The Therapist and the Digital Native
It is important as therapists that we start to examine the manner in which our practice intersects with the realities of the digital age. In order to do so, it is helpful to look at who is using digital media and where we can engage them as most of us work with populations who have a digital presence.
This has been an area of academic inquiry for at least the past 15-20 years. Psychology as a discipline has been a little behind the curve on much of this but, with the rise in popularity of Telehealth services and the aftermath of a global pandemic, we are now compelled to re-examine our ideas about how things “should be”.
What is a Digital Native?
A digital native is the generation of young people who were born post-teleconvergence, when computer technology and telecoms merged to produce the “digital age”. These are generally considered to be younger Millennials (a.k.a. Gen Y) and Gen Zers.
What is a Digital Immigrant?
A digital immigrant refers to all the rest of us who learned computing in adulthood before digital technology permeated the lived experience. Digital immigrants are assumed to be very change resistant especially in regard to transitioning into the online space.
These two groups of people were assumed by researchers up to the early 2010’s to be mutually exclusive. However, almost 10 years later, thinking started to change as researchers, (Qian, Myers & Sundaram, 2013) started to recognise the lived reality of those young people for whom access to technology was limited and adaptability low, and older people for whom there is a high degree of adaptability. Ultimately, researchers concluded that the better approach is to examine the idea of “digital fluency” which exists on a continuum.
In conclusion, the assumption that there is a divide between these two groups is actually false according to the research.
So, what is Digital Fluency?
Digital fluency, according to Qian et al (2013), is “the ability to reformulate knowledge and produce information to express oneself creatively and appropriately, and to produce and generate information rather than to simply comprehend”, (p 1).
This means that there is hope for all of us who were born before digital media! If this is a continuum rather than two mutually exclusive categories, then it means that we can move along that continuum.
It also recognises that the ability to comprehend digital media is one skill but that digital fluency also includes the ability to produce content for digital media. If we consider this definition, many young people who consume media are not dissimilar to those older adults who also consume digital media without generating their own content.
Examples of this are older adults with social media accounts who may share posts they see without ever creating their own memes, videos or anything. Many younger people do not create content either. If we proceed upon the basis that we are dealing with a continuum rather than a set category, it means we can approach engagement with digital technology as a skill we can hone rather than something that is just for “young people”.
What of ethics?
The Principle D of the ethics code of the Jamaica Psychological Society states “Psychologists and Counsellors recognize that fairness and justice entitle ALL persons to access and benefit from the contributions of psychology and to equal quality in the processes, procedures and services being conducted by Psychologists and Counsellors”. In Canada, this would be summed up under Principle IV of our ethics code which refers to “social responsibility”.
It is reasonable to put forward the view that under this idea of benefit from the contributions of psychology is access to accurate information which helps to promote social justice for everyone, even when they are not our direct clients. It is this social responsibility piece that covers the ethical imperative of engagement with media generally, and social media and the digital space in particular.
In essence, to not take active steps to de-stigmatize mental health and provide correct information to the general public is us not living up to our own ethics code. None of us wants to be guilty of not fulfilling the important role expected of us as professionals so, perhaps it is time to talk about how we can meet our ethical obligations to the wider society.
What is social media and why is it important?
One of the best definitions I have seen of social media is “the means of interactions among people in which they create, share, and/or exchange information and ideas in virtual communities and networks” (Tufts University, 2021)
Digital media is the first true communication tool invented by people. What sets it apart from traditional broadcast media is the fact that it is accessible instantaneously by so many people who have the opportunity to give immediate feedback and to generate content themselves. This means that the gatekeepers of media have ceased to have sole power to determine what is said, who says it and how.
There are many benefits to this because it allows for marginalized voices within society to be able to carve out space for themselves. It also allows people to connect with others and to share information that traditional media is not able or willing to focus on and therefore, on one hand it has the capacity to level the playing field for people to get their messages out. For a healthy, functioning democracy, this is a huge plus. However, with every technology, there are pros and cons.
With this type of access, comes potential danger. This means that anyone with a computer or smartphone and internet access can put out anything into the public space they want. The internet is an unregulated space and therefore, there are no requirements around fact checking in the same way that traditional media is subjected. Many examples of the quick spread of misinformation abound especially with social media. Recently, Facebook has come under very heavy fire for allowing misinformation related to US election results, anti-vaccination sentiment and flat earth perspectives on their platform. Where issues of mental health are concerned, there is so much misinformation that fear, mistrust and stigma abound.
We also know that youth who navigate the space are subject to bullying and are reporting higher rates of anxiety directly tied to unsupervised internet use. The effects of social media use on this vulnerable group are well documented. As the adults in their sphere, it is up to us to maintain a presence in their world to help guide them away from harmful behaviours and misinformation and this can only be effectively done when we establish ourselves as “safe adults” for them.
For others looking for support around relationships, life transitions, medical issues etc. social media has been a godsend. For many people, it allows them to connect with like-minded people so they can tap into the power of groups to help them cope with life’s challenges or share information specific to them. It is an excellent opportunity to get support in isolated communities.
What are the major social media platforms?
Given the amount of press they have received, Facebook is probably the best known social media platform currently. It destroyed its predecessors, (Hi5 and MySpace) and acquired its competitor Instagram.
Facebook allows people to share text, photos and videos as well as to live stream themselves. They also allow marketers to engage in targeted advertising to reach a specific audience with Facebook Ads and has been recognised as a major part of any social media marketing campaign. As of July 2021, Facebook boasts 3 Billion users worldwide. Put into context, of the almost 8 billion people on the planet, almost 50% of them use Facebook.
Instagram is a photo and video app which allows people to share their own content and to do live streaming from their smartphones and tablets. Jampsych has used this several times to reach their followers and allow for real time discussions of current topical issues. Instagram’s parent company is Facebook although it runs as a separate platform that allows cross posting.
LinkedIn is a professional social media platform which allows people to connect with colleagues and to engage in professional networking. Members can let recruiters know they are available for jobs or collaboration opportunities as well as share their own content, (articles, videos, flyers etc.) so that they can get greater visibility for their products and services.
Twitter allows people to share their thoughts and opinions in very brief statements called “tweets”. Their messages have to be 140 characters or less. Videos and photos can be shared but, the accompanying text has to be short. We have recently seen how Twitter has been used by politicians, celebrities and regular people to share ideas.
Clubhouse is a new social media platform that is currently only accessible by invitation as they are currently still in the beta testing phase. This is the first social media platform dedicated solely to audio. Members join “rooms” within the Clubhouse and can interact with each other by talking.
Likr is also beta testing and has billed themselves as a “nicer” version of Facebook. They have a similar set up but intends to avoid the trolling that is often seen on Facebook.
TikTok is popular with young people as it is short videos to which users are encouraged to post replies (in video). They also participate in challenges (remember the In my Feelings dance challenge?). This app originates in China and there have been concerns about TikTok mining the data of its young and often trusting users.
YouTube is a video platform which allows people to upload content to which people can subscribe. Once a content generator has a certain number of subscribers, it is possible to monetize their YouTube channel. The best local example of this is Dutty Berry. There are people whose entire job is to be a “YouTube Influencer” which means that they have access to millions of followers and are able to monetize their channels through product endorsements, tutorials etc.
Now that you have a sense of what the most popular social media platforms are, how do you engage in using them in a manner that is good for your practice and for your clients?
Social Media Tips for Therapists
For most of us who do use social media, we tend to associate it with connecting with long lost friends and sharing photos. However, social media is a very powerful tool for understanding your clients and promoting your business.
Since it is ethical to engage in the space as a voice of reason in what we are now calling a “post fact world”, we need to figure out how to do so.
1. Don’t be afraid of social media
Not because you were born before the digital revolution means you are excluded from the space. In fact, as therapists, we have a powerful voice and can truly do meaningful work with the public using social media. Remember the continuum? You can choose to move along it.
Social media right now, is the surest way to engage in mass communication without going through a third party like traditional broadcast and print media. Besides, with so much misinformation, it is important that the push against its spread be led by professionals who can speak en masse to counteract harm to the public.
2. Be authentic.
People connect with a person and remember, we attract clients and followers who align with our values. Especially in the Caribbean, people tend to be relational. As you know, the highest predictor of successful outcomes in therapy is the therapeutic alliance.
When people feel like they have connected with you in some way, they are more likely to take on board the things you say. This is the wider de-stigmatization work that should be done by all therapists as part of our social responsibility to provide psycho-education to people beyond those in our caseload. (If you are an Adlerian, this is gemeinschaftsgefühl or “social interest”).
3. Have a separate account for your professional life vs your personal life to preserve your boundaries
Obviously, professional boundaries must be maintained. Many of us have high privacy settings or a different name on our social media accounts which we use for our friends and family. The public one is one in which you reach people who are in the pre-contemplative phase of change. If you recognise this, you can provide basic information, manage discussions etc. which may be the catalyst for someone to move into the contemplative phase and call you.
In fact, by providing this important service, you are helping your community to recognise when they need help. This is often the case with situations where there is abuse and the person being abused is not even aware that what is happening to them is abuse. You may be the voice that helps them make sense of their reality especially when gaslighting is being done to them.
4. Talk to clients about your social media policy and include it in your informed consent form
In the same way that you talk to clients about what happens when you randomly bump into each other, it is important to talk to them to let them know that you do not accept friend requests on social media but that they are free to follow your accounts. Many of them, especially younger people, do not make a distinction between actual life and their online presence. Therefore, you do need to set and keep those boundaries with them.
5. Generate content of your own
This is a lot easier than it seems. You can simply record a beautiful sunshine, a waterfall etc. on your smartphone and upload it to your social media which allows people struggling with anxiety to take a few seconds of calm. If you don’t feel like you want to be in front of the camera but want to still have your own content, this is the easiest way to do it.
Short videos can also be recorded with a selfie stick and your phone. It isn’t hard to do this at all. A 60-second video talking about grounding techniques, hope, the importance of balance etc. are all very important and help build rapport with people who may be hesitant about going into therapy.
Eventually, you can start a podcast or a YouTube channel. Fellow Jampsych member Tricia-Kay Williams has one and focuses strictly on stories about life transitions. This has been a very important tool in promoting her visibility and inspiring others.
Finally, you can create your own photo and video content using apps like Canva. There are both free and paid versions so it is accessible to everyone. You can create your own memes with the hundreds of templates there. You can customize them using your own photos and inspirational quotes, change the colours etc. Doing this is very important because a meme is a video or image that represents the emotions and thoughts of a specific audience and is often social commentary or a response to something happening in society at that time. They abound on social media and are often shared multiple times.
6. Encourage discussion on your page
You can encourage comments on your page so that people can connect and you can get a sense of what prevailing thoughts are. This is important because it helps you to get a sense of what the untrained person thinks and feels. It is likely that this will filter into your practice when you are sitting with clients.
7. Use your pages to promote your blogs, websites, conferences, events, etc.
A blog is simply a space on your website where you can share your thoughts and feelings about whatever you choose. If you were to have a website through Wix, GoDaddy or some other provider where you can set things up yourself, you can create a blog which you can update regularly with content or, you can schedule posts. This allows you to have people who join your mailing list and receive updates from you when new content is available. The posts would then reflect material specific to your area of specialization. It helps potential clients to better determine if you are a good fit for them and it helps those who cannot afford therapy to at least get some psychoeducation.
You can also of course share your events and conferences to reach colleagues. Remember that visibility within the profession is also important as it may lead to referrals, collaboration possibilities etc.
As the field of psychology evolves to match the current reality we all inhabit, we as practitioners do need to change with it. The old ways of doing things are just no longer applicable and, it would be a shame if we did not rise to the occasion to meet our clients literally where they are. Relationship building is so important for vulnerable people and, there has to be a push back against misinformation and exploitation. May we all decide to do the work that benefits the wider society so that there is access for all those who seek accurate information.