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The ‘storm and stress’ of adolescence and young adulthood

By Laurie Meyers October 25, 2018

For much of human history, the idea of adolescence being a distinct life stage was nonexistent. True, in the Middle Ages, children were recognized not merely as “mini” adults but as distinct beings with different needs. However, the years from ages 13 to 19 were not considered part of childhood until the turn of the 19th century. Instead, the “teen years” were the time when one began to assume adult responsibilities such as making a living and starting a family.

During the late 1800s, changes in child labor laws and the push for universal education for those under the age of 16 began to influence society’s perspective on when adulthood began. G. Stanley Hall, the first president of the American Psychological Association (APA), is credited with the modern “discovery” of adolescence, defining it in a 1904 book as a new developmental stage — created by societal changes — in which children grow into adults. Hall described adolescence as a time of “storm and stress” and, unlike later researchers, ascribed this life stage as lasting from ages 14-24 (rather than today’s generally accepted range of 13-19).

Although adolescence is still considered to be synonymous with the teen years, Hall’s instinct to single out the early 20s as different from later “adult” years was prescient. In the past decade, neurological research has discovered that the brain does not fully mature until one’s mid-to-late 20s. This revelation has spurred many researchers, particularly in mental health fields, to call for a separate developmental stage that is generally referred to as “young” or “emerging” adulthood.

Adding more than a soupçon of complication to both the recognition of emerging adulthood and the established research on adolescence is the reality that being a teen or 20-something in the information age is, in many ways, significantly different — and arguably more difficult — than it was for previous generations.

Stressed and depressed

An abundance of research indicates that teens and young adults are experiencing increased levels of stress and depression. In recent years, APA’s annual “Stress in America” survey has gathered data only on adults. However, in the survey released in 2014, “Stress in America: Are Teens Adopting Adults’ Stress Habits?” young people ages 13-17 were also included.

Survey respondents reported that during the school year, they had a stress level of 5.8 on a 10-point scale. During the summer break, teens reported a slight decrease in stress levels — 4.6 on a 10-point scale. Furthermore, 31 percent of survey respondents said that their stress levels had increased over the past year. In response to their high levels of stress, 40 percent of respondents reported feeling irritable or angry, 36 percent reported feeling nervous or anxious, 36 percent reported feeling fatigued or tired, and 31 percent reported feeling overwhelmed.

Depression is another significant concern among adolescents. According to the National Institute of Mental Health, in 2016 (the most recent year for which statistics are available), an estimated 3.1 million adolescents ages 12-17 experienced at least one major depressive episode. That number represented 12.8 percent of the U.S. population in that age bracket.

Although most mental health surveys do not specifically target “young” or developing adults, data are available relating to college students. Among the more than 31,000 college students who completed the 2017 American College Health Association National College Health Assessment, 39.3 percent reported being so depressed that they found it hard to function at some point during the previous 12 months. Anxiety levels among respondents were even higher: 60.9 percent reported feeling overwhelming anxiety at some point during the prior year.

The high levels of anxiety and depression indicated in these studies are part of a national pattern of significantly increasing distress. A national poll published in May by the American Psychiatric Association noted a sharp increase in American anxiety levels over the past year. On a scale of 0-100, this year’s “national anxiety score” was a 51 — a five-point jump since 2017. A study published in the June 2018 issue of the journal Psychological Medicine found that rates of depression rose across all age brackets of Americans for those 12 and over from 2005 to 2015. Most significantly, among those ages 12-17, depression rates increased from 8.7 percent in 2005 to 12.7 percent in 2015.

Under pressure

Some researchers are eager to blame technology — particularly social media — for the increase of depression and anxiety among teenagers and young adults. The reality is more complex and involves myriad factors.

It is undeniable that some people do find their lives lacking when compared with what they see on social media. Carefully curated Facebook feeds can suggest to them that their friends are happier and more successful than they are. Celebrity photos on Instagram — most of which are professionally produced and heavily filtered — can encourage unrealistic expectations about body image and personal appearance. However, when one considers the role that social media plays in the quest for perfection, it may be something of a chicken-and-egg scenario.

A 2017 study on perfectionism that appeared in the journal Psychological Bulletin found that beginning in the 1980s, a culture of “competitive individualism” in the United States, Canada and the United Kingdom steadily increased the quest for personal perfection. So, is what we see on social media pushing us toward unattainable standards of perfection, or is it a reflection of the pressure we put on ourselves? At this point in time, we may be caught in a reinforcing loop. The study found that current generations not only feel intense societal pressure to be perfect but also expect perfection from themselves and others. The study’s authors also believe that this rise in perfectionism may be linked to an increase in myriad psychological problems.

Today’s teenagers and young adults are unquestionably subject to high expectations and demands. Licensed mental health counselor David Flack, who has worked with adolescents and young adults for 20 years, says he has seen a significant increase in anxiety related to academic performance among his clients.

“It is not uncommon for teens I meet with to have three, four or even more hours of homework most days,” he says. This reality creates significant pressure and is particularly stressful for students who are predisposed to anxiety. Flack, a member of the American Counseling Association, also believes that such heavy academic workloads are interfering with important social and developmental processes because many teenagers may be spending more time doing homework than socializing and engaging in extracurricular or other age-appropriate activities.

Licensed professional counselor (LPC) Sean Roberts, an ACA member who specializes in working with young adults, says he has witnessed a precipitous increase in anxiety among clients. He thinks this is strongly, though not solely, linked to teenagers and young adults feeling increased pressure to succeed.

Not coincidentally, the anxiety they experience makes it only more difficult for them to achieve. “Anxiety has a neurological effect,” explains ACA member Amy Gaesser, an assistant professor of counselor education at the State University of New York at Brockport whose research focuses on the social and emotional well-being of students in school. “The survival part of the brain activates and shuts off or interferes with the parts of the brain that help us think clearly.”

This can have a significant effect on academic performance, says Gaesser, a certified school counselor in New York who gives presentations and offers private consultations with parents. For example, some students can study extensively and be fully prepared for a test, but because of their anxiety, can have trouble accessing that information while taking the test. Anxiety can also interfere with the ability to take in and synthesize information, Gaesser says. Students become frustrated with their seeming inability to “get it,” which affects their feelings of self-efficacy and can even make them question their level of intelligence. Once a pattern of academic difficulty tied to anxiety is established, the problem can become self-perpetuating.

Disrupting the cycle is vital, says Gaesser, who recommends the emotional freedom technique (EFT) as an effective method of interrupting the stress response and downregulating the brain. In EFT, participants respond to stressful thoughts or situations by visualizing an alternative outcome while taking their hands and tapping acupuncture points on the body that have been linked to stress reduction. Students can go through the whole sequence of body points or just use the areas they find work best for them, she says.

Gaesser also recommends the “4-7-8” breathing method as a quick way to interrupt the stress response. This involves breathing in for four seconds, holding the breath for seven seconds and then breathing out for eight seconds. Students can practice this method themselves, but Gaesser thinks that teachers should also use it in their classrooms as a way to begin class.

Peter Allen, an LPC based in Oregon who specializes in counseling young adults and adolescents, used to work with teenagers in a wilderness therapy setting. Most of his clients were struggling with a variety of issues, including substance abuse, conduct problems (although not usually at the conduct disorder level) and mood disorders, principally depression and anxiety. In most cases, Allen says, the core elements of the wilderness setting were effective in helping these clients address their various presenting issues.

In part, he believes that’s because the pressures of school, family and social life were stripped away, leaving these teenage clients to focus on the basics, such as securing food and shelter. Surviving in the wilderness also required working together and building a community, which helped teach clients new communication skills. Participants also got daily exercise, ate healthy meals and were required to follow a regular sleep schedule, all of which had a calming and stabilizing effect. “Once diet, sleep and exercise have been regulated, about half of the problems disappear right away,” Allen says.

Many wilderness therapy clients also benefit from what Allen calls “expanding the size of their world. … If you are a 15-year-old kid and doing bad at school, arguing with your parents, your world is tiny.” The wilderness program not only provided literal wide-open spaces, but also introduced clients to people from different places and adults who didn’t have the same expectations as the teenagers’ parents or teachers did.

The wilderness can also serve as a mirror for clients, says Roberts, who has also worked in wilderness therapy, or, as he says it is becoming more commonly known, outdoor behavioral health care. For instance, when clients who struggle with executive function and organization encounter bad weather for which they are not prepared, the experience can be a vivid demonstration of the importance of working on those problem areas. Another example: Someone who is struggling with distress tolerance will need to get used to having to build a fire after hiking all day.

Information overload?

Although none of the counselors interviewed for this article view social media or technology as inherently negative, they agree that living in the information age is complicated. The current generation of teens and young adults is awash in an unprecedented flood of information, asserts Roberts, clinical director at Cascade Crest Transitions, a program that provides support to young adults struggling to launch their independence by attending college or obtaining a job. He maintains that this technological bombardment not only is difficult to assimilate but also can encourage the tendency to “get stuck” in one’s own head.

Allen adds that in the age of the internet, children and adolescents are exposed to a lot of information and knowledge at an earlier age than previous generations were. In certain cases, it is information that they may not have the maturity to handle. For example, most children and adolescents who grew up in the latter half of the 20th century had to somehow get their hands on a copy of Playboy or another adult magazine to satisfy their sexual curiosity. Today’s children and teens are exposed online to myriad genres of easy-to-access pornography, which not only present unrealistic ideals of sexuality but also can include disturbing practices such as bestiality and pedophilia. Children and young adolescents today are also more likely to be exposed to media coverage of frightening or horrific events before they have the ability to contextualize all that they are taking in, Allen says. He believes this early exposure is contributing to a kind of “nonspecific existential dread” that he says he commonly sees in his clients.

Roberts says that technology offers many positive benefits, but it also sometimes provides adolescents and young adults with a means to avoid their problems. He stresses the need for counselors to learn more about the draw of technology so that they can help clients evaluate whether they are using it in positive or negative ways. Roberts gives gaming as an example. For those who know little about it, gaming may seem like an excuse to “do nothing.” In reality, he says, it is a legitimate hobby that can provide enjoyment, stress release and even a sense of community while boosting problem-solving skills. However, like any other activity, when gaming gets in the way of schoolwork, chores or getting out of the house, it becomes a problem to be addressed, he says.

Another complicated aspect of online life is social media. For all the potential benefits, social media feeds have made it so that virtually no part of life is private anymore, Allen says. Many adolescents may not fully understand that by making everything public, the internet is, in essence, “forever” or grasp the potential ramifications of that reality, he says. In addition, he notes, social media feeds can encourage social contagion.

ACA member Amanda LaGuardia, a former private practitioner whose research focuses on self-harm, agrees. Much of the social media content targeted to young girls is focused on body image, says LaGuardia, a licensed professional counselor supervisor in Texas and a licensed professional clinical counselor supervisor in Ohio. Many of her former clients talked about the images they saw on Instagram, such as already-thin celebrities discussing “thigh gap” (as part of a supposedly “perfect” body, women and girls must have thighs that don’t touch each other) and other unrealistic physical standards. Such posts are usually popular, garnering a large number of likes and admiring comments, which gives girls the impression that this is what their bodies should look like, she says.

However, such standards are unrealistic for most females and are simply unachievable for girls with developing bodies, continues LaGuardia, an assistant professor at the University of Cincinnati. Regardless, these images are presented as the feminine ideal, presuming to highlight all of the elements that will make women attractive to men. At the same time, girls are often subject to sexual harassment at school and too often told by those in authority “that’s just how boys are” (boys will be boys) and that girls just need to find a way to deal with it, she says.

All of these messages about how girls should look and act and what they should accept come at a time when they are already struggling to figure out who they are. It is overwhelming, and self-injury is becoming a more common way to cope with the distress. Self-harm used to be most common in the eating disorder population, but according to LaGuardia, social media has introduced it to a wider audience. It isn’t necessarily that self-injury is presented as a positive behavior online. Most people who talk about it on social media are seeking support, she says. However, the widespread nature of the discussion has created social contagion.

The best thing counselors can do to help is listen and affirm, LaGuardia emphasizes. When adolescents talk about their experiences, some counselors focus on helping them feel better about themselves, but that is not what they need most, she asserts. Instead, adolescents need to express what they are going through and to process their confusion verbally. Counselors should respond, she suggests, by saying things such as, “That sounds really difficult” and “I’m here and I’m listening.”

“So many of the messages they [adolescents] are receiving are controlling,” LaGuardia explains. “They need to feel in control.”

As these clients become more comfortable, they will begin to talk about how they are coping with their turmoil. LaGuardia explains that these clients view self-injury as a means of surviving what they are currently experiencing, not a solution. “I ask clients, ‘Is this something you see working for you for the rest of your life?’ I’ve never had anyone say yes.”

Usually, LaGuardia notes, clients will say that they hope not to engage in self-harm forever, but at the current time, they don’t know what else to do. At that point, counselors can ask whether this coping method is something the client is ready to change. LaGuardia says the first step is finding out what the client needs help coping with and then exploring ways that will allow the client to cope without self-harm.

The most common underlying problem for clients who self-harm is conflict with a parent or sibling, LaGuardia says. In such cases, she works with the whole family on communication skills. She starts with the adolescent clients, teaching them how to express their needs without self-injury. She asks the adolescents to think about their most stressful conflicts and what they would like their parents to know. Then, through role-play, LaGuardia helps these clients practice asking for what they need.

Often, LaGuardia will also bring in the parents and have the adolescent express the source of conflict. As the parents and adolescent talk, things can get heated, so LaGuardia is there to help redirect the conversation. She also tries to educate parents about what adolescents need, which includes being treated as independent young adults and given space to grow, while at the same time knowing that their parents are always there to listen to them regardless of
the circumstances.

Adult transitions

Allen is the program director at College Excel, a residential, coaching-based college support program. The program’s clients are typically young adults who are coming out of high school and looking for extra support to succeed in college or those who previously attended college but dropped out because of a mental health issue or learning disability.

Many of the students have some level of anxiety and depression and often struggle with executive function deficits. College Excel provides the students with mental health support and coaching on life and study habits. Allen says he tries to run the program through the lens of good mental health practices. Calling on his background in wilderness therapy, he also encourages students to eat well, follow a consistent sleep schedule and get regular exercise. College Excel staff do not live on-site, but the program does provide students with housing, which helps them establish a sense of community and support — elements that are common among those who successfully adjust to college life, Allen points out.

Allen says that many of the program’s clients struggle with attention-deficit disorder and organization. College Excel staff teach students basic organizational skills such as using their attention strategically. For example, with students who struggle with memory and retaining information, Google Calendar can be a particularly useful tool. It can tell students where they need to be at any given moment, freeing up their attention and memory for other tasks.

Allen also talks with students about the importance of a clean workspace and provides them with practical tips on organization. For example, he says, students who constantly misplace things can save time and frustration by designating a space for pens, papers and other basics so that they will always know where to find them.

Students also work on developing good study habits. For example, rather than growing frustrated with their struggles to focus on what they’re reading for long periods of time, clients learn to study in 15- to 20-minute chunks, with five-minute breaks in between.

Roberts’ program is geared toward young adults who are coming from inpatient treatment and are ready to enter college or find a job. In addition to receiving ongoing mental health treatment, these clients take classes that focus on interpersonal skills, stress regulation, goal setting, time management and money management. They are also encouraged to exercise, and all students are matched with a case manager who helps them focus on sleep hygiene, peer interaction, health and nutrition, and, in some cases, dating.

Clients are required to attend one individual and one group counseling session per week. Counselors are also on-site five days a week, which allows them to give feedback outside of sessions. For example, a counselor might say to a student, “You say that you want to socialize, but you’re constantly retreating to your room or on the phone.” This opens up a discussion about why the student isn’t following through on counseling goals and allows the counselor and client to work on solutions together, Roberts says.

The students are usually enrolled in college or working when they start Roberts’ program. The coaching and classes take place around the students’ schedules, and staff members are available to help clients through whatever challenges they are facing in school or at work. Clients typically remain in the program about nine to 12 months. During the last six months, they move out of program housing and into their own apartments or college dorms.

Allen closes by noting that today’s adolescents and young adults — the oft-discussed millennials — are very much aware that older generations generally view them in a negative light. He believes this widespread maligning carries a psychic weight for this generation and can contribute to limiting their self-efficacy and sense of options.

Because this negative image of adolescents and young adults is so prevalent, Allen believes that even counselors may fall prey to it. “You can’t hold them in contempt and do good work,” he emphasizes. “The best thing we could be doing for them is stoking the fire of creativity.”

 

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Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

Books and DVDs (counseling.org/publications/bookstore)

  • Youth at Risk, sixth edition, edited by David Capuzzi and Douglas R. Gross
  • A Contemporary Approach to Substance Use Disorders, second edition, by Ford Brooks and Bill McHenry
  • Active Interventions for Kids and Teens, by Jeffrey S. Ashby, Terry Kottman and Don DeGraaf
  • Suicide Assessment and Prevention, DVD, presented by John S. Westefeld

ACA Mental Health Resources (counseling.org/knowledge-center/mental-health-resources)

  • Suicide Prevention
  • Substance Use Disorders and Addiction
  • LGBTQ Resources

Webinars (aca.digitellinc.com/aca/pages/events)

  • “Depression/Bipolar” with Carmen S. Gill (CPA22120)
  • “Trauma/OCD/Anxiety” with Victoria E. Kress (CPA22118)
  • “Substance Abuse/Disruptive Impulse Control/Conduct Disorder” with Shannon Karl (CPA22116)
  • “Counseling Students Who Have Experienced Trauma: Practical Recommendations at the Elementary, Secondary and College Levels” with Richard Joseph Behun, Julie A. Cerrito and Eric W. Owens (CPA24339)

 

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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

 

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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.

The age of isolation: How Instagram memes describe a lonely generation

By Adriana V. Cornell July 26, 2018

Instagram tells millions of stories. Many exhibit our personal daily moments, and, from a wider lens, others describe entire populations and social movements. With 800 million users, Instagram is one of the biggest and richest collections of societal data on the planet. We can learn a lot by noticing what these users choose to showcase personally and which accounts and posts they choose to follow. Lately, I’ve been paying attention to the latter.

Of course, Instagram has grown since its conception, from personal accounts to brand accounts. It seems every business, school, group, dog and fetish now has an Instagram account. “Celebrities” — foodies, beauty experts, daredevils, singers, comedians and more — are born on Instagram.

In the past year, I’ve been following a few comedic accounts that display almost exclusively memes. A “meme” comes from the concept of memetic theory, championed by Richard Dawkins in his 1976 book The Selfish Gene. Just as genetics connote characteristics passed from generation to generation, memetics refer to cultural ideas transferred from person to person. A meme spreads quickly because it can reproduce itself, jumping from mind to mind and therefore driving cultural influences across the globe. According to the theory, genetics and memetics are similarly affected by Darwinian rules of evolution: Their success is subject to their contribution to the effectiveness of the person carrying them.

Memes can concern any content, but the “units of culture” I have been focusing on seem to be targeting people in their mid- to late 20s who are still navigating the transition from youth to adulthood. I’ve noticed a trend in these memes that seems both disturbing and completely normal.

Here are a few that have been featured and reproduced on multiple accounts:

 

 

 

Posts of this kind receive an immense “ovation” of likes, comments and shares. More than 250,000 people liked the first meme, and more than 14,000 commented. Most comments “at” (or link) a friend’s account, inviting him or her to view the same post, and they remark together on the accuracy and truth of the message. These comments include:

“haha, us literally.”

“Lol my life story.”

“So accurate.”

“Us every day, all day.”
“Literally EVERY f*cking time, without fail…! Millennials & bad drivers make being an agoraphobe so much easier nowadays!”

 

Most memes display simply black Arial font on a white background; they seem to rely entirely on the words that compose them. Others feature text accompanied by graphics, pictures or GIFs, such as this one:

 

But even as memes become flashier and more complex with recycled photos or videos, the rule of Darwinian evolution remains critical: The success of memes depends on the effectiveness of the person carrying them — in this case, the account holder. The popularity of a meme, evidenced in the comments section, seems to multiply if the account holder’s caption provides funny, insightful, witty commentary on the meme: in essence, a meme upon a meme.

For example, in the third meme, an account holder captioned the image with: “I’m At Lunch Not Talking To The Person I’m With, But Instead Looking At A Facebook Photo Of The Lunch Belonging To A Girl I Haven’t Seen Since […] 2007.”

This caption — using a relatable, all-too-real anecdote — brings new life and humor to a recycled post. It successfully reproduces the memetic, refueling the cultural influence and giving it new shape before it is passed on.

Users react accordingly, many of them employing the “Face with Tears of Joy” emoji as they comment specifically on the caption:

“Hahaha omg ur caption”

“the caption!!!”

“what if ur sitting with a really boring person at lunch”

“hahaha the caption tho”

 

I simultaneously find myself laughing about and relating deeply to these memes and their captions. Even if my feelings don’t agree in the moment, many of the messages tap into emotions, reactions or thoughts that I’ve certainly had. I have wished that plans would fall through. I have spent too much time scrolling through Facebook. And I have used emojis and exclamations in text that I would never say or emote in real life.

Meanwhile, I can’t help but feel disturbed by these messages and the amount of praise and endorsement they receive. They are all deeply sad and negative in tone and content because they seem to connote a total lack of feeling, social inclination and zest for life, yet at the same time, the need to be liked, included and embraced.

For this reason, I started saving memes of this kind to a “collection” — an optional, user-controlled repository for images on Instagram — that I titled “Oxymoron.” The contradiction of craving and simultaneously rejecting social interaction became an apparent theme that puzzled me. I started asking myself and lots of other (mostly 20-something) people: What’s going on here?

Some friends, while acknowledging that we’re naturally social animals, offered a simple answer. “After working a 12-hour day, that desire to socialize becomes secondary to my need for sleep,” Kelly, 28, explained. “I’m so happy if plans fall through because I feel exhausted by the idea of devoting any more energy to anything in my day.” Others echoed similar ideas and sentiments.

But this explanation didn’t seem to capture the full picture, and it seemed even my busy friends agreed. As our email exchanges developed, so did our ideas about other possible contributors to what seems like an age of isolation, neediness and sadness. After all, depression rates for teens and young adults are higher than ever (12.7 percent as of 2015, according to Psychological Medicine). The chief perpetrators, we concluded: social media and smartphones.

 

Socializing without the authentic self

Comedy is successful when it shamelessly and nakedly brings to light the truest feelings we all possess but don’t readily admit to or talk about. It can be an immensely satisfying relief to hear our private thoughts, habits and emotions exposed and articulated in an anonymous way that lets us know we’re not the only ones experiencing them — that we’re not alone.

And we will do anything to avoid feeling lonely. We will maintain friendships that we don’t enjoy. We will agree to plans that we don’t look forward to. We will stay in relationships that make us unhappy. We will join gangs, extremist groups and cults. In studying our basic human needs, Abraham Maslow determined that we will even sacrifice our safety for the sake of belonging, as evidenced, for example, by children who cling to abusive parents.

Loneliness is deadly. According to research conducted by Julianne Holt-Lunstad, professor of psychology at Brigham Young University, loneliness has the same effects on our health as smoking 15 cigarettes a day. It is more fatal than obesity.

Conveniently, smartphones have given us a tool to dismiss and evade feelings of loneliness quickly and with little effort. Texting, of course, provides the sense of company and togetherness in any and every moment. But even scrolling feeds on Facebook or Instagram can make us feel invited into the lives of friends whom we might not readily meet up with or call.

“We know that engagement with social media and our cell phones releases a chemical called dopamine,” noted Simon Sinek in a 2016 interview on Inside Quest. “That’s why when you get a text, it feels good. It’s why we text 10 friends when we’re feeling a bit lonely, a bit sad. … It’s why we count the ‘likes’ on our Instagram.” And we can do all of this without getting off the couch, without putting on fresh clothes and — best of all — without actually speaking to anyone.

Because socializing in person, face-to-face, is hard. We’re required — in real time — not only to process and listen to what others are saying, but then also to compose (witty, sensible, empathetic, affirming, interesting) comments in reply, sensitive to the situation, conversation and environment. All the while, we must align our facial expressions to the context and content, some of which changes by the second. If live conversation can be described, as it often is, as “dancing,” then texting or using social media might be described as a card game. Both require thought and strategy, but in-person communication demands spontaneity. It commands us to be our authentic selves.

But that can be complicated and challenging. What if we don’t like who we are? What if we don’t know who we are?

The pressure to be perfect has never been more intense. In his 2015 bestseller Sapiens: A Brief History of Humankind, Yuval Noah Harari wrote, “If you are a teenager today, you are a lot more likely to feel inadequate. … Even if the other guys at school are an ugly lot, you don’t measure yourself against them, but against the movie stars, athletes, and supermodels you see all day on television, Facebook and giant billboards.”

Social media allows us to craft, edit, filter and recraft ourselves so that we can come closer to this ideal. We can even consult friends before we reply to a text or post a photo, giving us the ability to depict the (airbrushed) story we wish to tell. But allowing real-time spontaneity to eventually and inevitably reveal who we really are can feel risky and terrifying.

Brené Brown boils this down to a deep aversion to vulnerability. Because we are social animals, we need to feel connected and a sense of belonging in order to survive. “Connection is why we’re here,” Brown said in her 2010 TED Talk. “It’s what gives purpose and meaning to our lives.”

And it is the fear of disconnection, Brown asserts, that often makes us feel the most challenging feelings, like vulnerability and shame.

 

A downward spiral of loneliness

The memes I have observed and collected are popular because they send the message that putting ourselves out there is not worth the risk. No one else is going out; why should you? Why let yourself feel judged, offended or not good enough?

But “for connection to happen,” Brown continues, “we have to allow ourselves to be seen. Really seen. …When we numb vulnerability, we numb joy, gratitude, happiness.” We must accept who we are and embrace vulnerability. People who are most connected, Brown found, “were willing to let go of who they thought they should be in order to be who they were. You have to do that for connection.”

The concern that has nagged me over the past year is that these memes openly reject this kind of self-exposure and authenticity, essentially instructing us to give in to our fear of vulnerability. This not only prevents others from knowing us, it prevents us from knowing ourselves. We get stuck, therefore, in a developmental stage that looks and feels a lot like adolescence — afraid of judgment, lacking self-confidence and without a sense of true belonging.

Another distinct and crucial feature of face-to-face conversation is the opportunity for touch. A pat on the back, caress on the arm, stroke of the hair or hold of the hand is essential to our mental and physical well-being. “Being touched increases the number of natural killer cells, the frontline of the immune system,” says Tiffany Field, founder of the Touch Research Institute at Miami Medical School. “Serotonin increases. That’s the body’s natural antidepressant.”

Deprivation of the sensation of touch from another human often results in feelings of isolation, social exclusion and depression. What’s more, these feelings make people fearful and put them “into a kind of defensive state where the levels of cortisol [the hormone released by the brain in times of stress] are raised,” says Kellie Payne, researcher at the Campaign to End Loneliness. “Having had negative experiences, they anticipate that their connection with people will also be negative, which makes it hard to reinstate contact.”

In short, lonely people can get trapped in a downward spiral of loneliness. These memes tap into and perpetuate this vulnerability, actively discouraging ambition, social connection and productivity.

Fortunately, our brains are resourceful; they find alternative ways to satisfy our needs. For many, this compensation is happily found in communicating via text message and social media. That dose of dopamine can be the fix we need in sad or lonely moments so that, with the approval and company of tens of thousands, we can quickly wipe them away.

Returning to Maslow, these memes, therefore, allow us to reach the two highest orders of human need: esteem (being accepted and valued by others) and self-actualization (reaching our full potential; being all we can be).

The problem is that this solution is shallow, artificial and temporary. Because although it feels like we’re raising unspoken issues of loneliness and depression, and relating to others when we like or comment on these memes, we’re not actually facing our feelings or each other, or talking about them in a way that allows us to be honest, authentic or vulnerable. At the end of the day, the humor used in these memes is merely numbing and normalizing some of our deepest and truest emotions by providing a false sense of togetherness and belonging that inevitably lets us down.

But because “connecting” to others via social media has become so easy and satisfying, like any dopamine producer, it is highly addictive. We’re no longer willing to devote energy, time and effort to our relationships (or any project) because it is —comparatively — too hard.

In other words, social media has yet to find a way to produce serotonin: a far more gratifying, long-lasting and pleasure-inducing hormone. Serotonin provides a sense of relationship, allegiance and pride after dedicating time and effort to a project or task that transcends selfish motivations. But when a meme caption says: “If you do anything interesting or important today, you can go f**k yourself,” we’re excused from trying. Instant gratification has overtaken meaningful, lasting reward, and dopamine has overtaken serotonin.

And just as any addiction — drugs, food, sex — is, by definition, extremely satisfying in the first stages, it often loses appeal, allure and thrill as it becomes more intense and demanding. The craving or desire becomes a need or chore, and we in turn become a slave to our addiction. These memes and apps such as Instagram are designed not only to “rescue” us in times of loneliness or sadness, but to draw us in constantly, at all times of day and night.

“That itch to glance at our phone is a natural reaction to apps and websites engineered to get us scrolling as frequently as possible,” wrote Bianca Bosker in a 2016 edition of The Atlantic. “In short, we’ve lost control of our relationship with technology because technology has become better at controlling us.”

When we are or feel controlled, we lose our sense of self and self-worth — our ability to produce, invent and create. The majority of Instagram users are merely consumers of information; only a small percentage of users are actually creating the message, the humor and the trend. It requires far less thought and effort to simply “at” a friend or double tap to “like” a photo than it does to lean in and think about and interact with society so that we can create our own ideas — or even just talk to one another about them.

 

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Adriana V. Cornell has spent the past two years living in Nairobi, Kenya, working as a school counselor and college counselor at an international school. She has worked primarily with high school students and has focused her writing and research on students in transition and social media. She moved back to the United States with her husband in July. Contact her at adriana.v.cornell@gmail.com.

 

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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.

Counseling Connoisseur: Thanatechnology – Grief and loss in a digital world

By Cheryl Fisher June 8, 2018

Thanatechnology: Any kind of technology that can be used to deal with death, dying, grief, loss and illness.

 

Kelly (an alias), an eighth-grader, sits with her friends in the school auditorium as her principal calls out the names of each of her classmates who were killed in the recent shooting. To honor the lives of these young people, the school is hosting a remembrance ceremony. As tears run down her face, Kelly huddles close to her schoolmates and clicks away on her phone posting messages on several social network sites and a memorial site that she and her friends created. A text message pops up from a boy she met on one of the sites. He is a survivor of a school shooting that happened a couple of years ago — he understands.

Tony’s (alias) phone vibrates, rousing him from his slumber. He looks at the clock – it’s 2 a.m. He has to be up for school in just a few hours. He squints, trying to read the alert on his phone. Another teenager has died from drug overdose. He heaves a mournful sigh and turns on the bedside lamp. His phone begins to blow up with social media posts. The deceased didn’t attend his school but is related to his girlfriend’s best friend. Tony attempts to return to sleep, but he keeps thinking about the teenager [and] wondering why it happened.

Without a doubt, the youth of today are often exposed to significant and traumatic losses. Traditionally, we have marked death with rituals such as funerals and memorials and grieved with the support of counseling, faith communities and neighbors. In more recent years, technology has provided additional ways to remember and mourn, such as creating online memorials, seeking distant or virtual grief counseling and connecting with family, friends and even strangers without geographical limitations. It erases time and distance and allows for virtual experiences and expressions that promote a narrative that lives forever.

Digital Presence and Youth

In Dying, Death, and Grief in an Online Universe, researchers Kathleen R. Gilbert and Michael Massimi observe that digital technology can “bring people together for social support, provide information, and offer a venue for conducting grief work such as telling stories or building digital memorials.”

In another section of the book, researcher Carla Sofka writes that young people are even more likely to seek grief support online. Sofka explains that the internet, social media and other digital platforms are where younger generations are most comfortable because they provide opportunities for social interaction; a sense of independence and privacy; the ability to express and form their own identity; a sense of community that includes those that are marginalized; and instant alerts and communication. All of these elements allow youth to seek and find like-minded communities that can provide immediate support and strategies for coping with myriad life issues — including death and dying, and grief and loss.

 

Social Interaction

Online bereavement forums and chat rooms provide a sense of social connection with users. Sites such as Caring Bridge allow multiple users to maintain a virtual journal offering information and capturing narratives that are accessible to members. Tumblr, Facebook and Instagram create spaces where youth can just “hang out.” Video calling technology such as FaceTime and Skype bridge the distance between users and promote interaction and communication. Additionally, grief counseling may be offered via video, phone, chat or email formats.

Independence and Sense of Privacy

Teens turn to technology to carve out a private space for self-expression. However, research indicates that internet use often provides the illusion of anonymity, which may encourage a false sense of privacy. The struggle for privacy is nothing new: The tension between privacy and personal expression has existed between teens and parents for decades. In It’s Complicated: The Social Lives of Networked Teens, danah boyd*, principal researcher at Microsoft Research notes that social media introduced a new dimension to this age-old power struggle. Instead of worrying about what teens wear outside, parents are concerned about what pictures teens are posting about what they wear outside.

[*boyd prefers to spell her name with lowercase letters.]

“Although teens grapple with managing their identity and navigating youth-centric communities while simultaneously maintaining spaces for intimacy, they do so under the spotlight of a media ecosystem designed to publicize every teen fad, moral panic, and new hyped technology,” writes boyd.

Yet, online spaces allow for exploration of feelings and thoughts, examination of death anxiety, and expression of grief and loss. For example, a 14 year- old client crafted an entire mix of music and prose around the complicated emotions she experienced related to the death of her estranged father who had abused her as a little girl. Using an alias, she posted the eulogy online and watched as strangers connected with her, validating her feelings and experience.

Expression and Influence of Identity Formation

The internet provides creative space for expressing grief and honoring loved ones. Sites such as KIDSAID.com, offer children the opportunity to connect, interact and creatively express their grief. In addition to expressive sites and online memorial services such as Legacy, Remembered.com and Your Tribute provide an unfettered opportunity to honor loss, especially for those who are marginalized or disenfranchised. The use of letters, photos and sound provide rich and detailed memorials that allow users to express their grief, absorb their loss and ultimately move forward.

Sense of Community

Blogs provide a venue to capture experiences and to cultivate topic-based virtual communities. Boyd suggests that these constructed networks serve as a public place to interact with real and imagined communities, thus satisfying a desire to be part of a broader world.

Instant Alerts

Online communication is often in real time. Twitter, Snapchat and a variety of other digital sites offer instant notifications and ongoing engagement. Technology allows users to gather multiple streams of almost instantaneous information from afar. For example, recently I was at a social gathering where a young woman, glued to her phone, was continuously texting. At one point I interjected, “Is everything alright?” She looked up and shook her head. “No, I have a friend who was just in a car accident and the medics are transporting her to shock trauma. Her parents are on their way to the hospital — but no one thinks she’s going to make it.”

The accident occurred in another state, yet this young woman was experiencing the event minute by minute via her phone messaging.

There are numerous attractive features to thanatechnology. Information is persistent and endures. There is a sense of immortality and legacy when a person’s comments, photos and work is posted in cyberspace. It is visible to infinite numbers of individuals. It is spreadable, and with one repost or share, hundreds more are invited into our experience. It is searchable. Just yesterday someone emailed me after reading my article on pet loss and grief. She had been Googling information about pet loss and my article popped up. I was able to provide her with additional support resources.

While there are many helpful aspects of using technology for grief support, there are some serious causes for pause. Are the online interactions healthy? Who is actually participating in the network communities? Are youth oversharing personal information while in a vulnerable state? How pervasive are social divisions and are they perpetuated in the participating forums?

Clinicians, parents and educators must be digitally literate and provide opportunities for genuine face to face connection while acknowledging the cyberworld of teens. Using technology during this very vulnerable time can provide tremendous support and healing, but it may pose risks. Counselors have the responsibility to help youth develop the skills to navigate technology in a way that creates a safe environment for their grief experience and promotes bereavement support.

 

 

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Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling.  Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy: and geek therapy. She may be contacted at cyfisherphd@gmail.com.

 

 

 

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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.

#disconnected: Why counselors can no longer ignore social media

By Laurie Meyers April 30, 2018

As humans, we are wired to fear the unknown. A case in point: We often look askance at new technology, suspicious that it will completely upend our lives and perhaps even destroy society as we know it. These dire predictions have greeted every new technology, going back (in all likelihood) to Gutenberg and his printing press. Radio, the telephone, television and now the Internet and social media have all changed not just how we communicate but, to varying degrees, society itself. And each technology has been scrutinized in turn.

Thus, it may not come as a shock to read the current flurry of panicked headlines, such as “Smartphones are destroying a generation” and “Social media use tied to depression.” Counselors are well aware that depression, anxiety, alienation and even social isolation are tied to myriad factors, but most counselors also make their living talking to people face-to-face. So, although many counselors have embraced and are regular users of social media, it’s not surprising that others are skeptical about “faceless” interaction.

Regardless of personal viewpoint, however, the genie is out of the bottle. It’s too late to go back. Social media and other digital platforms are now the primary means through which adolescents and young adults socialize, form relationships and stay informed. But it’s not just for kids. People of all ages are staying in touch, pursuing interests and making new connections online. Digital personal interaction is here to stay, and counselors who shun any mention or understanding of social media risk not just failing to connect with clients, but actually alienating them, says Laura Gallo, a licensed professional counselor and former school counselor who studies adolescent social media use.

A matter of cultural competence

Given the role that face-to-face communication has traditionally played in counselors’ training and work, it can be difficult for practitioners to view digital communication as an effective way to form a therapeutic bond with clients, says American Counseling Association member Martin Jencius, a professor and the doctoral internship coordinator for counselor education and supervision at Kent State University. His research interests include the use of technology in counseling. Counselors are trained to garner information not just from speech but also from facial expressions and body language, he points out. “Unfortunately, that [in-person conversation] is only one way in which people communicate and form relationships,” he says.

Counselors may not want to engage in serious interactions on a virtual platform, Jencius says, but they should understand that many people — including many clients — are forming relationships in this way. Furthermore, these relationships are just as meaningful to people as those formed in the traditional manner, he adds.

Gallo, an ACA member, agrees. “We often ask ourselves, are people missing out on something by not looking at one another? But is this just a difference in values? And, as counselors, should we acknowledge that this may be our own bias?”

“Counselors must work to recognize this new culture — a culture with its own language, values and customs,” Gallo continues. “If a counselor does not identify as a ‘digital native,’ they may not be aware of the complexities of this culture and struggle to accept its importance in clients’ lives. Yet as counselors work to understand this cultural group, they are more likely to be able to empathize and make connections, strengthening the counselor-client relationship. I believe most counselors can understand how technology has become immersed in all of our lives. Whether it’s welcomed or valued may not be as important as accepting the significance it has for a client.”

ACA member Everett Painter, a former college counselor whose areas of research include technology, believes that understanding the role that social media and technology play in clients’ lives is a matter of cultural competence and ethical practice. As with other areas of cultural competence, counselors should do a self-inventory to determine what opinions and biases might be influencing their views on social media, he says.

Painter, an assistant professor of counseling at Edinboro University of Pennsylvania, recommends that counselors develop basic literacy, at minimum, in social media and other online platforms. Ultimately, counselors should learn enough about online activity to understand the part it plays in clients’ lives, he says.

“Our role as counselors is to meet our clients where they are, to communicate unconditional positive regard and to recognize how they view the world,” agrees Gallo, an assistant professor of counselor education at Boise State University. “If interacting online is a focus and priority for a client and we fail to acknowledge this, the client may feel misunderstood by the counselor or, worse, ignored. I believe this could be said for clients of all ages [but] especially young people who spend more time online. If a teen client has to spend 10 minutes to describe what Tinder is, they might not think it’s worth it. It’s impossible to keep up with everything in the technology world, but counselors can strive to understand more about the common social platforms being used, as it may help create common ground between counselor and client. Just as we work to become culturally competent counselors in relation to gender, race, ethnicity [and] sexual orientation, we must recognize that there is a new culture surrounding technology.”

Giving guidance

The reality is that digital culture is just “culture” for younger generations. Online interaction is inextricable from how they socialize.

Teenagers are still going through the normal developmental phases of defining themselves and figuring out who they are. It’s just that the cliques and the gossip and everything else that used to take place in the hallways at school are now occurring online, says ACA member Tracy Steele, the director of counseling for Stanford University’s online high school.

As comfortable as teenagers may feel in the digital world, however, there are still important aspects that they don’t understand, Steele continues. Counselors can play an important role in teaching adolescents to guard their safety by being careful about where they post personal information, being wary of people they don’t yet know and recognizing that people aren’t always who they say they are online, she explains. Teenagers — and many adults — also need to remember that the internet is forever. Once posted, impulsive remarks and photos cannot be taken back, Steele points out.

“The internet is relatively unmonitored, and teens often have more knowledge of its intricacies than the adults in their lives,” agrees Gallo. “Developmentally, we know teens place a lot of importance on peer groups, are developing their identity, can be more impulsive and are asserting their independence — all of which can factor into their online behavior.

“There is also the opportunity to interact 24/7, something different from past generations. This could lead to extra support from peers, but it could also lead to a higher probability of negative or risky behaviors. Counselors, especially those who work with teens, may be wise to learn as much as they can about different platforms, social media sites and popular apps that young people use. But more importantly, counselors may want to strengthen their relationships with young people, especially those displaying risky behaviors, in order to intervene and provide support when appropriate.”

Gallo recommends the website Common Sense Media, which maintains a variety of resources on children and technology, including a frequently updated list of popular social media platforms, for counselors, educators and parents.

Express and connect

The potential perils of social media use and other digital platforms tend to dominate coverage of today’s technology culture. Indeed, safety issues and the indelible nature of the “digital footprints” that all online users leave behind are important considerations to dissect and discuss. Often overlooked or discounted, however, are the positive aspects, including people of all ages who find that the digital world provides them with outlets unavailable in their offline lives.

In a survey that Gallo and her colleagues conducted, “School Counselors’ Experiences Working With Digital Natives: A Qualitative Study,” published in Professional School Counseling, school counselors reported that students often use technology as an expressive outlet. This outlet was especially helpful for shy or withdrawn students, but students of varying personality types also found expressing themselves online therapeutic, Gallo says.

“The ability to connect with others who have similar experiences, even from afar, may create much-needed companionship and help eliminate isolation,” she says. “Interacting with others online does not simulate ‘group counseling’ exactly, but it may contain some of the same therapeutic factors such as universality, altruism and, in some cases, instillation of hope and group cohesiveness. Some may also find opportunities for deep reflection, something they may not have felt comfortable with prior to the advent of technology.”

Painter notes that the ability to connect despite geographical limitations is not just useful for students. Finding online connection can be vital in areas such as rural communities, where resources such as support groups may be limited, he says. For example, when Painter was practicing in Tennessee, he had a transgender client who wanted to interact and receive support from other transgender people, but no local resources were available. Painter suggested that they look for an online group. He and the client found one that put the client in touch with other transgender people from all over the country, but they also discovered group members who lived in different areas of Tennessee, making it possible to meet in person.

Both Gallo and Painter acknowledge that there are some negative aspects of social media’s “always on” culture that warrant further attention. In this age of FOMO (fear of missing out), some people may be spending too much time online, and Painter urges counselors to educate themselves about overuse.

Gallo notes that online bullying continues to be a devastating force, fed by the inherent anonymity of online communication.

“Another important point to mention is the increase in anxiety we see today,” she says. “Many have asked, are the individuals who interact more online doing so because they have social anxiety, or does being online continuously create the anxiety they now experience? These are important questions researchers are studying, and the answers may influence the future work we do as counselors.”

Gallo believes that counselors can help clients strike a healthy balance between their online and offline worlds. “Through our discussions with clients, we may be able to help them understand both the positive and negative effects that technology has on their lives,” she says, “and we can provide the space for them to explore this phenomenon.”

 

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Facts and Figures

According to a Pew Center research study, “Social Media Use in 2018”:

  • 88 percent of 18- to 29-year-olds report using some form of social media
  • 78 percent of 30- to 49-year-olds use social media
  • 64 percent of 50- to 64-year-olds use social media
  • 37 percent of people 65 and older use social media

Across all age groups:

  • 68 percent use Facebook
  • 73 percent use YouTube
  • 24 percent use Twitter
  • 35 percent use Instagram
  • 27 percent use Snapchat

Americans ages 18-24 are substantially more likely to use platforms such as Snapchat, Instagram and Twitter.

 

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Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Podcasts (counseling.org/knowledge-center/podcasts)

  • “Ethics and Social Media” with Michelle Wade

Counseling Today (ct.counseling.org)

ACA Code of Ethics (counseling.org/resources/aca-code-of-ethics)

  • Section H: Distance Counseling, Technology and Social Media

 

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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

 

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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.

Technology Tutor: Starting the year off on the right technological foot

By Rob Reinhardt March 6, 2017

Many of us are aware of the ebb and flow of people seeking counseling services. Around the holidays and the beginning of the school year, more calls come in for help. During the summer, things slow down a bit.

Having provided technology consultation to mental health clinicians for seven years now, I’ve noticed some patterns myself. One that stands out is that many counselors in private practice seem to take stock in the business and technology side of their practices as we transition into the new year. I’ve reached this conclusion by looking at the significant rise in the number of emails and phone calls I receive each year at the beginning of January.

With that in mind, I present some of the top business and technology challenges and questions that counselors have been addressing lately. Some of these may not apply to every counselor, whereas others are items we should all be taking care of.

HIPAA compliance

Now is a great time to revisit your compliance with the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is not a one-and-done kind of thing. It requires that you periodically review your risk analysis and management plans, as well as your policies and procedures. Assuming that you already have completed at least an initial risk analysis, a review can be done fairly quickly. The following are some primary tasks to cover.

  • Review your current risk analysis and remove technology that is no longer used to store or transmit protected health information (PHI).
  • Of the items remaining, ensure that the level of risk presented by those technologies hasn’t changed and that your current methods for managing risk are still effective and appropriate.
  • Now be sure to add any new technologies that might be missing. It’s always best to add new items to your risk management plan as they are implemented in your practice. Making sure that you cover all bases to catch anything that slipped through the cracks is a prudent measure.

If you’re not sure what all of this risk management and analysis means, check out my blog article on the Tame Your Practice site for additional information (bit.ly/HIPAArisk).

Encrypted communications

Both HIPAA and the ACA Code of Ethics (see Standard H.2.d) require counselors to use encryption to secure PHI, including communications with clients, whenever it is reasonable. The truth is that, these days, it’s almost always reasonable to use encryption.

Encrypted email is inexpensive to implement, and although it isn’t always quite as user friendly as unencrypted options, sometimes the cost of privacy is a bit of inconvenience. It’s like those extra seconds you take to turn on the sound machine outside your office — it can really make a measurable difference.

Both the ACA Code of Ethics and HIPAA also provide for client autonomy, which means clients can choose for PHI to be transmitted through unsecured means. It is important to note, however, that this requires that clients have been informed of and understand the risks. It is also important to evaluate whether we should really consider risking confidentiality, either out of convenience or for the sake of saving a few dollars a month. Roy Huggins of Person-Centered Tech makes a great case for why it makes sense to follow through with encrypting email and text (bit.ly/encryptornot).

Want to see how easy it is to use encrypted email? I included a demonstration video in the following blog post: bit.ly/emailencrypt.

Social media policy

Now is also a great time to make sure that you’re satisfying the requirements of Standard H.6. of the ACA Code of Ethics pertaining to social media presence and use. If you are utilizing social media (Facebook, Instagram, LinkedIn, Twitter, etc.), the ethics code requires that you:

  • Maintain a separate personal and professional presence. This relates to our responsibility to avoid engaging in dual relationships. This means taking actions such as creating a professional Facebook page.
  • Incorporate social media into your informed consent. We have a responsibility to inform our clients of the “benefits, limitations and boundaries of the use of social media” (Standard H.6.b.). Depending on how you engage in social media use and marketing, this may vary according to the platform you are using. It is important for clients to understand, for example, the potential benefits and ramifications of them “liking” your professional Facebook page, such as their friends seeing that they liked your page and the kinds of online advertisements that will be displayed to them as a result of liking your page.
  • Maintain client confidentiality by not disclosing information about them online. Also respect their online privacy unless they provide consent to view that information. I strongly encourage you to read my September Technology Tutor column on the dangers of online disclosure (ct.counseling.org/2016/08/thinking-discussing-clients-online-think-twice/). It’s not as simple as making sure that you don’t use identifying information.

An excellent way to address this is to develop a social media policy that you can then incorporate as part of the client orientation/informed consent process. Keely Kolmes offers a wonderful template as a starting point (drkkolmes.com/social-media-policy/).

Business and technology evaluation

Even if you have all of the above buttoned up nicely, it’s always a good idea to evaluate your business operations at least once per year. Is what you are doing working? Could it be improved? Can you implement technology, streamline processes or align your efforts to better move toward your goals? This is also a great opportunity to examine the return on investment (bit.ly/ROITYP) on things you’ve already implemented. Are you getting the expected results?

You’ll find plenty of freely available articles at the Tame Your Practice website (tameyourpractice.com) on these topics and more if you need additional details.

 

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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.