American Music Therapy Association
Social Media Advisory for AMTA Members and Students

This document is an advisory statement endorsed by the AMTA Board of Directors and Assembly of Delegates. It was prepared with review and input from the AMTA Ethics Board and Technology Committee. The document offers suggested guidance and expectations to AMTA’s membership on the use of social media.

Social media is a useful and convenient set of tools for education, dissemination of information, professional networking, and business development (Anderson & Puckrin, 2011; Bates, 2014). Nothing is truly private on the internet (American Nurses Association [ANA], 2011). There are, however, principles that music therapists, interns, students, and other members are advised to consider in order to protect our patients/clients, and act in compliance with our professional documents, including the AMTA Code of Ethics and Scope of Music Therapy Practice. Section 12.0 of the Code of Ethics highlights the subject of online presence, “Music therapists ensure that their use of social media and their online presence is consistent with this Code of Ethics” (AMTA, 2017), implying that the entire Code of Ethics applies to social media. The Scope of Music Therapy Practice includes the overarching statement, “scope of music therapy practice is based on the values of non-maleficence, beneficence, ethical practice; professional integrity, respect, excellence; and diversity” (AMTA, 2017b). These values and the Code of Ethics inform the guiding principles listed below.

10 Principles for Professionalism and Social Media
(Adapted from ANA, 2011)

1. Understand social media and its benefits and risks

Be sure to know the risks and benefits of social media (ANA, 2011; Barry & Hardiker, 2012). Build your skills and competence and use good judgment. Know about online technology before you use it. Exercise your skills and judgment to use technology appropriately and ethically. Stay on top of changing technology in social media and online culture. Before you blog, post, or tweet -- think about the intent and potential consequences of your statements and online behavior, as well as the perception of your entire audience. What you publish will be around for a long time. Even if it is deleted later, it may live on, so consider the content carefully.

2. Maintain client confidentiality

Do not share patient/client information on social media sites. Leaving out names and details when you post information, music, or images does not necessarily protect client confidentiality. Report confidentiality breaches to the appropriate person promptly. Consider carefully your choice to use photos in an online format and ensure you have proper permission from the subjects of the photos, and/or their parents or guardians, and the photographer (Bates, 2014).

3. Respect privacy

Respect the privacy of your patients/clients and colleagues as well as your own. Set and maintain your privacy settings to limit access to your personal information. Learn about and be aware of your privacy settings. Know that even when the highest possible privacy settings are used, others can still copy and share your information without your knowledge or permission.

4. Comply with copyright laws and licensing terms

Follow the laws governing copyright and fair use or fair dealing of copyrighted material owned by others, including AMTA’s own copyrights and trademarked brands such as the AMTA logo. Attribute work and statements you cite to the original author/source. It is good practice to link to others' work rather than reproduce it. Obtain proper permissions and/or licenses for posting photos, songs, lyrics, or other copyrighted content (AMTA, 2017c).

5. Maintain professional boundaries

Just as with face-to-face relationships, you must set and communicate professional boundaries with clients online. When concluding or closing professional relationships with clients on social media channels, do so appropriately and consider the ramifications and unintended consequences of online relationships with clients. Avoid accepting client "friend" requests on personal social media accounts. If you use social media with clients (e.g., scheduling reminders and music therapy clinic/practice updates), use a professional account separate from your personal one. Similarly, professional boundaries should be maintained and respected online with other relationships, e.g., between faculty and students, between intern supervisors and interns, and/or between researchers and participants.

6. Manage clinical expectations

Use caution if or when you identify yourself as a board certified music therapist online. If you do so, be aware that others may ask for advice, which could lead to an unintended therapist-client relationship.

7. Protect your integrity, the integrity of the music therapy profession and that of your professional association(s)

You are AMTA. Help maintain the public trust in Board Certified Music Therapists, the American Music Therapy Association, the Certification Board for Music Therapists, and the music therapy profession as well as any other professional associations you may belong to or work alongside. Use appropriate communication channels to discuss, report and resolve workplace (or academic or supervision) issues and to ask personal questions about your own status or circumstances – not social media venues. When online, refer to colleagues or professional activity online with the same level of respect as you would in the workplace. Before you post, blog, tweet or share information about your practice, reflect on your intentions and the possible consequences. Your personal opinions may not be appropriate to share in a professional context. Understand that "liking" an individual’s comments, including disrespectful or sarcastic comments - no matter the intent, amusement, or context - can be seen as equivalent to making the same comment yourself.

8. Protect your professional image

Use the same level of professionalism in your online interactions as you would in face-to-face professional interactions. Keep your personal and professional lives separate. Clinicians are advised to use different accounts for personal and professional activities and be sure to know the privacy setting differences for each. Music​ ​therapy​ ​business​ ​owners​ ​should​ ​consider​ ​having​ ​a​ ​social​ ​media​ ​policy.

9. Be accountable and able to answer for your actions

Think about why, how, and when you use social media. Assist and encourage colleagues to do the same. Keep in mind that personal use of social media during working hours may be viewed as patient/client abandonment and/or neglecting work duties. Employers may consider this unacceptable during work hours. If you are unable, uncomfortable, or hesitant to discuss your online behavior with others, this may be your alert to reconsider, review, and adjust your online communications. Apply ethical thinking to social media activity (Dileo, 2000). Pause before you post and consider the implications. Avoid posting in haste or anger. Represent yourself honestly online. Do not create accounts in others’ names. Do not use anonymous accounts to cyberbully, shame, or harass others with impunity. Use good professional judgment to maintain your obligations to patients/clients, colleagues, and employers as your priority.

10. Understand and follow employer policies

If you are employed at a facility or contract with a facility, know and follow employer policies on using social media, recordings and photography, online encryption (as applicable), and computers and mobile devices, including use of personal devices at work. If you communicate with clients via social media, work with your employer to develop appropriate policies. Follow good practices to ensure cybersecurity of your online communications, financial transactions, as well as billing and appointments methods.

Following these guidelines and considering your online activity carefully, not only helps make social media online spaces more just, useful, and enjoyable place to be, but also helps to educate the public about the benefits of music therapy, and ensure those who need music therapy may receive quality services.

Numerous professions and facilities offer guidance and tips for online presence for professionals detailing some of the above factors. One guidance advisory that is especially concise is from Dr. Timimi of the Mayo Clinic Center for Social Media. Dr. Timimi published in poetic form, “A 12-Word Social Media Policy”:

“The biggest risk in health care social media is not participating in the conversation.  Simply putting “find me on Facebook" or “follow me on Twitter" badges on your website does not equate with health care social media.  Having noted this, among the most common concerns that seem to limit participation are those regarding professionalism.  So, let’s make this as easy as possible, with 12 words to light your way:

Don’t Lie, Don’t Pry,

Don’t Cheat, Can’t Delete

Don’t Steal, Don’t Reveal”

(Source: http://socialmedia.mayoclinic.org/discussion/a-12-word-social-media-policy/)

Example Scenarios and Social Media

A music therapist records a brief video clip speaking in their office. A photo of a client is visible on the wall and permissions to post on the Internet are not given.

• Check all images before posting. Redo the video or blur the image.

A close-up image of a music therapist at the bedside posted on a social media site does not show the patient/client except a readable armband is visible as the patient strums an instrument held by the therapist.

• Check all images before posting. Do not inadvertently violate pt. privacy. Take down the image.

A clip of a group session mini-performance by clients with special needs for their friends and caregivers is posted online in celebration of a special event. There is no indication to viewers online as to client permissions and informed choice among these persons.

• Clinic or clinician posting the clip has informed choices and permissions from all clients. Video is taken down and a note is added on the video and reposted.

A client or client’s family member asks to “friend” their MT-BC online at their personal account.

• Keep professional boundaries. Refer client to your professional/business site and professional social media account(s).

A​ ​music​ ​therapy​ ​business​ ​owner​ ​posts​ ​a​ ​thread​ ​on​ ​a​ ​music​ ​therapy​ ​business​ ​owners​ ​networking​ ​page detailing​ ​issues​ ​regarding​ ​their​ ​employees/contractors.

• Before​ ​that​ ​business​ ​owner​ ​posts​ ​this​ ​information​ ​he/she​ ​should​ ​consider​ ​the ethical​ ​implications​ ​of the post, especially as it relates to​ ​Section​ ​4.0​ ​of​ ​the​ ​AMTA​ ​Code​ ​of​ ​Ethics​. ​

On a private MT Networking social media page, a conversation thread is posted by a clinician who shares a portion of a client interaction but no names are noted. Based on the amount of information shared you are concerned someone might be able to determine who the client is and questions regarding maintaining client confidentiality arise during the thread. How might you address the situation?

• As an ethical issue, it is important to speak up professionally and without hesitation. As a potential practice issue, breaches, inadvertent or otherwise, may violate Standards of Practice and the Code of Ethics. As a legal issue, infractions to client privacy and confidentiality expose clinicians and health care entities to liability under federal HIPAA and state privacy laws (HHS.gov, 2017; Ventola, 2014). The site administrator may be contacted if they support the social media page when concerns arise. You or the site administrator may be able to contact the individual directly via private messaging and request a brief real time conversation to inquire about potential confidentiality concerns. It may be useful to determine if consent, or some exception, exists that would permit release of confidential information. Take the inquiry off social media as a private conversation. The administrator might also offer general guidance and reminders on the topic to members of the social media site.

References and Resources

American Music Therapy Association. (2017). Code of Ethics. Retrieved from http://www.musictherapy.org/about/ethics/

American Music Therapy Association. (2017b). Scope of Music Therapy Practice. Retrieved from http://www.musictherapy.org/about/scope_of_music_therapy_practice/

American Music Therapy Association (2017c). Continuing music therapy education: Ethics & copyright: An overview for music therapists. Retrieved from http://www.musictherapy.org/careers/continuing_music_therapy_education/

American Nurses Association. (2011). Fact sheet: Navigating the world of social media. Retrieved from http://www.nursingworld.org/FunctionalMenuCategories/AboutANA/Social-Media/Social-Networking-Principles-Toolkit/Fact-Sheet-Navigating-the-World-of-Social-Media.pdf

Anderson, J., & Puckrin, K. (2011). Social network use: A test of self-regulation. Journal of Nursing Regulation, 2(1), 36-41.

Bates, D. (2014). Music therapy ethics “2.0”: Preventing user error in technology. Music Therapy Perspectives, 32(2), 136-141. doi:10.1093/mtp/miu030

Barry, J., & Hardiker, N. R. (2012). Advancing nursing practice through social media: a global perspective. Online Journal of Issues in Nursing, 17(3), 5. Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No3-Sept-2012/Advancing-Nursing-Through-Social-Media.html

Chandler, D. & Munday, R. (2016). A dictionary of social media. Oxford, UL: Oxford University Press. 

Dileo, C. (2000). Ethical thinking in music therapy. Cherry Hill, NJ: Jeffrey Books.

HHS.gov. (2017). HIPAA for professional. Retrieved from https://www.hhs.gov/hipaa/for-professionals/index.html

Ventola, C. L. (2014). Social media and Health care professionals: Benefits, risks, and best practices. Pharmacy & Therapeutics, 39(7), 491-499, 520.

Approved by the American Music Therapy Association on November 18, 2017. Ver. 12.0