While an influx of followers can be confusing for therapists who are just looking to let off a little steam online, some view it as an opportunity to expand their client base. Marquis Norton, a licensed professional counselor in Hampton Roads, Va., posts under the TikTok account @drnortontherapy. (His bio reads: “CEO of therapy.”) He started his account in February, after a friend who’s a psychiatric nurse practitioner had also begun posting on TikTok. By summer, Norton had 100,000 followers. “That’s when I said I’m a content creator now,” he said. “I’m an influencer.” He has since hired a team of two interns to help manage his social media accounts, which he thinks of as marketing for his private practice. Like other therapists interviewed for this piece, demand has spiked for his services since he started going viral. He only just started taking new patients again, after working with other counselors to address his full outpatient practice and long wait list.
The line between content creator and licensed professional blurs often in TikTok’s frenetic ecosystem. For therapists in particular, often pegged as stoic, notepad-clutching intellectuals, showing off social aspects of their personalities can feel like rebellion. Therapists are trained “primarily to be a blank slate,” Dr. Tracy said. “We’re told not to talk about ourselves, to act like we don’t have a past.” That distinction, she said, can be a barrier to healing. Dr. Tracy posts openly about her experiences with mental illness and trauma; she said she has heard from more than 150 teenagers with symptoms like hers that they didn’t think they could become therapists themselves until they saw her videos.
Drawing a distinction between educating young people about mental health and offering therapeutic advice can be difficult. A group of about 40 TikTok therapists have joined a Facebook group to discuss the challenges and offer each other advice in safe spaces. They exchange countless text messages and hold monthly Zoom meetings where they discuss the ethical dilemmas that come with creating content — how to talk about suicide or respond to public comments — and trends they’ve seen in their own practices.
“What’s concerning, I think for everybody, is oversimplification,” said Lisa Henderson, a licensed professional counselor and past southern region chairwoman at the American Counseling Association. She worries that on TikTok, where videos are necessarily short, mental health treatments can be presented as quick, easy fixes, instead of “a long slog of hard work.” “It can be misleading,” she said, “more so than intentionally harmful.”
Therapists need to be careful to urge patients to not self-diagnose, Dr. Tracy said. The tips she offers online are educational, she stressed, not diagnostic. “We want them to absorb the information and then decide if they need to talk to a professional, versus them thinking it’s actual therapeutic advice,” she said.