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Understanding Social Media Culture and its Ethical Challenges for Art Therapists Christopher M. Belkofer a & Jill V. McNutt a a Milwaukee, WI

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Understanding Social Media Culture and its Ethical Challenges for Art Therapists

Christopher M. Belkofer and Jill V. McNutt, Milwaukee, WI

Abstract

This article discusses ethics in the context of the partici- patory culture of social media as it relates to art therapy. The authors present the view that social media formats are impor- tant venues for expression that contribute to interpersonal con- nections and social learning via the active participation of their members. To make informed ethical choices regarding partic- ipation in social media, it is essential to understand the cul- ture of social media and their relationship to identity formation and personal expression. Art therapists may navigate the com- plex ethical issues of social media by expanding their range of expertise, being mindful of online behaviors, and establishing clear policies and procedures to protect clients, themselves, and the therapeutic relationship.

Introduction

An art therapist is sitting at home in front of a computer reconnecting via Facebook with a long-lost friend she hasn’t seen since the second grade. As she looks at photos posted of her friend’s 3-month-old baby, a red icon appears in the upper corner of her profile page. Clicking on the icon she sees the image of a former client requesting to be her Face- book friend. Startled, the art therapist considers the ethics of “friending” clients. She may rationalize, “a Facebook relationship is not the same as a personal relationship”; “my former client may feel hurt and rejected”; or “this is a client-initiated circumstance” as she negotiates her self-talk thoughts arising from this unexpected invitation. Due to the rapid cultural shifts associated with Internet-based social media environments—including blogs, online postings, file sharing, and social networking websites—art therapists today are faced with complicated ethical issues that did not exist 5 years ago.

The increased prevalence and diverse applications of social media are “reinventing and tearing at traditional boundaries, stirring up a hornet’s nest of new issues” (Rice, 2009, p. 131). How can art therapists set appropriate professional boundaries within a society that is uncertain

Editor’s Note: Christopher M. Belkofer, MA, ATR, LCPC, is an Instructor and Practicum Coordinator for the Graduate Art Therapy Program at Mount Mary College, Milwaukee, WI. Jill V. McNutt, MS, ATR-BC, ATRL, is an art therapist with Aurora St. Luke’s Medical Center, Milwaukee, WI, and with the Milwau- kee Art Museum. Correspondence concerning this article may be addressed to the first author at [email protected]

about what personal, private, and available now means? Recognizing the creative potential of social media, how can art therapists help their clients use new media as a means of expression while still honoring the need for privacy, reverence, and even sacredness of their work? How do we prevent our clients and peer practitioners from being stung by the ethical challenges this hornet’s nest may bring?

The New Culture of Social Media

Social media refers to multiple technologies that include computer-based communities and environments along with their corresponding modes of expression, documen- tation, and communication. Social media are not solely defined by their components (networking websites, blogs, podcasts, wikis, etc.) but also by their cumulative effects on the dynamics of information processing and human relationships (Social Media Club, 2007). The impact of the high levels of participation in social media, both today and in the future, is creating a multifaceted, multi-networked social construct where ideas of belonging and creativity may be profoundly and permanently transformed. The skyrocketing use of social networking has been described as the “fourth revolution” (Shih, 2009, p. 11) following the rise of the mainframe computer, the personal computer, and the Internet. This advancing revolution of interpersonal connections and interactions, which Shih (2009) described as the “online social graph” (p. 11), is redefining human understanding, experience, and navigation of the world.

The origins of modern day social media can be traced to 1995 when early social networking websites (SixDegrees, Classmates, Friendster, etc.) introduced the concept of the profile page and later the connection through “friends.” According to Shih (2009), these sites paved the way for Facebook, MySpace, LinkedIn, Orkut, Hi5, Cyworld, and other popular websites of today. Other venues for social media include YouTube, Twitter, Skype, multiple blogging sites, and online video games, as well as e-mail. This list is not comprehensive because the dynamics of social media are continually expanding. Nor is the use of social media limited or confined to one generation. Demographically, a higher percentage of adolescents and young adults are using social media for entertainment and communication; however, 75% of all Internet users are between the ages of 18 and 54 (Jones & Fox, 2009). In the United States Facebook is used by more than 85% of 4-year college students, but over 50% of its users are not attending college

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and Facebook’s fastest growing user demographic is people who are 25 or older (Shih, 2009). The likelihood of this technological revolution ending any time soon is small, considering that multiple generations are participating in it.

Professional perspectives on social media are evolving to keep pace with technological change. Stephen Behnke (2008), the director of the American Psychological Associa- tion’s Ethics Office, noted that although the differentiation between professional and private domains remains, the technological and cultural shifts occurring because of the popularity of social media present a lack of clarity with respect to defining or revising standards of ethical behavior. Behnke asserted that therapists must understand the culture of online participation in order to make informed ethical decisions regarding behaviors for both clients and therapists in the realm of social media.

Although it is beyond our intent to suggest whether or not art therapists should participate in social media formats, our perspective echoes that of Behnke (2008). We assert that an informed understanding of the culture of social media is primary in effectively navigating the complicated ethi- cal issues that social media entail. As Moon (2006) wrote, “The real world of professional ethics in art therapy is, more times than not, a spectrum of shades of gray” (p. xv). Thus, to make ethical decisions, one must often work within nu- anced, gradual shifts of tone and shadow, as opposed to the black and white world of right or wrong. Such a process entails knowledge of the self, of the other, and of com- plex systems (Moon, 2006). Understanding one’s personal responses to social media as well as the overall cultural and global resonance of social media is key to making sound ethi- cal judgments. Such a process may begin with an exploration as to why social media has become so appealing.

Drawing from the work of Martin (2008), Lankshear and Knobel (2010) asserted that highly invested partici- pation in social media is a form of identity work that re- flects an “integral and radically coherent dimension of be- ing a contemporary person living in contemporary life” (p. 14). Thus, the success of social media outlets may be a disconnected society’s response to an unspoken need, which is to heal its members’ distress over isolation and lack of belonging. Because many institutions for self-identification, development, and understanding have been lost in today’s cultural environments, the “work” of developing an identity must be self-generated. In this view, participation in social media is one expression of a continual search for identity and meaning. More than an expression of a narcissistic culture or a distraction from meaningful face-to-face realities, partici- pation in social media can also be viewed as an attempt to increase understanding of the world and of the self.

Although the majority of behaviors particular to social media outlets may not have identity work as their original intent, the tremendous appeal of social media forums seems related to their underlying ability to foster self-defining behaviors (Lankshear & Knobel, 2010). Rice (2009) at- tributed the success of Facebook, for example, to its abil- ity to (a) evoke a feeling of belonging via the capacity to store highly meaningful items such as pictures, (b) help the user stay connected with friends and family, (c) offer a sense

of safety and control over one’s environment, and (d) pro- vide a culture of perceived acceptance and authenticity. As of this writing, half of the more than 500 million Face- book users visit the site daily (Facebook, 2010). It is evi- dent that for many people, participation in digital media is providing a home base and a sense of control and cer- tainty in a postmodern world where identity, community, and meaning are increasingly difficult to experience and define (Martin, 2008; Rice, 2009).

The cultural popularity of social media also is having an impact on artistic expression, as well as how and by whom art is generated and distributed. Certainly economic and social factors limit who can access social media; however, techno- logical advancements in digital technologies are leading to a social reality in which the lines between high art and low art, creator and viewer, and expert and novice are blurring (Lankshear & Knobel, 2010). As online communities grow, the roles of consumer and creator are becoming further en- meshed (Bruns, 2008). Various new technologies are con- tributing to what it means to be an artist, to be creative, and to be a community. According to Jenkins (2006), social me- dia are creating a “culture of convergence,” which he defined as “the flow of content across multiple media platforms, the cooperation between multiple media industries, and the mi- gratory behavior of media audiences” (p. 2). Rather than simply being present in the components of a particular social media outlet, convergence is manifest in actual individual and communal cognitive structuring (Jenkins, 2006). Above all, social media culture is “participatory”—that is, “rather than talking about media producers and consumers as occu- pying separate roles,” Jenkins suggested, “we might now see them as participants who interact with each other accord- ing to a new set of rules that none of us fully understands” (p. 3).

Participatory social media culture means that its mem- bers create the content of the media they are consuming (Lankshear & Knobel, 2010). Facebook (2010) reported that its average user creates 90 pieces of content each month, which collectively amounts to more than 30 billion pieces of content being shared in the forms of web links, news sto- ries, blog posts, notes, photo albums, and so on. Members of the online participatory culture no longer have to rely exclusively on outside media providers for content (Jenk- ins, 2006). Such active participation is contrary to both the standard view of the “couch potato” or passive media con- sumer as well as the stereotypic 1950s image of the nu- clear family gathered together to watch a single television program provided by a dominant media outlet. In a video posting by Highest Common Denominator Media Group (2009), Jenkins described this convergence culture as a re- turn to the tradition of orally passing down dominant cul- tural narratives. In this view, story telling is shifting away from the reliance on large media corporations and back to the general population. Thus, social media in many ways offer an opportunity to revisit old models of storytelling. Of importance to the art therapist is the growing degree of attunement that can be expected between clients and this budding cultural frame. The therapist should discover not only whether or not a client participates in this culture of

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convergence but also the degree to which the client claims creative investment.

Ethical Challenges of Social Media

Despite the promise of active participation, the ethical uses of new media are inherently challenging in that along with the new world comes the need for new regulations, as well as new applications and models of understanding. One of the primary needs art therapists have is to maintain healthy boundaries within the cultural constructs of social media. An obstacle is that new social media formats and their dynamic “make it up as we go” qualities are a moving target that is seemingly impossible to define. Communities and re- lationships are being redefined by the wide reach and intri- cacy of digital technologies. Social media present powerful ethical challenges because online communities are paradox- ically divergent (i.e., information between intimates can be distributed to vast audiences) and convergent (i.e., informa- tion sharing can connect and draw people closer). Although social media formats may seem intimately private when the participant is sitting at home alone in front of a computer, the reality is that they are far from it. Rice (2009) com- mented that a particularly interesting aspect of cyberspace is that it doesn’t “forget.” “If you’ve downloaded it, posted it, searched for it, or looked at it, there is probably a record of the event flowing ‘out there’ somewhere” (p. 131). Thus, a central ethical issue that therapists have in the context of so- cial media derives from one of the digital revolution’s great- est strengths: The ability to instantaneously distribute in- formation to a vast amount of people from highly accessible sources (e.g., cell phone cameras).

In the past a person’s mistakes, bad choices, and even moody rants were primarily available solely to other family members, the parties involved, or perhaps the local news- paper. Today, social media formats threaten to display these missteps in profoundly public realms. With only the “click of a button,” an angry response, damaging rumor, or inflam- matory remark can reach hundreds of people instantly. Such power has both positive and negative potential as well as vari- ous ethical challenges. Jenkins (2006) illustrated the negative potential in the following scenario:

Intoxicated students at a local high school use their cell phones spontaneously to produce their own soft-core porn movie involving topless cheerleaders making out in the locker room. Within hours, the movie is circulating across the school, being downloaded by students and teachers alike and watched between classes on personal media devices. (p. 17)

Jenkins’s (2006) example, although dramatic, illustrates how information can spread in ways that, like Pandora’s box, are difficult to control and undo. In addition it illustrates that not all who participate in the new media culture fully grasp or understand the potential for harm that such par- ticipation holds. Adults who are unfamiliar with these new technologies may struggle to monitor their children’s social media behaviors or may simply fail to imagine potential pit- falls and therefore anticipate them. Adolescents, who are still developing the higher order executive functioning of the

brain (Restak & Grubin, 2001), may lack the neurobiolog- ical structures to appropriately anticipate and self-monitor their reactions. Many students now entering undergraduate and graduate programs have been raised in a climate satu- rated by social media and the realities ingrained therein. Al- though they are adept at navigating social media, younger generations may not have experienced a media culture that could teach them the consequences of certain online behav- iors. Some individuals may never have contemplated to any substantial degree whom they have let into their personal world or how long the shadows or footprints of those inter- actions may linger in cyberspace.

Professional Development and the Culture of Art Therapy Education

A lack of awareness of online behaviors and their conse- quences can be problematic upon entering graduate school, as art therapy students encounter a professional training culture in which sharing certain elements of their personal experiences is no longer considered appropriate as profes- sionals. For example, students may casually post negative in- formation about their internship experiences on a blog or on Facebook. Negative consequences could result regardless of whether the internship site has policies on how information about the institution can be disseminated in public forums. Complaining about one’s boss or supervisor is fairly normal in the workplace and at times is a natural release of stress. However, students may be unaware of the many people who have lost their jobs or faced thorny work dynamics when their venting or rants were made public in online outlets.

Art therapy educators would be wise to outline for students clear expectations and consequences for online behaviors upon admission into their programs. Cultural norms can be established by these policies—such as refraining from “friending” clients while on Facebook—as well as professional values for the program. Students may need to be reminded of their roles as representatives of an institution, whether graduate program or internship agency, and of the field of art therapy in general. We do not suggest that supervisors police their students’ online behaviors; rather, the goal should be to create a safe yet clear environment where students can appropriately navigate and explore their developing professional roles.

Discussing the standards and expectations of online behaviors should be integrated into the internship experi- ence and used in supervision to inspire discussion related to termination, boundaries, and identity. We feel that is it essential for both the on-site and the academic supervisors to have open discussions regarding the professional and ethical responsibilities that art therapy students have around online behaviors that they will be held accountable for in their internships. The transition from student to new professional is not always a linear journey and students must grapple with expectations, a loss of innocence, and new responsibilities that can feel at times punitive, stifling, and overwhelming (Moon, 2003). Although self-awareness can be an essential ingredient in developing into an effective

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therapist, it can also be a burden. An emphasis on being more mindful of their online behaviors can stimulate a fruitful discussion on how to address and manage the changes that students undergo in becoming a professional and the loss they often entail.

Art therapy practitioners also must be conscious of how their own online identities can be viewed and monitored by their clients and others. The therapist may ask, “Would I post a picture in an online forum that I wouldn’t want a client to see in the office?” “Would I write a comment in an online forum that revealed something I wouldn’t want a person to know in a professional setting?” Clinicians need to be aware of what their online participation reveals about their personae. As Yalom (2005) wrote, “You must be clear about why you reveal yourself. Do you have a clear therapeu- tic intent?” (p. 229). Despite the fact that an online forum might have privacy settings to help regulate and protect so- cial media users, it may be best to assume that all online be- haviors are, in effect, taking place in a public forum. Ethical decision making requires anticipation of potential problems; thus, even when posting personal information without ther- apeutic intent, the ramifications of that information being viewed by clients and coworkers must be considered.

Boundaries and the Role of the Therapist

An important ethical issue in the realm of social media is transparency. Facebook and social media sites where “friending,” “following,” and “fanning” occur give clients the possibility of interfacing and interacting with art therapists outside of their sessions. Moreover, a therapist’s self-disclosure is no longer limited to the personal informa- tion he or she chooses to share (Zur, 2008) because search engines such as Google have opened unprecedented chan- nels of information that are available for general curiosity and in some cases cyber-stalking. In a relatively simple search effort a person may locate aspects of a therapist’s identity on websites, publications, vitas, and blogs—including personal demographic information and professional and personal activities (flattering or otherwise). Zur (2008) suggested that therapists conduct their own random self-searches to determine how much of their personal information is available to casual searchers. In addition, he offered general guidelines for the therapist: (a) consider that everything posted online is viewable, (b) use caution and informed consent before discussing any client information online, and (c) be aware of the ethical and legal ramifications of clients searching for therapists and therapists searching for clients.

Ethical issues involve not only how much personal in- formation should be or is available to the client, but also how much is available to the therapist. According to Scarton (2010), “the tremendous availability online of personal in- formation threatens to alter what has been an almost sacred relationship between therapist and patient” (para. 5). Should therapists conduct online searches for their clients? Should they display personal information on their Facebook pages or even participate in social media at all? With no clear an- swers to these and similar questions, Scarton concluded that “how and when a therapist should use the Internet—and

even whether he or she should—are questions subject to vig- orous debate” (para. 3).

Art Therapy File Sharing, Blogging, and Video Posting

Malchiodi (2009) addressed the complex nature of pro- fessional networking and the promotion and advertising of art therapy via social networking sites, expressing particular concerns regarding the ethics of posting client artwork and videos depicting actual art therapy sessions. She differenti- ated content generated from community-based art therapy settings where a goal of treatment is to “reframe clients as artists” (para. 4) from the more ethically questionable behaviors of posting content lifted from art psychotherapy sessions. Malchiodi questioned whether informed consent could truly address the complexities entailed with the divergent and shifting realities of social media platforms:

Does any person really understand what it means to have one’s therapy session visible in one of the most public cyber-places in the world? How well does any client understand that any- thing on a social networking site is accessible and download- able by anyone with a few clicks of a mouse? I am not con- vinced that any informed consent document or explanation could adequately convey this to any individual, particularly a child. (para. 4)

In acknowledging our own abilities to grasp the vastness of digital impact, as art therapists we ask how it is possible to ef- fectively convey information about online posting to a client in such a way as to enable the informed consent. Do we con- clude, as Malchiodi did, that perhaps “the Internet has rede- fined the nature of self-disclosure and privacy, but ethically, it’s just too much information” (para. 6)?

Alders and Allen (2010) recently debated the ethics of clients posting therapy artwork online or using social media sites such as YouTube to post movies that document their clinical treatment in sometimes excruciating detail. Shar- ing one’s therapeutic journey online can inspire the darker side of online communities, which is that an enormous amount of bigoted and hateful comments may be unleashed by “anonymous” viewers. On the other hand, client art in public forums such as community art shows can empower clients and develop their self-worth as artists. In any case, online postings welcome the potential for documented crit- icism that likely would not exist in a more traditional art show setting. Thus, online postings can place clients in a very vulnerable position, and could be counterproductive as well as counter to therapeutic goals.

Although showing client art in a gallery or a community setting allows for some monitoring of the audience as well as the art, online posting or file sharing, by contrast, is much harder to monitor. Most notably, there is much less control possible through being able to take the art “down” when clients decide they no longer want their work exhibited online. Removing the art becomes problematic because of the reality that the online world “never forgets.” This issue, along with the potential for receiving negative comments, should be taken into account and discussed with the client

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when considering whether to publish or put client artwork online for public viewing. Moreover, it is essential that the necessary consent forms reflect these limitations and the client’s awareness of the digital impact of the decision.

Establishing Social Media Norms and Expectations

Anticipating possible media-related problems and ad- dressing them early within the therapy milieu through clear policy and procedures can be an effective means for manag- ing the complex nature of online environments—whether for students and supervisors, for practitioners, or for clients. Kolmes (2010a) found that an effective method for introducing clear parameters into the client–therapist relationship was to have a “social media policy” for her private practice. She informs each new client whether and how she will engage with him or her online, and she discusses the limits she may set, including refusing to accept “friend requests” on Facebook from current or former clients and a “no fanning or following” policy. Any violation of these policies are discussed directly in session. To those who have criticized her policy, Kolmes (2010b) responded:

I certainly don’t want for [sic] a client to feel hurt or re- jected. The very reason I’m creating a Social Media Policy in the first place—and discussing it with clients—is to min- imize the potential for such feelings of rejection. I’m making it extremely clear that this policy is universal for all clients and not personal. I’m also explaining my rationale. I want this information to be clear and accessible before such events transpire so that it’s not a mystery as to how I’ll respond. (para. 2)

Following Kolmes’ (2010a, 2010b) example, it may be prudent for art therapists to introduce their own social media policies as an explicit part of their intake and introductory protocol for new clients and for establishing individual and group norms. In addition to creating a safe and predictable therapeutic environment, a discussion of social media management also could offer a therapeutic opportunity to explore healthy interpersonal boundaries and limit setting. Having a clearer understanding of the boundaries and nature of the client–therapist relationship may accelerate issues that may typically arise in therapy, such as the role and identity of the therapist and issues around transparency. Given the pervasiveness of social media and the likelihood that either or both the art therapist and the client are members of online communities, discussion of online relationships should be an elementary feature of setting limits and boundaries with a client.

Conclusion

The ethical issues around social media formats are dy- namic and complex. The balance between an art therapist’s personal rights and professional responsibilities has new implications as we further invest ourselves in the digital age. A collective agreement on what the appropriate boundaries

of online relationships are is still in a state of formation. Nonetheless, we believe that art therapists can effectively navigate the complex ethical issues of social media environ- ments, beginning with the following strategies: (a) expand- ing the definition of art to include new media and digital technologies; (b) developing a greater range of expertise to help people deal with the realities of new media; (c) engag- ing mindfully in the monitoring of online behaviors; and (d) establishing clear policies and procedures to protect clients, themselves, and the integrity of the therapeutic relationship.

It is essential that the field of art therapy begin to recog- nize social media as powerful, contemporary tools that can be used for finding meaning in an increasingly uncertain world. Social media formats are means of expression that contribute to interpersonal connections and social learning via the active participation of their members. Whether or not art therapists are experts in the web-based world of so- cial media, we have experience to offer in the realms of meaning making, social participation, and the power of im- agery, which are all factors related to social media. As Austin (2009) wrote, “Because art therapists work with fantasy, pro- jection, symbol, and metaphor, they are well positioned to contribute a unique perspective on the impact of technology on the creative process and on emotional life” (p. 83). An understanding of the ethics of social media must address the role these environments play in the lives of art therapists and their clients as they partake in the growing online culture.

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