If you had overly strict parents, it makes complete sense that you would suffer with self-doubt,” the therapist said, sympathetically. “I work with many clients who have had a similar parent-child dynamic to yours and they can also experience burnout.”
If you imagine here that I am sharing a snippet from a personal discussion carried out within the confines of a private therapy room, you’d be wrong. Instead, I’m hunched over my phone on the sofa, watching along with 132 other people, as faceless users send their questions into a live stream hosted by a therapist. She attempts to answer as many as she can, though she does make clear that she isn’t intending to give out personal advice, rather help point people in the right direction. I watch as question after question comes rolling in, referencing anything and everything from how to spot a toxic relationship to how to cope with the death of a family pet. It’s mesmerising, and it’s not the first time I’ve come across similar types of content on the social media platform.
The TikTok therapy movement is big – videos can rack up millions of views, spur thousands of comments, bookmarks and shares, and catapult the therapists behind them towards social media stardom. In fact, hardly a day goes by where I don’t find myself liking, sharing or simply scrolling past a counsellor or psychologist of some sort who is sharing advice on the app. It’s picking up on Instagram too.
As someone who has been in and out of therapy for much of her adult life, I can see the benefits: primarily, it allows therapy access to many people who wouldn’t be typically able to afford it. On top of this, it seems like a good business move for a therapist themselves, likely earning them more clients, more notoriety and likely, for those with bigger followings, an extra income stream. But what about when that TikTok therapist who everyone reshares is your actual IRL therapist?
I began to question how I would feel if, while scrolling aimlessly through a video platform, I came across my own story being (anonymously) shared and how this might impact my relationship with my therapist – or even the concept of therapy altogether. Do the benefits to a wider audience (I’ve lost count of how many videos from therapists have resonated with or helped me on some level) outweigh the impact it might have on a singular client, paying for one-to-one support?
“I’ve decided not to work with a therapist before because they mentioned that they use TikTok and Instagram, even though they explicitly stated that they would never share personal details from sessions,” Rebecca*, a 32-year-old living in London tells me. “I’ve never seen them online so I have no idea what sort of content they share, I just thought I might end up feeling paranoid about recognising myself in a story, or even a friend or family member connecting the vague dots. On top of that it almost made me feel resentful that others might benefit for free from something that I had paid for.”
The consent form was very clear that she would never share any personal details of mine or repeat anything I had told her as part of our client-therapist confidentiality agreement, but that sometimes there might be a crossover between something we discussed in our session and her content online— Daniel*
Casey*, 25, who has been seeing her current therapist for six months, has a different view. “I actually found my therapist through TikTok,” she tells me. “I just found myself nodding along to all her videos and feeling like she had really valuable things to say around the areas I was struggling with.
“I searched for her online, found her private practice and contacted her there, after which we had an initial consultation to discuss whether we were a good fit,” she continues. “My work with her has been more transformative than my previous experiences with therapists, and I do think, in part, this is to do with the fact that I felt comfortable with her from the beginning; I felt I had a sense of who she was, that feeling of familiarity was already there through watching her on TikTok first.”
This idea of helping people feel more comfortable around therapists is something that Katie McKenna and Helen Villiers, practising psychotherapists and authors of the Sunday Times bestseller You’re Not the Problem: The Impact of Narcissism and Emotional Abuse and How to Heal, see as one of the biggest positives as therapists on TikTok.
“Many people can be fearful of entering therapy and there is still a stigma surrounding it,” the pair, who have nearly one million followers across TikTok and Instagram, tell me. “Engaging content can help humanise therapists, making them more relatable and approachable. We are able to reach millions of people globally, including those who might not have access to traditional therapy. It helps our followers feel less isolated in their struggles.”
And this desire to help people feel less alone came up numerous times during my discussions with therapists around the topic. Other reasons for joining TherapyTok (as it has become affectionately known online) included wanting to correct the widespread misinformation around about mental health and to offset the under qualified people online dishing out advice, as well as encouraging people to seek help by drawing attention to ‘unhealthy’ thoughts, patterns and behaviours and, crucially, hoping to help those who can’t afford therapy themselves. Some also acknowledged that it was a free way of promoting their private practices, earning extra money and aligning themselves as an expert in their field.
And this desire to help people feel less alone came up numerous times during my discussions with therapists around the topic. Other reasons for joining TherapyTok (as it has become affectionately known online) included wanting to correct the widespread misinformation around mental health, and to offset the under qualified people dishing out advice online. Further reasons included encouraging people to seek help by drawing attention to “unhealthy” thoughts, patterns and behaviours, and, crucially, hoping to help those who can’t afford therapy themselves. Some also acknowledged that it was a free way of promoting their private practices, earning extra money and aligning themselves as an expert in their field.
The world of therapy content in its current form is a new one though. Many online therapists are therefore having to grapple with boundaries. Daniel* reported that he’d been asked to sign a consent form by a new therapist, acknowledging that she was on TikTok. “The form was very clear that she would never share any personal details of mine or repeat anything I had told her as part of our client-therapist confidentiality agreement, but that sometimes there might be a crossover between something we discussed in our session and her content online,” he says. “I was fine about it, particularly as she explained that this would only be the case with widespread topics, like anxiety, for example, rather than something that might be super niche within my story.”
And Daniel’s therapist isn’t alone in the tweaking of her onboarding process to reflect an increased TikTok presence. If you google “social media consent form for therapy”, you’ll get pages and pages of results showing you how to draw up a social media policy for your practice, and even sellers on Etsy offering easy-to-edit consent forms to be used in this manner too.
But even with a contract in place, the concept of “anonymity” here is a tricky one, as Rebecca highlighted when we discussed her reticence around the topic. “A therapist can’t necessarily know which specifics from your story would make you identifiable to those with a personal connection to you,” she says. And when I reflect on my own journey with therapy, I suspect that finding a topic that I’d discussed during a session had come up online via my therapist – even sans case study – could make me feel uneasy and oddly exposed.
Rebecca and I aren’t alone – X is littered with people discussing how they would feel about their therapist being on TikTok. “If I saw my therapist posting on TikTok I would jump off a bridge,” reads one. Over on Reddit, there are numerous threads asking variations on “My therapist is on TikTok now and sharing personal information – what should I do?”. Replies vary from, “What’s the big deal?” to “I stopped working with my old therapist because of this – I was worried I’d be exposed”.
McKenna and Villiers recognise this worry, too. “Being anonymous is subjective. If a client recognises themselves, then it’s not anonymous enough,” they say, citing this as one of the reasons why they would never discuss real life case studies online. Instead, they share collated experiences that are common across the board.
The pair themselves joined TikTok to “raise awareness around the impact of childhood trauma,” and they have made it their mission to demystify what therapy actually is. From the outset though, they have been clear about their boundaries. For example, they will never give out personal advice via the video app, despite receiving lots of messages from followers asking for exactly that.
“We cannot give anyone one-to-one advice through social media, this would be both unprofessional and unethical. We have autoresponders on our accounts that state as such.” And they take great care to ensure that what they post won’t impact client relationships as a result, never sharing client material or experiences and being careful that posts aren’t touching on themes discussed with clients in the last couple of weeks. “It’s not hard,” they say. “The client comes first.”
My younger clients often come to me and say they are much clearer about what’s happening for them because they’ve seen it on TikTok— Dr Sally Baker
In fact sometimes, and increasingly around younger users, a therapist appearing on TikTok only deepens a sense of trust. Award-winning therapist Sally Baker, who often appears on TV and now also uses TikTok (though not extensively) as part of her work, reasons, “I see clients who range from 12 to 70 years of age, my younger clients are often influencers and creators, so it makes sense for them to search on TikTok just as they do they do for their nail inspiration, their hair styles – it’s a natural place for them to look. My younger clients often come to me and say they are much clearer about what’s happening for them because they’ve seen it on TikTok.”
However, despite using the platform herself, Baker – who recently published her third book, The Getting of Resilience From the Inside Out – is clear about the pitfalls of therapy content gaining traction online. “The kind of content we see on TikTok often reinforces people’s needs for labels – take the current ADHD epidemic, which has seen people self-diagnosing themselves due to a rise in content around the topic. They’ve had it explained to them by various sources on TikTok and this feeds into the idea that there is something really wrong with them.”
For Ashley Meyer, a psychotherapist and EFT master trainer, who in addition to his private practice runs courses and supervision for therapists looking to train in EFT, the line is clear. “I believe that the key reparative element of therapy results from the trust that comes from the relationship formed between client and therapist,” he says. “This must not be underestimated as it is often the lack of trust in a relationship that brings the person into therapy in the first place. Events, from the immediate past or dating all the way back to childhood, can leave an imprint on us that it is not safe to trust, even, or particularly, those closest to us who are entrusted with our care.”
“Therapy clients need to feel safe and ‘loved’, or even special to the therapist,” he continues. “I worry therefore that a therapist discussing and referencing their client work in public runs the risk of ‘cheapening’ the all-important bond that is worked towards in sessions. While the encounter may be professional in nature, it is often the most intimate a person may ever have.”
“I am all for ‘psycho-education’,” he adds, “and using social media as a way of distributing information to help people understand more … but not as a replacement for the containment of the therapeutic relationship.”
And I agree. Though on balance, and after careful reflection, I feel more OK about therapists being on TikTok than I thought I would. Unless it was my therapist. Then I’d be outraged, obviously.
