimulates appetite, in their blood. The findings seem counterintuitive to what researchers would expect in people who are hungrier, but Calvin said the hormones were most likely an outcome, rather than a cause of people eating more.

Scientists have previously studied the physical downsides of getting too little sleep.

In 2011, Australian researchers found that adolescents and teenagers were more likely to be slimmer if they went to bed earlier, while those who stayed up late were more likely to engage in sedentary activities.

Previous studies have also found that workers covering late and overnight shifts were  more likely to be obese and have type 2 diabetes, which may be associated with unhealthy eating habits, according to an editorial published in December.

The connection between sleep and weight may be important for the more than one-quarter of Americans who get six hours of sleep or less every night. Calvin said the future research on how sleep affects eating habits may give scientists useful insights into two of America’s biggest health problems: sleep deprivation and obesity.

“This study, while small, suggests that these two may indeed be linked, and if the findings are confirmed, they may suggest that sleep is a powerful factor in how much we eat and our chances of gaining weight,” he said.

Source: http://abcnews.go.com/blogs/health/2012/03/14/sleep-less-eat-more-gain-weight/

Related Articles:

• 7 Big Nutrition Myths (pdresources.wordpress.com)
• Warning Sign? Disrupted Sleep Tied to Alzheimer’s (pdresources.wordpress.com)
• Overeating May Double Risk of Memory Loss (pdresources.wordpress.com)

 

How to Survive the Daylight Saving Time Switch

The health effects of daylight saving time and how to mitigate them.

By Claire Penhorwood, CBC News

It’s almost time for that annual ritual of turning the clocks forward, which means we will soon be enjoying an extra hour of daylight at the end of the day. But along with the hour of daylight we gain this Sunday, the quarter of the world’s population who observe daylight saving time will also be losing an hour of sleep.

One hour might seem like a small change, but it has proven to have a larger effect on us than just being a little groggy come Monday morning.

Health Effects

Today, the original purpose of daylight saving time — maximizing the amount of light during waking hours —still holds true. But more studies are popping up suggesting that people who are already susceptible to certain health problems, such as high blood pressure and depression, will feel the effects even more when the clocks move forward.

A Swedish study published in the New England Journal of Medicine in 2008 found the risk of a heart attack increases in the days right after the daylight saving time change.

“The most likely explanation to our findings are disturbed sleep and disruption of biological rhythms,” the lead author of the study, Imre Janszky, told National Geographic in an interview last year.

Researchers and sleep specialists have in recent years warned that the pace of modern working life, especially in the West, has left the majority of people sleep deprived. In 2007, Till Roenneberg of Ludwig-Maximilians University in Munich tracked the sleeping patterns of Europeans to explore the effects of moving from daylight time to standard time.

The study found that while both late and early risers adjusted to the time switch in the fall, night owls had a particularly difficult time adjusting to the time shift in the spring.

Australian researcher Greg Roach of the University of South Australia’s Centre for Sleep Research, who studies the body’s internal clock, said the study was commendable, even if it did confirm what many of us already knew.

“Until now, most of the impact of daylight saving time has been anecdotal,” Roach told the Australian Broadcasting Corporation. “One of science’s aims is to find evidence for things that seem common sense.”

Shyam Subramanian, a pulmonologist at Baylor College of Medicine and medical director of the sleep lab at Ben Taub General Hospital in Houston, spoke to the Houston Chronicle in 2010 about the effect of daylight savings on sleep patterns. Like Roenneberg, Subramanian’s research led him to conclude that most people in the West are already sleep deprived and are more affected than they realize by the time change.

“Losing an hour of sleep contributes to sleep debt,” he told the Chronicle. “If you don’t make up the debt, it manifests in waking up tired, needing a lot of caffeine to get going, nodding off during the day.”

The underlying lack of sleep and the adjustments people have to make to their schedules during daylight savings can also cause more accidents, Subramanian said.

“There is a higher incidence of workplace and occupational accidents, particularly in industries like mining and transportation, for about two to three weeks right around this time,” he told the paper.

Necessity or Nuisance

Scientists aren’t the only ones warning about the effects of daylight saving on health and behaviour. The Insurance Bureau of Canada doesn’t keep data on the number of accidents associated with the time change but uses the clock adjustment to remind people to be more cautious and pay greater attention to safety.

“From a property and casualty standpoint, [daylight saving is] a reminder for people to be awake, be aware and be safe on the roads,” said bureau spokesperson Steve Kee.

The bureau suggests people use the ritual of adjusting their clocks to remind themselves to also check around their home for possible safety risks, Kee said people can take that time to replace batteries in smoke and carbon monoxide detectors, put together an emergency supply kit and check homes for hazardous materials.

There are those who believe that the health and public safety risks associated with daylight time changes are significant enough to make changing the clocks twice a year more trouble than it’s worth.

Groups around the world have been lobbying governments to get rid of seasonal time changes altogether.

In Canada, areas of Quebec east of 63 degrees west longitude do not change to daylight time and remain on Atlantic standard time year round. Pockets of Ontario and British Columbia do not use daylight time.

Most of Saskatchewan has not observed daylight time since 1966 and stays on central standard time all year-round, with the exception of some border towns that follow the same time as their neighbours in Manitoba or Alberta.

Daylight time is observed in most of the United States. Just two states, Arizona and Hawaii, and three territories, American Samoa, Puerto Rico and the U.S. Virgin Islands, do not participate.

Some groups are pushing for daylight saving to be implemented all year long. A campaign called Lighter Later in the U.K., for example, has suggested that clocks be put forward an hour permanently. That way, come springtime, clocks will essentially be put ahead two hours, resulting in two extra hours of daylight in the evening.

The extra two hours of light for half of the year would mean a significant reduction in electricity use and approximately 300 more hours of daylight a year, according to Mayer Hillman, a Lighter Later advocate.

The campaign has strong support from road safety groups, the tourism industry and certain special interest groups representing children and teens, women, pensioners and people living in rural communities, Hillman said.

The group’s proposal was brought forward in the British Parliament earlier this year as the Daylight Saving Bill but has since been tabled.

The growing debate on the relevance of daylight saving will no doubt continue, but for now, most of us will turn our clocks forward this Sunday at 2 a.m.

Source: http://www.cbc.ca/news/canada/calgary/story/2012/03/08/f-daylight-saving-time-spring.html

Related Articles:

• RoadFish.com Reminds Americans to Spring Forward This Sunday, March 11th for Daylight Savings Time and Advises a Sunday Afternoon Nap to Make up for the Hour Lost (prweb.com)
• Daylight Savings Time and “Cyberloafing” (freakonomics.com)
• Daylight Saving 2012: Put your clocks forward this Saturday night (news.nationalpost.com)

 

Free Webinar on the Proposed DSM-V

DSM-IV-TR vs. Proposed DSM-5: Comparison, Implications and Impact

Join NAADAC on February 29, 2012 from 3-4 p.m. EST and earn one continuing education credit. A revised edition of the Diagnostic and Statistical Manual of Mental Disorders will be released in May 2013. This webinar will examine the proposal and let professionals know what to prepare for.

More info: http://www.naadac.org/component/content/article/45-knowledge-center/625-february-2012-dsm-v-webinar

Related Articles:

• Possible DSM Changes Spark Controversy (pdresources.wordpress.com)
• Grief is a Mental Illness…Really? (pdresources.wordpress.com)
• Proposed DSM 5 Changes and Autism: What Parents & Advocates Need to Know (pdresources.wordpress.com)