Social Work Practice in the Digital Age: Therapeutic E-Mail as a Direct Practice Methodology
Mattison, Marian, Social Work
It is indisputable that newer forms of digital communication used for personal, recreational, informational, and business purposes have created a virtual tidal wave of change in the ways in which interpersonal comnmnication takes place. Traditional face-to-face (F2F) conversation (offline communication) is often supplanted by digital communication (online communication). Digital communications include e-mail and text messaging; each allows for nearly immediate, 24/7 communication with others. E-mail communication combines elements of "interactive in-person communication and traditional written-word communication" (Childress, 2000, Introduction section, para. 3) and, when used as an adjunct to traditional meetings with clients, holds the potential for mental health professionals to enhance therapeutic relationships with clients, thereby improving therapeutic outcomes (Murdoch & Connor-Greene, 2000).
NEED FOR PROFESSIONAL GUIDELINES
Although more and more social workers acknowledge using online media in their clinical practice, standards for professional competence are inadequate, and ethical rules of practice (to guide interactive text-based communication with clients) are lacking (Santhiveeran, 2009). The National Association of Social Workers (NASW), in conjunction with the Association of Social Work Boards (ASWB), developed Standards for Technology and Social Work Practice (NASW & ASWB, 2005), designed to "serve as a guide to social workers incorporating technology into their services" (p. 4). Although a valuable first step, this document falls short of detailing the recommended practices expected of social workers, thus putting the burden on individual practitioners to operationalize the standards into ethically and legally sound practice behaviors. Statements such as "Social workers should make every effort to ensure that the use of technology conforms to all practice and regulatory standards addressing the ethical conduct and protection of the public" (NASW & ASWB, 2005, p. 7) are conceptual rather than practical, general rather than specific. In view of the fact that "when laws and regulations governing practices are silent or unclear, [clinicians] may partake in practices that could be harmful for their clients and/or put their licenses to practice at risk" (Ohio Psychological Association Communications and Technology Committee, 2008, p. 1), explicit descriptions of best practices are needed for social workers to "use technology appropriately, and adapt traditional practice protocols to ensure competent and ethical practice" (NASW & ASWB, 2005, p. 6).
COMPUTER-MEDIATED COMMUNICATION AS A NEW NORM
As the use of the Internet for delivery of mental health services becomes "increasingly widespread" (Midkiff & Wyatt, 2008, p. 311), there is little doubt that "technology will become more prevalent in social work practice over the next decade" (Reardon, 2009, Getting Used to IT section, para. 2). Therapeutic services provided over the Internet can no longer be considered experimental in nature and are fated to become "just one other consumer option in the delivery of evidence-based treatment for clinical mental health disorders" (Abbott, Klein, & Ciechomski, 2008, p. 373). For social workers to both adapt to the changing climate of delivering counseling and support and meet clients' expressed preference for the integration of online communication as a treatment practice method (Cartwright, Gibbon, McDermott, & Bor, 2005), professional investigation must accelerate with the explicit purpose of establishing practice standards and compliance protocols.
My goal in this article is to inform social work practitioners of the many benefits and risks of using online communication with clients (notably e-mail exchanges) as an emerging practice methodology. I describe the legal and ethical challenges arising from the use of therapeutic e-mail in social work practice and offer recommendations for establishing and implementing best-practices standards. …