Saturday, March 23, 2013

Digital Communication with Clients: Do We or Don't We?

The answer to this is, well, yes and no. Controversy exists over if there should be communication between clients and social workers via digital methods. Texting and e-mails are an especially ethical and logistics nightmare.  But…everyone is doing it. There are 80% of American’s with Internet access and almost all Americans have access to a cell phone. If we do not give clients our e-mail or personal numbers, they can find them. I used to enjoy caller ID, now I have a choice between “unknown” in which people think I am sales person ignoring me or allow for my number and I am accessible. 

This lead to discussing the practice of digital communication with clients. Limits and boundaries about the capabilities of my e-mail and phone are explored in the first session. Both are not confidential, family could access my phone/iPad which has text and e-mail capability or they could also be stolen by someone and read all my information. Administrative information versus crisis contact (no crisis e-mails or texts) is explicitly discussed. So far adults have been great about this, adolescents are another story. Our digital culture has allowed children and adolescents to not think twice about sending red flags through digital means. I have texted/talked adolescents off the ledge and reinforced techniques to deal with stressful situations.  Later, I have to transcribe the communication for my records. Important e-mails I print out. The adolescents have not abused the tool. They understand I may not answer right away because my phone is not attached at my hip. We discuss technology as not a reliable form of asking for help and explore other methods of intervention.

Text Messaging Statistics
 

 Most of my clients use texting as a form of communication about session times or cancellations.  An excellent example of an e-mail agreement you can adapt to your practice is available here. I know I will adapt this form for my use with clients. This document is a good resource for digital communication standards.

I believe social work educators who are practitioners are particularly vulnerable to boundaries regarding e-mails.  Students are being taught to communicate with instructors through Skype, texting, e-mails, and learning management systems. “The more communication the better” is toted when courses are blended or online. A slippery slope may occur when this translates to client interaction. Social work educators need to be especially mindful because they are a mentor in the field. The boundaries they teach and exhibit will be remembered by their students.

I am diligent in my efforts to maintain boundaries between my different responsibilities. Not that mistakes don’t happen, but I learn fast. This is the whole crux of the issue; change is constant with digital communication. Even with our adaptation to these technologies there may not be models for us to refer in case of a concern. Then all we can do is learn, get supervision, and refer back to our code of ethics. What have been your experiences with digital communication and clients?

References

Mishna, F., Bogo, M., Root, J., Sawyer, J., & Khoury-Kassabri, M. (2012). 'It just crept in': The Digital Age and Implications for Social Work Practice. Clinical Social Work Journal, 40(3), 277-286. doi:10.1007/s10615-012-0383-4