The past two decades has seen a proliferation of social media use, leading to a growing body of research on the potential utility for clinical contexts. In the current study, we examine willingness of psychologists to utilize client social media to inform suicide risk-assessment and risk-related treatment decisions, and the ethical principles they used to guide their considerations. Participants were asked of the likelihood they would engage in 1) a social media-informed risk assessment, where the therapist uses client social media to inform their initial determination of risk level, and 2) a digital welfare check, where the therapist accesses an at-risk client's social media page to determine if they are in immediate danger and require further protective measures. Participants’ likelihood of engaging in these behaviors was assessed using two fictional clinical vignettes. The ethical principles they used in their deliberations were assessed using the General Ethical Principles Questionnaire, in which participants rated the relative contribution of each general ethical principle (Beneficence and Nonmaleficence, Respect for Peoples' Rights and Dignity, Integrity, Justice, and Fidelity and Responsibility) to their responses on the vignettes. Therapist factors including professional status (licensed vs. in-training), digital literacy, and theoretical orientation were examined in terms of how they influenced likelihood ratings for each vignette. Overall, most participants reported being unlikely to engage in either a social media-informed risk assessment or a digital welfare check. Results also indicated participants were more likely to conduct a digital welfare check than a social media-informed risk assessment. Interestingly, relative value placed on Beneficence positively predicted likelihood to engage in both forms of social media checks, and Respect for Peoples’ Rights and Dignity negatively predicted likelihood to engage in a digital welfare check, but not a social media-informed risk assessment. Professional status, digital literacy and identification with any specific theoretical orientation did not predict likelihood to engage in either form of therapist accessing clients’ social media. We conclude with a discussion of how psychologists can effectively and ethically incorporate social media into their practice and potential implications for the development of future ethical standards and guidelines related to digital practice.

LLU Discipline

Clinical Psychology


Clinical Psychology


School of Behavioral Health

First Advisor

Janet Sonne

Second Advisor

Hector Betancourt

Third Advisor

Stephanie Goldsmith

Fourth Advisor

Jenny H. Lee

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Ethics, Professional; Suicide Prevention; Risk Assessment; Social Media



Page Count

xii, 101 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives