Where does the therapist end and the person begin online?

A long day ends, you open Instagram, and there it is: a follow request from a client you saw earlier that afternoon. Do you ignore it? Decline it? Worry they’ll take it personally?

For many mental health therapists, this moment is now routine. Digital spaces have become part of clinical work, whether or not therapists want them to be. Clients search for therapists online, follow them for educational content, and sometimes try to connect on personal platforms. Therapists use telehealth portals, websites, and social media for outreach or public education.

The boundary between “therapist” and “private person” has never been thinner.

The new reality: Everyone is watching

Therapists once occupied a private professional space. Today, search engines and social media make the personal lives of clinicians easier to find.

Many therapists use Instagram for work, marketing, or education. TikTok is growing fast, too. This visibility brings a new problem: discoverability. Clients can find your family photos, your political views, or your weekend hobbies with a simple Google search.

The numbers tell the story.

A 2023 survey revealed that 32% of social media users followed therapists and mental health professionals for mental health content. And 20% of users followed mental health advocates, influencers and brands for mental health content.

This constant connectivity takes a toll. Therapists who deal with frequent digital intrusions report higher levels of burnout and emotional exhaustion. When you feel like you are always “on,” it’s hard to recharge.

Why online boundaries matter

Digital spaces collapse distance and time. A post, comment, or message can be seen instantly, shared widely, and revisited later, often out of context. For therapists, this raises risks that do not exist in a traditional office setting, including confidentiality breaches, and role confusion. These moments matter because they can unintentionally create dual relationships or shift power dynamics, even when no harm is intended.

Professional ethics bodies in the U.S. consistently emphasize that therapists are responsible for maintaining boundaries across all spaces where professional identity is visible, including personal online presence.

Boundaries can be blurred online with actions like:

• Sending friend or follow requests on social media

• Messaging therapists outside of secure portals

• Therapists sharing personal opinions or daily life publicly

• Discovering personal information through Google searches

• Therapists feeling pressure to respond quickly to digital messages

It’s not just clients. In this study, 61.7% of therapists said they checked their client’s social media for psychotherapy, and 92% thought they could provide more effective treatment as a result.

Why the rules feel confusing

If you feel unsure about what to do, you’re not alone. The rules are struggling to keep up with reality.

We have big laws like HIPAA that protect patient privacy. We have the 21st Century Cures Act that pushes for fast access to records. Then we have ethical codes from the APA, ACA, and NASW.

These codes all agree on one thing: You must protect client confidentiality.

However, they are often vague about the specifics. For example, HIPAA makes it clear that you cannot share patient information. But what about a TikTok video where you react to a generic situation? If a client recognizes themselves in your “generic” story, you could be in trouble.

Even connecting across state lines is tricky. With telehealth compacts like PSYPACT, you might be seeing a client in a different state where the marketing rules are different. It’s a lot to manage.

How online visibility shapes therapy

Research on therapist self‑disclosure has long shown that personal information can influence how clients perceive their clinician. Digital presence extends those dynamics into everyday life.

Several studies have explored how client perceptions of therapist values—including political, social, or cultural beliefs—shape alliance and engagement. Findings vary, but many note that perceived alignment can strengthen rapport, while perceived mismatch may deter some clients from seeking care.

That’s not to say that social media can’t be helpful. On the contrary! When therapists post general educational content without discussing individual cases, it can contribute to public understanding of mental health topics and reduce stigma. It may be annoying at times to hear “therapy-speak” or to see a client convinced they have ADHD because of TikTok, but it’s a jumping point that gets them to therapy.

The key is relevance. Does this post help the client, or does it just serve you?

How to protect yourself (and your clients)

You don’t need to delete every account. But you do need structure and consistency.

1. Separate roles and spaces

A helpful rule of thumb is one role, one space.

When personal and professional roles overlap online, expectations blur. Ethics guidelines from the APA, ACA, and NASW all recommend clear separation between personal and professional digital identities to reduce confusion and protect clients.

In practice, this means:

• Separate personal and professional accounts

• Lock down privacy settings on personal profiles

• Use professional platforms only for professional communication

• Avoid informal interactions with clients in public or social spaces

• Post only general, educational content

• Avoid replies to client comments that acknowledge the therapeutic relationship

• Never provide individualized advice in public messages

• Use disclaimers such as “Content is informational and not therapy”.

This protects both therapist and client from crossing boundaries unintentionally.

Ethics experts also recommend not viewing client social media profiles without clinical relevance and informed consent, even if those profiles are public.

2. Triage your messages

You can’t stop private messages, but you can manage expectations.

• Set up auto replies on all professional accounts. State clearly that you do not check DMs for clinical issues.

• Include crisis numbers (like 988) in your bio and autoreply.

• If a client messages you on social media, gently redirect them to your secure, HIPAA-compliant portal.

3. Moderate your comments

The comment section is a minefield. A well-meaning client might comment, “Thanks for helping me with my issue last week!” Suddenly, they have revealed their medical status to the world.

• Use keyword filters to block sensitive words.

• Pin a “House Rules” post that explains you cannot acknowledge client relationships online to protect their privacy. 

4. Google yourself

It sounds vain, but it is necessary security work.

• Every three months, search for your name in an incognito browser window.

• See what comes up. If you find your home address or personal phone number on data-broker sites, request to have it removed.

Bringing digital boundaries into the therapy room

Boundary issues online are easier to manage when discussed early.

Include a short social media policy in intake materials explaining that declining follow requests protects client privacy and confidentiality. Clarify response times for email and portal messages.

If a boundary is crossed—such as a late-night DM—address it directly and neutrally in session. Explore the meaning of the contact, then restate your policy.

Boundaries protect therapists, too

Clear boundaries support sustainable practice. Studies on provider burnout note that blurred personal‑professional lines—digital or otherwise—limit rest, increase anxiety, and erode emotional resilience.

Boundaries allow therapists to:

• Be fully present in sessions

• Rest outside of work hours

• Reduce anxiety about online visibility

• Practice ethically with confidence

They also model healthy boundary‑setting for clients.

A simple checklist for every therapist

Before sharing anything online, ask:

1. Purpose: Why am I posting this? Is it to educate, or am I venting?
2. Audience: Would it be comfortable if every client—or future client—saw this?
3. Content: Does this reveal too much about my personal life or my specific clinical methods?
4. Control: Do I have the settings in place to manage comments and messages?

If a post scores high on risk in any of these areas, save it for your private group chat, not the public feed.

Digital spaces are part of modern practice. With thoughtful, intentional boundaries, therapists can engage online without compromising ethics, privacy, or their own well‑being.

If you want to learn more about creating an ethical digital presence, check out this post.

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