Jeff Ayars didn’t like his therapist. Their sessions felt stilted and her mind seemed to be elsewhere. Ayars, a news producer from New York, wondered whether it was his fault—after all, she had good reviews online and he had found her through his work’s insurance. Then he found her TikTok account.
It wasn’t just her follower count—50,000 people—that caught his eye. It was the videos themselves. His therapist, it turned out, was also an influencer. Her bite-size videos helped people “make decisions quicker” or explained why people “don’t have to apologize” for their feelings. “Was she just thinking about her next post while we were in the session together?” Ayars says. “What’s her real goal?” Was she trying to help him, he wondered, or was she chasing social media clout?
During the pandemic, when the world’s mental health took a nosedive, the amount of mental health content on TikTok shot up; today, the #mentalhealth tag has 70.5 billion views. Add to this the explosion of the app’s popularity, with users more than doubling since Covid struck, and you get TikTok therapists broadcasting advice to their followers en masse.
As more and more therapists have started posting advice online, especially on TikTok, professional bodies have struggled to keep up. In the United States, the American Psychological Association (APA) published its first set of social media guidelines for psychologists only in October 2021. In the United Kingdom, the British Association for Counselling and Psychotherapy (BACP) refreshed its guidelines in March 2021.
These guidelines call for the online and physical worlds to be kept separate as much as possible. With their IRL clients, psychologists should “consider the need to avoid contact with their current or past clients on social media, recognizing that it may blur boundaries of the professional relationship,” the APA suggests. Yet, as in Ayars’ case, an algorithm can quickly take this out of a therapist’s hands. If your therapist has tens of thousands of followers on TikTok, chances are they’ll pop up in your For You page. Does stumbling upon your therapist dancing to Hannah Montana when you’re scrolling on your lunch break cross a line? Ayars felt uncomfortable that his therapist hadn’t been transparent about also maintaining an online presence: “I think it’s just strange to find you’re working with someone who’s pursuing that—and it’s not upfront,” he says.
A bigger problem is that when a therapist is posting online, there’s the temptation to use subject matter from sessions as inspiration for content—an absolute no-no. This happened to Michael, who lives in the US and asked WIRED not to use his real name for privacy reasons. He actually found his therapist through social media—he had a specific emotional issue he wanted help with, and he came across a therapist who made YouTube videos for about 12,000 subscribers, whose content specialized in psycho-education about this more niche issue. Michael realized this therapist was a practicing psychologist in the same state as him, so he reached out, and began sessions with him.