I’m nearing an impasse with my psychologist over what I feel is an ethical issue, and I would be interested in hearing your opinion on this matter. I’ll keep it short, and cut right to the question:
Would it be ethical, under any circumstances, for a psychologist to post his/her profile with photos included, on dating websites that he/she knows his/her patients are members of? Additionally, would it be ethical for a psychologist to view a patient’s dating profile (considering the context and possible implications)? This happened to me. I became aware of it because a particular dating site I use allows me to see who has viewed my profile. In other words, I see my therapist’s profile, in my listing of who has viewed my profile recently. This happened several times within a two week period.
I was very stirred up as a result of seeing that my therapist had viewed my profile, and so I brought this up with my therapist via email, who then claimed (via a lengthy email response — that I was charged for, incidentally!) that it was not she who looked up my profile (and that she has never and would never look at it), but rather was likely to be a friend that she had loaned her account to, for the purpose of viewing/contacting other profile holders.
I can hardly believe this explanation and can’t imagine it isn’t an ethical issue in itself to casually loan one’s dating profile account to friends, when you know your patients use this dating website and might in fact be contacted by your friends. This therapist claims that due to our both being part of a “smaller community” (meaning, the gay/lesbian community), that different rules apply. Otherwise, she reasons that other psychologists in her position would not be able to “live.” In other words, we’re bound to “bump” into each other considering the small size of our “community.”
I’m still not comfortable with the explanations I’ve been given, and I’m looking for someone else’s thoughts.
The information age has posed some interesting challenges for patients and therapists. From an ethical standpoint, there are two major issues to be considered in the situation you describe. There are some other issues, too, but we’ll examine the major ones first.
One big issue is the issue of confidentiality. A professional is the keeper of the patient’s confidence, but the privilege belongs to the client. So, a therapist’s ability to disclose information imparted in the context of a therapy situation (even the mere fact that a therapy relationship exists) is severely limited. But when individuals freely post information to the general public, the information is not protected.
Another major issue is the issue of potential dual relationship. Ethical guidelines are clear that for a fair client-patient relationship to be established, there should exist no competing relationship. So, generally speaking, therapists don’t take on clients with whom they already have a different relationship, and they don’t establish other relationships with a patient. While it is true that in some very small communities, such dual relationships are hard to avoid, when that is the case some other very strict guidelines apply for addressing those issues and ensuring the best interest of the client. The situation you describe touches on this principle somewhat because the nature of the relationship you had with your therapist changed to some degree (even if you don’t have a formal intimate relationship) once pieces of information about each of you became known that were not part of the necessary disclosures within the therapy relationship. Although the change in circumstance made you uncomfortable, there appears no clear ethical breach.
Psychologists and other health professionals are also obligated to actively strive to benefit their clients through their work, to take care to do no harm, to demonstrate honesty and foster trust, and to work in good faith with their clients to avoid any and all conflicts of interest that could potentially lead to exploitation or harm. So, even though it would be impossible to deny a professional access to a public service just because someone else who happens to be a client also uses the service, it gets much murkier when the issue is whether the use of the service creates a conflict of interest of some sort. When a client expresses discomfort at a circumstance that involves their therapist, they have a right to expect that their concern will be taken seriously.
Clients are always advised to bring any concerns they have directly to the professional. You also have a right to evaluate for yourself whether the professional is responding to your legitimate complaints in a sufficiently conscientious manner. If you feel damaged in some way and you don’t think your concerns have been sufficiently considered, you have every right to seek an opinion from any of the regulatory agencies that govern practice, including the licensing board. In fact, unless the professional is absolutely sure that they are within their legal and ethical rights to handle a situation just as they have, many times they will seek guidance from their overseeing entities just to be on the safe side.
Even in those situations where an official body has determined that no ethical breach exists, there can be situations that so impair the necessary trusting bond between a therapist and client that the therapeutic relationship cannot endure. Ultimately, you are the final arbiter of that issue.
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