SAN FRANCISCO – New curricula will help psychiatry residents who grew up in a Web 2.0 world think about the Internet and electronic media in more professional ways, and how the connectivity to which they are accustomed can pose problems for psychiatrists.
The American Association of Directors of Psychiatry Residency Training (AADPRT) offers the curricula on its website to its members. Portions of it, such as some of the resources provided, will be publicly available, Dr. Sandra M. DeJong said at the annual meeting of the American College of Psychiatrists. A podcast about "Professionalism and the Internet" also is accessible there.
"If you’ve grown up with this technology, it truly is second nature to you" and the potential pitfalls are not always obvious to young trainees, Dr. DeJong, who is chair of the AADPRT Task Force on Professionalism and the Internet, said in a discussion session at the meeting.
For example, e-mailing between psychiatrists and patients "sets up all kinds of problematic boundary issues," she said in a separate interview. AADPRT President Sheldon Benjamin said in an interview that a frequent scenario involves mental health professionals who choose to participate in social networks such as Facebook and thereby make available information about themselves that patients otherwise could not access. When a patient asks to "friend" a psychiatrist on Facebook, any response or lack of it can be problematic.
"Social networking and Web 2.0, this ability to create new content by dint of your connections to other people, has created new dilemmas for psychiatric education, for hospital administration, and for psychiatrists in practice," said Dr. Benjamin, director of neuropsychiatry and professor of psychiatry and neurology at the University of Massachusetts, Worcester.
"Dr. DeJong and I are not suggesting that psychiatrists run from new technology and the Internet. Not at all," he said. The new curricula are not designed to deliver absolute rules or guidelines but rather to help residents think through the professional ramifications of social media and electronic technology and make better-informed decisions.
Students and residents sometimes don’t realize that information about themselves online can have professional consequences. Dr. Glen O. Gabbard, who co-led a discussion session about the Internet and social media at the meeting, said information posted on Facebook accounts sometimes has influenced decisions to not accept a medical student to a residency program, or to not offer a resident a job.
Although other medical specialties are beginning to produce guidelines on the use of social networking, psychiatry has few resources for guidance, Dr. DeJong and Dr. Benjamin said. The American Medical Association’s decade-old guidelines on the use of e-mail say little about higher standards needed when dealing with mental health or substance abuse issues, and the AMA’s 2010 Policy on Professionalism in the Use of Social Media also is not specific to psychiatrists.
The new AADPRT curricula focus on 36 vignettes that cover a variety of media and topics, including confidentiality, liability, academic honesty, and managing technology in psychotherapy. "We found that everybody had a story" about a clinical problem involving the Internet or social media, "and that the stories are really what galvanized people’s interest," said Dr. DeJong of Harvard Medical School, Boston.
A list of resources from medical journals, mainstream media, and the Internet accompany each vignette.
"Hopefully, we’ll be able to continue to update" the curricula as the world of Web 2.0 – and psychiatrists’ place in it – evolves, Dr. DeJong said. "It’s very much a moving target."
Dr. DeJong is a paid contributor to the nonprofit website "Children’s Emotional Health Link." Dr. Benjamin and Dr. Gabbard reported no relevant financial disclosures.