Tag Archives: social media

Nonprofit News: Avoiding client disclosure on social media

By “Doc Warren” Corson III February 13, 2017

To many people, social media is the best thing since the abacus, transforming the way we live and do business. It offers us a world of knowledge with the stroke of a few keys and the briefest of pauses.

Of course, social media can be both a tool and a crutch that leads to sloppy habits. With the advent of clinician-centered discussion groups on Facebook and other online and social media sites that cater solely to clinical professionals, clinicians are posting an increasing amount of client-related information, sometimes going beyond what the ACA Code of Ethics and relevant laws allow. These clinicians are potentially leaving their clients vulnerable, while leaving themselves and their employers open to ethical complaints and legal suits.

The discussions that were once the domain of individual or group supervision now can be found on any number of social media platforms designed for counselors. Some of these posts come from clinicians from large programs, while others originate with those who are in private or small group practices. Perhaps this shows a lack of experience and knowledge combined with little to no supervision or oversight. I haven’t been able to find a comprehensive study that helps shed light on this topic.

Whatever the cause, accusations that a client’s privacy has been violated can lead to charges of malpractice (and other charges) being filed against the clinician and his or her employer. Comprehensive training followed by regular refreshers could do much to reduce this type of liability.

 

A problem since the early days of the internet

Since the advent of the internet and online bulletin boards (the precursors to Listservs, social media and online groups), there have been issues trying to balance new technology with privacy. About a decade ago, I briefly ran an online group for clinical professionals that was designed so that we could discuss general issues and concerns related to the counseling profession. Sometimes the discussion turned to challenging client cases. Several people, including David Kaplan, chief professional officer of the American Counseling Association, raised questions about this issue. A good-hearted, if sometimes heated, debate took place on these threads, and some very differing opinions were presented. It ultimately did little, however, to change the content of the postings. Within months, I was no longer affiliated with the online discussion group, in large part because of concerns I had about potential ethical violations.

I recently contacted David Kaplan again (he is still in the same role with ACA) to get his opinion on this topic. He agreed that it has been a long-standing issue and that, for both ethical and legal reasons, client information should never be posted on social media. To me, the most powerful thing he said was, “The key for me is the statement at the end [of the ACA Connect site rules and etiquette page]: ‘Please ensure that you phrase your post in a manner that does not describe an actual client.’”

Rather than listing several pages of links to ethical codes, state and federal laws, and the like, I will share the applicable rules and etiquette section from ACA Connect, ACA’s online communities that encourage discussion between counseling professionals.

“Do not present aspects of a case even if the client’s name is not given. Posts that give details about a specific client will be removed. Due to the potential violation of both the ACA Code of Ethics, state and/or federal law, case consultation is not allowed on ACA Connect. It is not permissible to present aspects of a case on a counseling listserv or online forum even if the client’s name is not given. Information shared by a client and clinical impressions must be afforded the same level of confidentiality as the name of the client. Describing a client’s presenting problem, diagnosis, or clinical treatment approach through listservs or online forums – even if the client’s name is not given – is a violation of confidentiality. It is perfectly fine to discuss issues (e.g., asking, ‘Does anyone have any resources on eating disorders in male wrestlers?’ or, ‘Does anyone have a referral to a specialist in PTSD in the Boston area?’), but please ensure that you phrase your post in a manner that does not describe an actual client.”

Owners, overseers, monitors and associated workers of online professional sites, Listserves, groups on social media and other platforms, be they volunteer or paid, could benefit greatly by posting rules that are similar to those above. The enforcement of those rules would prove invaluable.

 

Examples of violations

What follows are some examples of posts that, although they are well-meaning, could potentially lead to ethics or legal charges. (These examples are inspired by actual posts but are not being shared verbatim because I do want not to spread liability or bring possible embarrassment to the original posters; this article is about education, not shaming or embarrassing my fellow clinicians who work hard daily to assist those in their care).

  • “Hi all. I’m looking to make a referral for marriage counseling for a couple that has been married for 14 years. There have been multiple affairs by the stay-at-home husband while his wife was working in the insurance industry. She works till 6 p.m., so evening sessions are a must. They are in the Springfield area and have XYZ insurance.”
  • “I have a client who is 14 years old, has a history of cutting and has recently regressed after her parents told her and her twin brother that they are divorcing. She had also disclosed that she feels she may be bisexual. Any resources that may assist me in treating her would be greatly appreciated.”
  • “OK, so I have this client I’ll call ‘Will.’ I’ve worked with him for several years in my private practice in Newport News. He’s a retired steamfitter and the father of three young adults — two male and one female. Recently, the daughter called me to tell me that she noticed that some of her underwear is missing and suspects that he may have taken them and is possibly wearing them. She doesn’t want to talk to him about this but wants me to explore this in my next session with him. Any suggestions as to how I should approach this with him?”

 

Ways to avoid a violation

  • “Hi all. I’m looking to increase my referral list and am looking for clinicians in the Springfield area who have evening session times and take XYZ insurance. Experience with familial issues would be a plus.”
  • “I’m looking for resources for working with teens who cut and also for sexuality related issues. Thanks!”
  • In my opinion, the third example is beyond paraphrasing. It shows the need for good supervision even when in private practice. The information provided would make it easy to identify this family, even in a city that has a large shipyard.

 

Social media is not a replacement for supervision

In an increasingly connected world, it is important to remember that social media cannot replace the ethical requirement for supervision and it should not be treated as such. Joining these online/social media discussion sites for clinicians can make us feel more connected and less isolated professionally. They can help build a referral base and can help us to plan social events, but they are simply unsuitable for case consults.

Many of us employ a “we are all on the same team” mindset, and that can do much to help our profession. At the same time, we need to remember that seeking advice on these online/social media websites will never be the equal of calling the clinician in the office next to you and doing a case consult. Our clients are counting on us to keep their lives private; our ethics code and laws related to our profession are here to ensure that we do just that.

If you are in a small practice, be it group or individual, for-profit or nonprofit, be sure to have a solid source for clinical supervision and consultation that falls well within industry standards. This not only helps protect our clients, but also protects us against potential legal and ethical violations.

 

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Dr. Warren Corson III

“Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, and clinical and executive director of Community Counseling Centers of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). Contact him at docwarren@docwarren.org. Additional resources related to nonprofit design, documentation and related information can be found at docwarren.org/supervisionservices/resourcesforclinicians.html.

 

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Nonprofit News: Building a community on social media

By “Doc Warren” Corson III October 24, 2016

As a guy who doesn’t even use a cellphone, I’m not exactly what many would consider a technology wizard. Still, I make sure to maintain an updated and functioning website and a viable and active social media presence for the charity that I direct. This has helped us not only when it comes to receiving referrals, but also in building a community feel for our programming and growing our volunteer base.

Here are a few guidelines that may help you establish a solid social media presence for your counseling nonprofit.

 

Make your name matter: This is a time to keep things simple and clear. Try to avoid acronyms unless you have a widely known one. Many folks may be familiar with HRC (Human Rights Campaign), WWF (World Wildlife Fund) and NPR (National Public Radio), but chances are good Social Media Logotype Backgroundthat your program isn’t a household name. Our main program is a therapeutic farm that many call the “WIP” for short, but on social media we spell out the name (Pillwillop Therapeutic Farm) so that folks can find it easily.

Having a social media page name that is known and understood only by an inside few is not going to help things grow. Having a clear and concise name can help you pick up random followers and those who are legitimately looking for you without having to possess any inside knowledge of nicknames or the like.

You can also choose to name a specific program that your nonprofit runs as opposed to featuring the main company. We elected not to have much social media coverage of our parent company because it seemed much more limited than our community-based therapeutic farm. We do, however, make it clear that the farm is one of our programs.

Moderate your page and membership: A small percentage of people may want to get into your social media page for all the wrong reasons. Some may want to sell things such as cheap sunglasses, whereas others may want to use it as a platform to go on a political, religious or hate-filled rant. This can kill or greatly reduce your program’s reach and reputation.

Thankfully, it is typically rather simple to keep most of this stuff out by moderating your page. First, set up your page to require permission to join, and then screen these members to make sure they are real. Take a minute to go over their personal pages to ensure they are not spammers. Look for pictures of the person and the types of posts they generally make to help you determine a spammer. In addition, have moderators for your social media page who help ensure that people are staying within established bounds. If things do go beyond what is allowable, be sure to react swiftly and politely.

Establish clear and simple rules: No one wants to belong to a page with a ton of boilerplate rules that need to be read, signed off on and followed to the letter. Instead, pick a few clear and simple rules that help establish group norms. For our program we have three main rules:

  • No religion
  • No politics
  • No negativity or personal attacks

“No religion” does not mean that churches or other spiritually based programs are forbidden from posting. It simply means that no one is allowed to belittle beliefs that differ from their own. In fact, we actively have people on our site who offer to pray for someone going through tough issues, and folks do indeed post events that are being held at local churches, synagogues, etc.

Our “no politics” rule is set up much the same way. Folks can encourage others to vote or register to vote, but they cannot promote a given candidate or party because that is beyond our scope. The “no negativity or personal attacks” rule can be a bit more confusing for some folks because they are allowed to speak about things that are troubling them. However, they are not allowed to personally attack someone or be overly rude when discussing something that is troubling them.

Lead by example: Moderators help set the tone and pace of a page. Ask folks to serve as moderators who are active, positive and have an ability to get and keep people interested. Moderators should make posts consistently without giving page members the sense they are being flooded. For instance, moderators might consider holding back a few of their planned posts if the page has been particularly active.

Encourage communication among members: Encourage your members to post openly and often. Maintain a safe posting environment that leads people to feel that their voice is important and valuable. You will be surprised at the great ideas often posted by the general membership. Your social media page shouldn’t be meant as a place where only a select few people post.

Provide a solid description: A solid description can help folks get a better understanding of your program and the goals of the group. Be clear and help people get to know the program better by offering a few short paragraphs. If your program name is hard for some to pronounce, offer a pronunciation key. Also include the types of services you offer, a word about the setting and whatever else you feel sets your program apart from others. Here is an example:

“Pillwillop (pronounced: pill will up) Therapeutic Farm is a program of Community Counseling Centers of Central CT Inc. (www.docwarren.org; www.pillwillop.org). We provide high-quality, affordable holistic mental health services to the greater central Connecticut area.

“Nature supports healing of all kinds. Within this picturesque setting we offer outpatient therapy, art therapy, therapeutic gardening, hiking, passive recreation and other programs to support mental health and wellness. Nurture in Nature.

“We are a working community in which all members contribute in their own unique ways to the best of their abilities. By taking an active role in the work and the life of a community, people can gain or recapture a sense of self-esteem, self-identity and a sense of purpose that can often become lost in today’s fast-paced, electronic age. By connecting with each other in a natural setting, each member learns more about themselves and the ways they interconnect with the world.”

To advertise or not, that is the question: Some folks set up social media pages and let them grow organically through word-of-mouth, whereas others aim for fast growth through paid advertising. There really is no right or wrong way. However, paid advertising can create somecoffee with foam in like form issues with quality control and monitoring. This is where moderators can really come in handy.

If you do advertise, be realistic in the scope, cost and reach of the advertising plan. If you are a local program with limited reach, a national ad campaign will likely be a waste. Some social media sites offer targeted advertising that can reach particular towns or even certain sections of towns. Think and choose wisely.

Be aware of HIPAA and confidentiality issues: It’s important to remember that while you may be doing your best to build an online community, HIPAA (the Health Insurance Portability and Accountability Act) and other confidentiality issues are still in play. Be careful not to ever put any information on the site that is protected or that will identify anyone as a client. Do not ever identify page members as clients, even if they identify themselves as such. You owe it to your clients to maintain their privacy.

Pictures can be posted, but it is best to focus on the program itself and not the people unless 1) the pictures are of a public event that you held, 2) the pictures do not identify anyone as a client AND 3) you have full permission to post the pictures.

Social media can be an effective and free way to help promote your nonprofit program. If you are not currently using it, you really should give it a second thought.

 

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Dr. Warren Corson III

Dr. Warren Corson III

“Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, and clinical and executive director of Community Counseling Centers of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). Contact him at docwarren@docwarren.org.

 

Technology Tutor: Thinking about discussing clients online? Think twice

By Rob Reinhardt August 29, 2016

Our work as counselors can be isolating at times. It is important for our professional growth, our work with our clients and our own mental health to seek peer consultation.

The internet has significantly broadened the potential pool of peers with whom we can consult. Counselors are flocking to mailing lists, forums, LinkedIn and Facebook groups to connect and learn from one another. This is a good thing! It comes with some caveats, however, especially facebookwhen the focus of a discussion is a client issue.

I hope most of us have had the positive experience of taking a client situation to a group of peers and receiving helpful feedback. These discussions might start with a brief case study: “I’m working with a young black male who is in management at his work. He has a history of anxiety that has been exacerbated recently because he feels he is being discriminated against and passed over for promotions despite his excellent performance reviews.”

This likely would be followed by questions from the counseling peer group to learn more about the situation and then a group exploration of how to proceed with the case. It’s nice to think that this discussion could take place with a large number of peers from all over the country — or even the world. Imagine gathering the synthesis of a wide array of different perspectives on this case.

The challenge on the internet is creating this scenario while maintaining client privacy and confidentiality. You’ve likely been informed at some point not to put anything on the internet that you don’t want the whole world to know. In truth, there are some areas and services on the internet that are far more secure than others (for example, electronic health records, banks, etc.). However, such high-level security doesn’t apply in places such as mailing lists and Facebook groups. In considering whether to post something about clients online, I encourage you to use the mnemonic PIT — the place where information falls in and can be discovered by anyone who happens to peer in. PIT stands for Permanence, Identity and Transferability.

Permanence

It’s important to assume that once something is sent across or stored on the internet, it’s there forever. Unless you’re operating on a private server that you have complete control over, presume there are redundant backups and other measures in place to ensure that data aren’t lost. Need a visual example? Head to the Wayback Machine and have a look at what the American Counseling Association website looked like in 1997 (bit.ly/ACAWayBack). And be aware that it is not only websites that are archived like this.

Some of us might think, “Well, if we share minimal data about this client, it won’t matter if it’s permanent.” Consider, however, that this permanence increases the chances that someone may recognize the client through your description because that information has the potential to be read for months and years to come.

Identity

In educational, employment or office settings, you are likely sitting face to face with people you know. Their identities have either previously been verified or can be verified quite easily in the moment.

Now consider online forums. Even those with the most stringent identity-verification procedures are problematic. Yes, there are professional peer groups that ask members to verify their identities and professional licenses, but few of these groups engage in authentication processes. In other words, there is no way to be perfectly sure that everyone in the online group:

  • Is who they say they are
  • Is a mental health professional
  • Subscribes to the same code of ethics and conduct
  • Agrees to hold all information posted in confidence
  • Will not make a mistake and share, forward, screenshot or otherwise cause the information posted to be viewed by someone outside of the intended audience (can you say “reading your Facebook news feed while sitting in a coffee shop?”)

That last bullet point is a big one. I don’t know of too many people who have never accidentally hit the “Share,” “Forward” or “Retweet” buttons. Even though some groups (particularly on Facebook) are set up to prevent sharing of posts outside of the group, it isn’t foolproof. And they can’t prevent things such as screen shots, which brings us to the next point.

Transferability

Almost all information posted on the internet can be forwarded or duplicated in some manner. Emails can be forwarded. Replies can be inadvertently sent to the wrong person. Facebook posts can be shared and reshared. And then there are screen shots.

Screen shots make it possible to share any type of content virtually anywhere. A screen shot of an email can be posted on Facebook. A screen shot of a Facebook post can be placed on a webpage. There’s no limit to how far and wide a piece of information can be shared.

Perhaps you’ve seen the posts on Facebook by teachers and parents who want to prove this concept to kids. They post a picture and ask everyone to like and share it so that kids can see how quickly information can travel to thousands — potentially millions — of people. Although this is a deliberate behavior, I encourage you to consider it when deciding whether to post something online.

Additional considerations

When discussing this topic with mental health professionals, their first consideration is often whether someone might recognize the client. They reason that if they leave out identifiers and keep the information general enough, the likelihood of someone positively identifying the client is small.

What I think many neglect to consider is the possibility that the clients themselves may view this information. It’s very difficult to speak generally about clients and not have them recognize themselves, particularly when they already know they are working with the counselor who shared this information.

Not convinced? As an exercise, think about how you would describe a client in a peer support context in a way that would leave that client unidentified. Now give thought to whether the client would recognize himself or herself if you shared those same details.

Psychologist and “Selling the Couch” podcaster Melvin Varghese echoed these sentiments when asked his thoughts on discussing clients online: “When thinking about asking a clinical question in a public forum like a FB [Facebook] community, I run my mind through two steps. First, I ask myself, ‘If my client saw what I just typed, would they feel like their privacy was being violated?’ Second, I ask myself, ‘If the roles were reversed, would I feel like my privacy was being violated?’ If the answer is yes to either question, I either need to make the question more general (i.e., remove anything that could remotely identify a client, from geographic location to age, gender, etc., and/or connect them to me) or leave it to an in-person consult with a colleague or supervisor.”

From a big picture perspective, I also encourage counselors to consider the public perception of mental health professionals. Even if someone can’t recognize a client on the basis of something you’ve written online, how will that person feel knowing that a mental health professional is discussing clients online? Will this change the likelihood of that person seeking help when he or she needs it? How will it change that person’s perception of counselors?

Tamara Suttle, chief inspiration officer at Private Practice From the Inside Out (tamarasuttle.com), hosts her own Facebook group and is a member of others. Although she has strict rules prohibiting the discussion of clients on her Facebook group and website, she knows that others do not. Here’s what Tamara, a member of the American Counseling Association, said about this topic: “I see [and] hear therapists talking about clients on social media almost weekly. It’s tragic really that they don’t realize how damaging this can be [not only] to their clients, but also to a therapist’s own professional reputation. I left one Facebook group for a while because of this very thing. The shocking part is that when therapists were confronted either on the group or privately, many rationalized and attempted to justify their behaviors by stating things like, ‘Therapists need a place to vent too!’ Even more shocking were the numbers of otherwise well-respected therapists who chose to remain silent on the issue.”

Ethics

To reinforce the importance of these points, we need to look at this topic from our ethical framework as counselors. The ACA Code of Ethics states that:

  • “Counselors protect the confidential information of prospective and current clients.” (Standard B.1.c.)
  • “Counselors discuss confidential information only in settings in which they can reasonably ensure client privacy.” (Standard B.3.c.)
  • “Counselors take precautions to ensure the confidentiality of all information transmitted through the use of any medium.” (Standard B.3.e.)
  • “When consulting with colleagues, counselors do not disclose confidential information that reasonably could lead to the identification of a client … unless they have obtained the prior consent of the person …” (Standard B.7.b.)

As previously noted, case consultation is an import aspect of the work we do as counselors. We typically address this through informed consent, letting clients know that case consultation happens and what the parameters are. It’s important to note the context of those consultations. Most clients are likely to understand and support face-to-face case consultations between licensed professionals within a secure office environment. But will they provide their consent if you inform them that these discussions may take place in Facebook groups? Can you ensure their privacy and confidentiality there?

To be clear, ACA representatives share these concerns, advocating for a strict interpretation of the ethics code. This includes a stance that online group forums do not constitute group supervision or consultation. ACA Chief Professional Officer David Kaplan states, “Professional counselors are ethically mandated to not discuss clients — with or without identifying information or circumstances — in public spaces, to include online spaces.”

Readers interested in exploring this further may want to pick up a copy of Using Technology to Enhance Clinical Supervision by Tony Rousmaniere and Edina Renfro-Michel. The book is published by ACA.

Legality

It is also important that counselors consider the legal implications of anything they share online. In addition to HIPAA (the Health Insurance Portability and Accountability Act), they need to be aware of any applicable privacy laws in their states.

Anne Marie “Nancy” Wheeler, an attorney licensed in Maryland and Washington, D.C., serves as ACA’s risk management consultant. “Discussing clients online can lead to potentially serious risk management and legal problems for counselors,” she warns. “Even when the information is supposedly deidentified, a client who recognizes himself in an online post could file a complaint against the counselor alleging a number of issues, including intentional infliction of emotional distress.”

Now look back at the client example I presented at the beginning of this article. It may have seemed appropriately vague at the time. But having read this article, I encourage you to give some thought to whether you would still post such information anywhere online.

Appropriate discussion

These cautions don’t mean that we have to ignore all the wonderful benefits that can result from connecting and discussing things with peers online. We simply have to give careful thought to our approach. Consider these guidelines.

1) Approach it from a “nonclient” perspective. Using our example, you might ask, “I’d like to hear experiences from those who have worked with people experiencing discrimination. What techniques and interventions have you found to be effective?”

2) When seeking someone to refer to, focus on the counselor’s skills, not the client’s issues. For example, you might say, “I’m looking for a counselor who helps clients with anxiety and also has experience working with clients experiencing discrimination.”

3) Before posting, give consideration to whether any of your clients might think you are talking about them in public and breaking confidentiality, or whether the general public might have a negative or positive view of what you are posting.

4) If you can’t be sure of protecting a client’s privacy and complying with laws and ethics, save the discussion for peer consultation in a secure environment.

As we increasingly lean on technology to carry out our work, it is important that we continue to analyze the risks and make informed decisions according to the priority of protecting our clients and their confidentiality.

 

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Rob Reinhardt, a licensed professional counselor supervisor, is a private practice and business consultant who helps counselors create and maintain efficient, successful private practices. Before becoming a professional counselor, he worked as a software developer and director of information technology. Contact him at rob@tameyourpractice.com.

Letters to the editor:ct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Fertile grounds for bullying

By Laurie Meyers April 21, 2016

Bullying isn’t just for kids anymore. In the past 10 to 15 years, recognition has grown that bullying goes beyond taunts in the schoolyard. Adults can encounter it at work, “traditional” bullying is now enhanced and magnified by online or cyberbullying, and those who identify as lesbian, gay, bisexual, Branding-Images_bullytransgender or queer (LGBTQ) can experience it at any age just for being who they are.

“Bullying and interpersonal violence are tragic experiences that far too many people undergo every day,” says American Counseling Association President Thelma Duffey, who has shined a spotlight on anti-bullying/interpersonal violence efforts as one of her main presidential initiatives. “People can be hurt in such devastating ways when they are bullied, and counselors are in prime positions to help.”

But to be effective, counselors need to increase their understanding of bullying in all of its forms.

Trouble in the schoolyard

The first place many people experience bullying is, of course, at school, and school bullying remains a complex problem. Researchers say putting an end to bullying and ultimately preventing it requires the involvement of everyone in the system, including not just teachers, counselors and students, but also staff such as janitors and bus drivers. Even without a comprehensive anti-bullying program in place, however, there are many steps school counselors can take to help those who are being bullied.

Although any student can face bullying, those perceived to be somehow “different” and, critically, viewed as easy targets most often find themselves in the crosshairs, says JoLynn Carney, an associate professor of counselor education at Penn State whose research focuses on bullying.

“Abusers of all ages seem to have an uncanny sense of who can defend themselves and who may be unable to self-defend,” she explains. “Youth who are isolated — meaning few to no friends — are often targeted. They may have poor social skills … or other qualities not valued in the peer social network such as disability, different sexual orientation, different religion/culture or socioeconomic background. Even just being the new kid can be the characteristic that has the person being targeted. Kids who are highly anxious by nature or depressed also often seem to be the students who are bullied.”

Regardless of the reason behind the bullying, being a target is very isolating. A first step for counselors to take is to listen to and to act as advocates for students who are being bullied to reduce their sense of isolation, says Carney, a member of ACA. But she cautions that counselors must not give the impression that students are passive participants in solving the bullying problem. “The worst thing I’ve seen done over the years is to inadvertently teach kids that the adults in the situation have to handle this, which yields a sense of helplessness in the targets,” Carney explains.

Instead, counselors should work with students who are being bullied to help them understand the situation they are facing and what actions they might take to change it, she says. “Actions for targets are meant to change the dynamics of the situation by changing the target’s conceptualization of the situation and the target’s actions before, during or after the situation,” she says.

Carney says counselors should focus on problem-solving, helping bullied students to:

  • Increase connections to others who can provide immediate or follow-up support. Counselors can help bullied students make connections in multiple ways.

“Whether elementary, middle or high school, the counselors know their students; they know the students they can count on who have the social skills and the empathy to be peer mentors [to the student being bullied],” Carney explains. “They also know about the groups of students — like what club could the target student join to form bonds, and so forth. The bridging the school counselor can do often makes a huge difference. Honestly, I’ve had students or parents tell me in clinical settings that having that one friend saved their child’s life.”

The more friends and support from others the student has, the less vulnerable the bullied student will be.

  • Change some aspect of their behavior so that they are less “predictable” for their abusers, thereby reducing the abusers’ confidence that bullying will produce the desired effect. Taking away the desired result can help shift the power imbalance that is inherent in all bullying situations. For example, students who are being bullied can work on reacting in a different manner or even simply changing their body language. Those who are bullied often display a classic posture — slumped shoulders, head down, perhaps crying. Shifting that submissive posture to a posture in which the body is held more upright sends a different message to all concerned — the abuser, the target and any bystanders.
  • Learn appropriate physical, verbal and social assertiveness. Having a sense of assertiveness allows bullying targets to understand their own power and influence in the situation.

Carney says it is also crucial for counselors to show students who are being bullied how, where and when to seek support when necessary. “Working clinically with targets and their families, I’ve helped with the smallest of shifts that [would] seem inconsequential but have yielded good results, such as helping the person being bullied [not to] see themselves as the ‘victim,’ [which is] a disempowering … view of the self,” she explains. “Instead, helping them see themselves as simply the current ‘target’ of an abuser brings a sense of empowerment because anyone can be a target, and it’s not an internalized sense of negative self-worth. Helping the student see themselves differently can make a big difference in the ability to make the changes to end the abuse.”

Those who are being bullied don’t always ask for help or talk in great detail about what they are experiencing, so Carney has identified several red flags that might indicate that a student has become a target. These include:

  • Changes in behavior such as not wanting to go to school or avoiding other social situations such as birthday parties or school trips.
  • Changes in eating habits such as consistently saying they’re not hungry or skipping meals at school (which might be the result of not wanting to face bullying behavior in the cafeteria) or even engaging in binge eating as a source of comfort.
  • Self-destructive behaviors such as running away and serious talk about (or even an attempt at) suicide.
  • Changes in physical symptoms such as frequent headaches or stomachaches, frequently feeling ill, trouble sleeping or an increase in nightmares.
  • Changes in academic performance such as slipping grades or a lack of interest in classes that the student used to enjoy.
  • Changes in emotional state such as feeling helpless, hopeless, depressed, highly anxious or worthless.

Students who are being physically bullied may also have injuries that can’t be explained or damaged personal objects such as clothes and electronic devices.

Carney believes that if bullying is to be fully addressed, a school culture must be developed that doesn’t tolerate bullying behavior. She and her colleague and fellow researcher Richard Hazler, a professor of counselor education at Penn State, are currently part of the research and implementation team for a major anti-bullying initiative called Project TEAM, which former school counselor Lindsey Covert created based on a framework she developed as a graduate student at Penn State. Covert had success implementing the program and then collaborated with another school counselor, Lisa Dibernardo, to expand the program in the Stafford Township School District in New Jersey.

Covert is the director of the program, which is now part of the College of Education at Penn State. Carney says the curriculum, which she and Hazler are currently implementing in several grade schools, teaches students to focus on the importance of teamwork and leadership in their daily lives. It emphasizes helping others, the concept of positive change, problem-solving and conflict resolution, resilience and leadership.

Individual school counselors can help prevent bullying by conducting professional development trainings that educate teachers, school staff and administrators about the behavioral indicators of bullying and victimization, says Rebecca Newgent, a professor of counselor education at Western Illinois University–Quad Cities. “Bullying can take on several forms, such as physical, verbal and relational bullying,” explains Newgent, an ACA member who researches school bullying and children who are at risk. “Signs that school personnel might notice in regard to physical bullying are hitting, pushing and kicking. Signs for verbal bullying typically include calling the other student names, threatening other students or teasing other students. Relational bullying is somewhat harder to recognize, but some typical behaviors include leaving other students out of activities, not talking to other students and telling rumors about other students.”

School counselors should also emphasize the importance of all school personnel teaching children to demonstrate empathy for the bullied classmate by imagining what the student might be feeling, says Newgent, a member of the Association for Counselor Education and Supervision, a division of ACA. Children should also be encouraged to report bullying and helped to understand that this differs from “tattling,” she continues. “Consistent support and encouragement from teachers and school counselors can reinforce this [reporting] behavior,” she says.

Newgent also urges counselors to reach out to parents via newsletters and parent workshops to engage them in anti-bullying efforts. “Counselors can help parents to work with their children on increasing social skills and assertiveness,” she says. “Parents can help ensure that the family environment is one where the child feels safe and understood.”

Workplace bullying

Bullying isn’t confined to childhood or adolescence. Adults can experience bullying too, particularly in the workplace. Bullying in the workplace involves less obvious behavior than does school bullying and can be almost intangible, says Jessi Eden Brown, a licensed professional counselor and licensed mental health counselor with a private practice in Seattle.

“Bullying in the workplace is a form of psychological violence,” says Brown, who also coaches targets of workplace bullying through the Workplace Bullying Institute (WBI), an organization that studies and attempts to prevent abusive conduct at work. “Although popular media theatrically portray the workplace bully as a volatile, verbally abusive jerk, in actuality, the behaviors tend to be more subtle, insidious and persistent.”

Instead of shoving and name-calling, Brown says, workplace bullying includes behavior such as:

  • Stealing credit for others’ work
  • Assigning undue blame
  • Using public and humiliating criticism
  • Threatening job loss or punishment
  • Denying access to critical resources
  • Applying unrealistic workloads or deadlines
  • Engaging in destructive rumors and gossip
  • Endeavoring to turn others against a person
  • Making deliberate attempts to sabotage someone’s work or professional reputation

“It’s the fact that these behaviors are repeated again and again that makes them so damaging for the target,” she explains. “The cumulative effects and prolonged exposure to stress exact a staggering toll on the overall health of the bullied individual.”

What’s more, those bullied in the workplace often stand alone, Brown notes. “While the motivating factors may be similar between workplace bullying and childhood bullying, the consequences for the bully and the target are unmistakably different,” she says. “In childhood bullying, the institution — the school — stands firmly and publicly against the abuse. Teachers, staff, students and administrators are thoroughly trained on how to recognize and address the behavior. Students are given safe avenues for reporting bullying. Identified bullies are confronted by figures of authority and influence — teachers, administrators, groups of peers, parents. When the system works as intended, there are consequences for the bully, as well as resources and support for the target.”

Brown continues, “In the workplace, bullying receives far less attention and focus. Management may fail to appropriately label the bully’s behavior as being abusive, especially if it doesn’t violate the law. Some employers recognize the problem and still choose to turn a blind eye. And even worse, there are some companies that actively encourage ‘weeding out the weak,’ whereby successful bullies are rewarded with promotions, bonuses, extravagant gifts and other incentives. After counseling and coaching more than 3,000 targets of workplace bullying over the years, believe me, I’ve heard it all.”

The consequences can be devastating. “There is a significant body of research linking workplace bullying to physical, mental, social and economic health harm for the bullied target,” Brown notes. “Hundreds of empirical studies have linked repeated exposure to stress, including stress originating from emotional and psychological sources, to severe physical ailments, such as cardiovascular disease, gastrointestinal problems, immunological impairment, diabetes, adverse neurological changes, disorders of the skin, higher levels of cortisol leading to organ damage, musculoskeletal pain and disorders, and more.”

Workplace bullying has also been linked to panic disorder, generalized anxiety disorder, major depression, substance abuse and posttraumatic stress disorder, Brown continues.

Brown began specializing in counseling clients who have experienced workplace bullying after going through the experience herself in two different positions. “Both times were painful and deeply confusing,” she says. “I seriously considered leaving the counseling profession after the second experience.”

However, a friend who was doing web design for WBI introduced her to psychologists Gary and Ruth Namie, the founders and directors of the institute. The Namies were looking for a professional coach and offered Brown the job. As she worked with those who had been bullied, she began to integrate her experiences into her private counseling practice.

“The vast majority of my clients present as capable, accomplished professionals with a documented history of success in the workplace,” she says. “At some point in their careers, they encounter the bully and everything changes. Under constant attack, belittled and sabotaged, the once-competent, assured worker may begin to question her abilities and role at work. She tries everything she can think of to remedy the problem but finds few working solutions. Mounting stress starts to take its toll and spills over into other areas of life. Throughout this process, many targets fall victim to self-blame. Deep confusion, shame, anger and exhaustion are common at this stage. … This seems to be when most clients discover my services.”

Brown says the first step toward helping clients who are being bullied is to identify what they are experiencing — workplace bullying and psychological violence. Naming the behavior helps clients frame and externalize their experiences by realizing that they are not creating or imagining the problem, she explains.

“Encouraging the client to prioritize [his or her] health comes next,” Brown says. “Working closely with other health care providers is essential in situations where the individual’s health has been severely compromised.”

“It is imperative that the counselor promote the client’s self-care and turn attention toward enhancing [his or her] social support network,” she continues. “This may mean helping the client figure out a way to take time off from work, teaching new coping skills and encouraging time spent with loved ones — time that is deliberately not focused on recounting the situation at work.”

“Targeted workers may choose to file formal or informal complaints to unions, the EEOC [Equal Employment Opportunity Commission], the bully’s boss, ethics hotlines or professional boards,” Brown says. “Although there is no legal protection against bullying in the United States, some workers find grounds for harassment, discrimination, constructive discharge, intentional infliction of emotional distress, wrongful termination or other legal claims.”

According to Brown, WBI research indicates that once targeted by workplace bullying, there is a 77.7 percent likelihood that the individual will lose his or her job due to resignation (voluntary or forced) or termination. A 2014 study conducted by WBI found that 60 percent of bullied workers were women and that men were more than twice as likely as women to act as bullies (69 percent versus 31 percent). However, when women exhibited bullying behavior, they were also more likely to bully other women — 68 percent of female bullies’ targets were also female.

Counselors can help clients who experience workplace bullying to consider their options, starting with whether to stay in their current job or leave. “Many targeted workers choose to transfer or quit just to escape the abuse,” Brown says. “The decision to leave on one’s own terms can be empowering and frequently results in better emotional health than being fired or laid off due to the bullying.”

Brown believes that counselors are in a unique position to help those who are bullied at work. “First, and most importantly, we can believe them when they tell us about the mistreatment at work,” she says. The stress and exhaustion that targets of workplace bullying endure are often isolating and paralyzing, Brown points out, adding that it is generally the bully’s goal to disempower the target.

“Even when they do speak up, targets of workplace bullying tell me that their employers, family and friends often do not believe them or understand their level of distress,” she says. “As counselors, we can listen to their story, convey a sense of belief and offer a distinctly different response than the target has received thus far. … Do not blame the client for the abuse [he or she is] experiencing.”

In most cases, Brown says, the target has done nothing to deserve the mistreatment; the bully chooses the target, timing and tactics, and the targeted individual may have very little control or influence over these factors. The responsibility to stop the abusive behavior ultimately rests with the employer. In these instances, just teaching clients to be more assertive or to stand up to the bully is not the answer, Brown emphasizes.

Cyberbullying: Virtual environment, real bullies

Bullying is presumably as old as the human race, but one thing about the dynamics of bullying has changed dramatically during the past 10 to 15 years. Online, anyone can bully anybody anywhere, from next door to halfway across the world. Cyberbullying is often used to enhance the “traditional” bullying tactics that are taking place in a school or workplace, but it can also serve as a standalone method of harassment.

“Cyberbullying can take place via email, text, instant messaging, social media or any other digital form of communication or information dissemination,” Brown explains. “It may manifest as harassment, impersonation, defamation, stalking, manipulation, denigration or other types of abuse.”

Unfortunately, even people who might never consider participating in traditional bullying behaviors are often tempted by the anonymity of cyberbullying. “When people get on [an electronic] device, normal roles of civil interaction somehow become less relevant,” says Sheri Bauman, author of the book Cyberbullying: What Counselors Need to Know, which is published by ACA.

People who previously were afraid of getting caught for bullying or didn’t want to accept responsibility for their actions now feel free to indulge their baser instincts online, she says. “[They think], ‘I can be as nasty as I want to be; no one knows who I am.’ They don’t have to censor themselves and don’t have to follow social rules,” explains Bauman, a professor and director of the counseling degree program at the University of Arizona.

Researchers don’t know exactly why anonymity has this effect, but Bauman, an ACA member, speculates that it may in part be because online interaction doesn’t quite feel real.

Janet Froeschle Hicks, a licensed professional counselor and certified school counselor in Texas, posits a similar explanation. “Not being face to face with a person makes it easier to dissociate and reduce empathy,” she says. “Technology also gives the false impression that the person on the other end is an ‘object’ rather than a person.”

Young people appear particularly adept at cyberbullying, Hicks says. “Youth participate in cyberbullying several ways. They impersonate one another by stealing passwords, create fake social media pages and send cruel messages anonymously. Often they create pages for another person without that person’s knowledge. This is very damaging because several others can be harmed with one posting.”

“For example, Student A creates a page for Student B without Student B’s knowledge. Student A then uses Student B’s fake page to bully Student C. When this happens, Student C is now upset with Student B, and Student B has no idea what has happened. Rumors about others, gossip, humiliating pictures and rude comments can be posted by Student A on this fake page,” explains Hicks, a professor of counselor education at Texas Tech University whose research focuses on cyberbullying, social aggression and school, child and family counseling.

Many students also participate in a practice known as “sub-tweeting” on Twitter. “Anonymous tweeters comment on others’ tweets without identifying themselves,” Hicks says. “This means rude anonymous messages appear in the midst of a conversation.”

Cyberbullies can use a wide array of methods — from texting to social media to digital pictures — to torment their targets online. As a result, Hicks says, those who have been bullied may develop a fear of technology. “Since we live in an age where students need technology to complete homework, apply for college admission and succeed at a future job, it is important to teach that technology can be safe,” she emphasizes. “I teach parents and youth to use privacy controls, not to share confidential information and to avoid negative conversations [online].”

Although adolescents are typically assumed to be both the culprits behind and the targets of cyberbullying, experts say this isn’t always the case. Adults may be targeted as part of a workplace bullying campaign, a neighborhood grudge or simply at random.

Brown urges her clients to think about ways they can minimize the potential of being bullied. “I encourage my clients to be intentional about their online presence and reputation by actively reflecting upon the image they want to portray,” she explains. “What skills, attributes and experiences are important to highlight? Where do you want your information to appear? Who is likely to find and use your information based on how and what you choose to share? What are you most concerned about regarding your online persona? By exploring questions like these, [clients form] a picture and a plan of how they want to manage their online information.”

Brown also advises clients to thoroughly search their own names on the Internet to find out what information — or misinformation — is already out there about them. “I recommend they set up a Google Alert for their own name and any related identifying key terms. Using myself as an example, I’d set an alert for ‘Jessi Eden Brown,’ ‘workplace bullying counselor,’ ‘professional coach workplace bullying,’ etc. This way, I increase my chances of catching any references made to my name or professional identity. The more I know, the better able I will be to respond to online attacks.”

After clients have identified the details of their online presence, Brown talks with them about how to respond to damaging content and minimize future problems. For example, she advises clients to periodically review the privacy settings on their social media and web-based accounts. “For those being actively cyberbullied, it is wise to lock down all privacy settings or, in some cases, to delete or suspend accounts altogether to give the bully fewer points of access to the target,” she says.

Bauman, who is also a member of the American School Counselor Association, a division of ACA, says that given the prevalence of cyberbullying, counselors need to educate themselves about all social media and related online platforms so they can knowledgeably discuss the issue if a client brings it up.

No walking away

It’s certainly not an ideal option, but if all else fails, those who are bullied at school or work might be able to switch schools or change jobs. At the very least, those who are cyberbullied can choose to reduce their online presence or temporarily go offline. Simply being able to leave a bullying situation can provide precious relief.

But for those who are being bullied because of their sexual or gender identification, there is no walking away. “LGBTQ individuals are bullied in all facets of their lives,” says Tonya Hammer, an assistant professor of counseling at Oklahoma State University-Tulsa whose research interests include both bullying and the intersection of gender and sexual orientation. “We are socialized as a society to bully or reject that which is perceived as different. Unfortunately, it permeates so much of our daily lives.”

LGBTQ individuals usually start facing bullying behavior at a young age, regardless of whether the individual is already “out,” says Hammer, who adds that most bullying prevention efforts don’t start until middle or high school. By that time, according to the National School Climate Survey by the Gay, Lesbian and Straight Education Network (GLSEN), a majority of LGBTQ students are routinely hearing anti-LGBTQ language and experiencing victimization and discrimination at school.

The 2013 survey — the latest year for which statistics are available — found that of the 7,898 students between the ages of 13–21 who participated in the study, 55.5 percent felt unsafe at school because of their sexual orientation, while 37.8 percent felt unsafe because of their gender identity. In addition, 71.4 percent of LGBTQ students heard the word “gay” used in a negative way frequently or often at school; 64.5 percent heard homophobic remarks frequently or often; and 56.4 reported hearing negative remarks about gender expression (for example, not acting “masculine” enough) frequently or often.

Distressingly, 51.4 percent of the survey respondents reported hearing homophobic remarks from their teachers or other school staff, and 55.5 percent reported hearing negative remarks about gender expression from teachers or other school staff.

The effects of this widespread bullying are significant, says Hammer, who presented a session on LGBTQ bullying across the life span at the 2016 American Counseling Association Conference & Expo in Montréal. “Bullying results in feelings of shame and humiliation, which can lead to isolation, lack of emotional regulation [and] violence against self or others,” she notes. Hammer adds that it also increases dropout rates and negatively affects academic performance.

Although counselors cannot completely stop school bullying single-handedly, they can provide a refuge for LGBTQ students to feel supported and accepted, says Hammer, president-elect of the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling, a division of ACA. “Counselors can create a safe space by a variety of means. It can be as simple as displaying an HRC [Human Rights Campaign] equal sign [the organization’s logo] in their office or a small rainbow flag somewhere. I know that sounds minor,” she says, “but small symbols can signify something to students.”

Hammer says counselors can also reach out to students who may be subject to bullying, but she emphasizes that counselors should not address sexual/affectional or gender identity unless the student brings it up. Instead, counselors could start by letting the student know that they have noticed a change in the student’s behavior that they think might be connected to bullying.

“You can also [just] ask them if everything is OK and if they need someone to talk with,” says Hammer, who during her time as a board member of the Houston GLSEN chapter trained school personnel in Texas using GLSEN’s anti-bullying program. “Sometimes it is also simply providing a space for them. When working with counselors or librarians, we often suggest creating an actual physical space in their office where students can come and just hang out. Make the space feel inclusive in the way you decorate it and in the material that you provide for them to read or occupy their time with.”

“Also understand that the students may still be questioning their sexual/affectional orientation or gender identity or expression and need people who they can confide in while doing this. Furthermore, their parents may not be that safe space,” Hammer says. “Give them time to feel comfortable and to trust you so that they will open up about what is going on with regard to the bullying and also about their sexual/affectional orientation or gender identity and expression.”

Hammer also cautions counselors not to assume that a student is gay simply because he or she is perceived as being gay. “The most important thing is the relationship,” she emphasizes. “Listen to them with respect and treat them with dignity, not as if they are abnormal. Let them know that they matter to you, to their family and to the world.”

Because eliminating bullying requires altering a school’s culture, counselors can also help students by offering schoolwide education on LGBTQ issues or sponsoring formation of gay–straight alliance groups, Hammer says. Additionally there are awareness activities counselors can help organize such as No Name-Calling Week, Ally Week and Day of Silence, in which silence is used to protest the silencing of LGBTQ people due to harassment, bias and abuse.

Workplace bullying based on sexual/affectional orientation or gender identification is also still very common, Hammer says. In fact, according to HRC, of the LGBTQ Americans who have experienced discrimination, 47 percent reported experiencing it in the workplace. To add insult to injury, HRC reports that only 19 states and the District of Columbia explicitly prohibit workplace discrimination based on sexual orientation or gender identity. A 2009 HRC study found that 51 percent of LGBTQ workers hid their identities from most or all of their co-workers. Strikingly, the report found that younger workers were even more likely to hide: Only 5 percent of LGBTQ employees ages 18–24 said they were completely open at work, compared with 20 percent of older workers.

Unfortunately, leaving a hostile working environment and finding another job isn’t always possible — regardless of sexual or gender identity. And given the extent of bullying that LGBTQ workers face, leaving one job for another is far from being a surefire solution to the problem.

“Sometimes it is a matter of helping people to develop support systems outside of work that can help them to address the hardships of their daily life at work,” Hammer says. “If possible, it is our responsibility as counselors to help advocate for our clients. If legal resources are available, we help connect our clients to those resources. Organizations like HRC, the Southern Poverty Law Center and the ACLU [American Civil Liberties Union] can help in some situations, but not all. We can also connect them with career counselors or agencies that can help them see if there are options for them to change jobs or careers.”

Hammer also believes counselors have a responsibility to help lobby to change laws that make it legal for people to be fired because of their sexual orientation or gender identity.

“LGBTQQI clients, like all clients, want to know that they matter and that they are important,” Hammer says. “The therapeutic relationship may be the first and only relationship in which they experience that, and it may be the only place where they can truly be all of who they are. Providing that space and time for them to do that may empower them to be able to do it with other relationships in their life as well. You can help them to understand that they are worth [having] healthy growth-fostering relationships and provide them with the skills and resources to develop those relationships.”

 

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To contact the people interviewed for this article, email:

 

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Additional resources

For those who would like to learn more about the topics addressed in this article, the American Counseling Association offers the following resources:

Books (counseling.org/bookstore)

  • School Counselors Share Their Favorite Classroom Guidance Activities: A Guide to Choosing, Planning, Conducting, and Processing edited by Janice DeLucia-Waack, Meghan Mercurio, Faith Colvin, Sarah Korta, Katherine Maertin, Eric Martin, and Lily Zawadski
  • Youth at Risk: A Prevention Resource for Counselors Teachers and Parents, sixth edition, edited by David Capuzzi and Douglas R. Gross
  • Casebook for Counseling Lesbian, Gay, Bisexual, and Transgender Persons and Their Families edited by Sari H. Dworkin and Mark Pope
  • Cyberbullying: What Counselors Need to Know by Sheri Bauman

DVDs

  • Working With Perpetrators and Targets of Cyberbullying presented by Sheri Bauman
  • Bullying in Schools: Six Methods of Intervention presented by Ken Rigby

Webinars (counseling.org/continuing-education/webinars)

  • “Children and Trauma” with Kimberly N. Frazier (part of the ACA Trauma Webinar Series)
  • “Counseling School and College Students” with Richard Joseph Behun, Julie A. Cerrito and Eric W. Owens (part of the ACA Trauma Webinar Series)

Podcasts (counseling.org/continuing-education/podcasts)

VISTAS Online articles (counseling.org/knowledge-center/vistas)

  • “Anger Management for Adolescents: A Creative Group Counseling Approach,” Carolyn O’Lenic and John F. Arman
  • “BEST Buddiez: A Programmatic Innovation in Early Child Mental Health Treatment for Physically Aggressive Preschool Children,” Rita J. Terrago
  • “Brief Solution-Focused Counseling With Young People and School Problems,” John Murphy
  • “Domestic Violence and Children,” Laurie Vargas, Jason Cataldo, and Shannon Disckson
  • “Making the Change From Elementary to Middle School,” Laura M. Hill and Jerry A. Mobley
  • “Solution-Focused Counseling in Schools,” John J. Murphy
  • “The School Counselor’s Role in Easing Students’ Transition From Elementary to Middle School,” Matthew Mayberry
  • “Empowering LGBT Teens: A School-Based Advocacy Program,” Matthew J. Mims, David D. Hof, Julie A. Dinsmore, and Laura Wielechowski
  • “School Climate Perception: Examining Differences Between School Counselors and Victims of Cyberbullying,” Megan M. Day, Lindsay R. Jarvis, Charmaine D. Caldwell, and Teddi J. Cunningham
  • “School Counseling for Systemic Change: Bullying and Suicide Prevention for LGBTQ Youth,” Jeffry L. Moe, Elsa Sota Leggett and Dilani Perera-Diltz
  • “School Shootings and Student Mental Health: Role of the School Counselor in Mitigating Violence,” Allison Paolini
  • “Sexually Active and Sexually Questioning Students: The Role of School Counselors,” Vaughn Millner and Amy W. Upton
  • “The Bullying Project,” Le’Ann L. Solmonson
  • “The Impact of Attendance at a LGBTQIA Conference on School Counselors’ and Other Educators’ Beliefs and Behaviors,” Aaron Iffland and Trish Hatch
  • “Using the Reflecting As If Intervention to Reduce Bullying Behaviors,” Gerald A. Juhnke, Brenna A. Juhnke, Richard E. Watts, Kenneth M. Coll, and Noreal F. Armstrong

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

 

Facebook: Don’t let friends’ cries for help go unanswered

By Bethany Bray October 7, 2014

“I can’t handle life right now.”

“Didn’t get out of bed today.”

#worthless

For those who use Facebook, status updates, comments and hashtags such as these may be all too familiar. In this electronic age, people often turn to the availability and relative anonymity of social media to vent frustrations and sad feelings – or indications of deeper, more serious distress.

With this in mind, Facebook recently introduced a guide to help users know what to do if a friend posts a suicide threat or other serious cry for help.

facebookThe guide, which Facebook created in partnership with the nonprofit Jed Foundation and Clinton Foundation, was launched Sept. 10, on World Suicide Prevention Day.

Dubbed “Help a Friend in Need,” the guide is available on Facebook’s safety materials page and will also be promoted in Facebook ads geared toward college students.

Close to 90 percent of young adults (ages 18 to 29) use Facebook, according to a recent Pew Research Center study. Adults ages 30 to 49 are not far behind, with 82 percent reporting that they use Facebook.

The social network’s three-page “Help a Friend in Need” guide lists red flags and warning signs users should look for, as well as guidance on how to respond and ways to get help, including suicide hotline information. The material is based on evidence-based practices, according to the guide’s creators.

In the guide, Facebook urges users to trust their instincts. “If you see someone posting messages, photos, videos, links, comments or hashtags that suggest the person is in emotional distress, you should reach out and get them the help they may need,” the guide says. “… Never be afraid to give your friend a call, pay a visit, or send them a Facebook message to let them know you are concerned, and offer to help connect them with any extra support needed.”

The guide urges users to reach out directly to the individual, either in person or electronically, rather than clicking the “like” button on a concerning post, which could be misunderstood by the individual in distress.

If the individual declines to talk about what is troubling him or her, Facebook users are advised to say, “It’s OK if you don’t want to talk to me, but it is important that you talk to someone.” Options such as a mental heath center, college counseling office or chaplain are suggested.

“No matter what, you shouldn’t be embarrassed or worried about offending or upsetting your friend,” the guide says. “Helping your friend may take some courage, but it is always worth the effort to support their health and safety.”

The guide, launched for both Facebook and Instagram in the United States, is also available to users in seven European countries and Canada.

 

 

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Find the “Help a Friend in Need” guide at  fb.me/helpafriend

 

A full slate of safety materials, including information for parents, teens and educators, is available at facebook.com/safety

 

Facebook’s suicide prevention page: facebook.com/help/suicideprevention

 

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Red flags

Be aware of statuses/posts, messages, photos, videos, links, comments or hashtags that include the following themes:

  • Feeling alone, hopeless, isolated, useless or a burden to others: “I feel like I’m in a black hole”; “I don’t want to get out of bed…ever”; “Leave me alone”; “I can’t do anything”
  • Showing irritability and hostility that is out of character: “I hate everyone”; “F*@K the world”
  • Showing impulsive behaviors such as driving recklessly, a significant increase in substance use or taking other risks
  • Insomnia posts: “3 a.m. again and no sleep”
  • Withdrawal from everyday activities: “Missed another chem lab – I’m such a waste”; “Another day in bed under the covers”
  • Use of negative emoticons: for example, repeatedly using emoticons that suggest someone is feeling down or thinking about using a tool to hurt themselves.
  • Use of concerning hashtags: #depressed #lonely #whenimgone #noonecares #suicidal #selfharm #hatemyself #alone #sad #lost #worthless #neverenough #givingup
  • On Facebook’s “News Feed” and Instagram’s “Following Activity,” you can see the accounts and posts people start to follow. If you notice a friend liking or following feeds or posts that promote negative behaviors, even if they aren’t sharing concerning content themselves, it may serve as a warning sign that they are engaging with troubling messages or communities.

Source: fb.me/helpafriend

 

 

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Related reading

 

From the September issue of Counseling Today: “Losing Face: How Facebook disconnects us” ct.counseling.org/2014/08/losing-face-how-facebook-disconnects-us/

 

Online exclusive: “Critical social skills to incorporate in a 21st century social skills group” ct.counseling.org/2014/09/critical-social-skills-to-incorporate-in-a-21st-century-social-skills-group/

 

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday