Discussing Social Media During Psychotherapy Consultations: Patient Narratives and Privacy Implications

Social media platforms are being utilized by individuals with mental illness for engaging in self-disclosure, finding support, or navigating treatment journeys. Individuals also increasingly bring their social media data to psychotherapy consultations. This emerging practice during psychotherapy can help us to better understand how patients appropriate social media technologies to develop and iterate patient narratives -- the stories of patients' own experiences that are vital in mental health treatment. In this paper, we seek to understand patients' perspectives regarding why and how they bring up their social media activities during psychotherapy consultations as well as related concerns. Through interviews with 18 mood disorder patients, we found that social media helps augment narratives around interpersonal conflicts, digital detox, and self-expression. We also found that discussion of social media activities shines a light on the power imbalance and privacy concerns regarding use of patient-generated health information. Based on the findings, we discuss that social media data are different from other types of patient-generated health data in terms of supporting patient narratives because of the social interactions and curation social media inherently engenders. We also discuss privacy concerns and trust between a patient and a therapist when patient narratives are supported by patients' social media data. Finally, we suggest design implications for social computing technologies that can foster patient narratives rooted in social media activities.