Give and Take

I’ve run the clinpsy forum for 18 years, and before that I spent a couple of years as a moderator on a precursor forum. I’ve compiled and/or written about 200 wiki posts that have been viewed millions of times between them. Some individual posts have had over 100,000 page views – the most popular being a giant list of interview questions I compiled, a post about transference and counter transference, and one about keeping a reflective journal and one I wrote on clinical vignettes, followed by my post about formulation, and one about clinical interviews. There are also popular posts such as one about what to do with a low degree mark, a more general post on reflective practice, one on supervision and posts about preparing for assistant psychologist and IAPT interviews. The site peaked at about a million page views per month, but has slowed a little as technology has moved away from forums towards WhatsApp groups, and various people have tried to cultivate this audience via social media (often selling products and/or services).

I’ve never really seen running the forum as potential source of income. In fact, it has been a huge drain on my resources – I spent an hour a day for a decade building the content and community, and I’ve paid the server fees, programming, design and other costs out of my own pocket (subsidised at times by a trickle of advertising income). Even now I have to check and activate the new members, respond to emails and PMs at least 2-3 times per week. On the other hand, I have saved a little bit of money on advertising, I’ve been able to promote my own book without cost (and various courses and jobs offered by people that I know). It has given me reach that I might not have had otherwise (I’ve got about 10,000 followers on Twitter, over 5,000 on LinkedIn and this blog has had over 100,000 reads). And I’ve saved a little time in accessing information or publications. So whilst it has cost me about two years of full-time work, and about £5000 overall (plus the cost of the clinpsy URLs and the time spent on social media, but those aren’t constrained to this purpose or audience), I don’t feel like the time has been wasted.

Maybe that is because I don’t do it for the money. I’ve mainly seen it as a way to undermine the added value of nepotistic networks, where information was kept amongst a privileged few who had access to CPs. I wanted to democratise the profession, by puting that information into the public domain, and allowing equal access to sources of support for people from all different demographics. I quite intentionally undercut those who marketed to this group, by offering forum membership and access to various activities for free, and by asking only for a charitable donation for the various webinars, training days, professional development workshops and reviews of applications that I offered (with the level of donation being recommended, but the option being available to pay less or even nothing for people of low means or groups who have been traditionally excluded from the profession). That has also led me to raise thousands of pounds for charities like UNHCR, Magic Breakfasts, food banks, refugee support, and various other causes from replacing the broken electronic whiteboards at a local primary school to dementia care, to educating girls in Africa.

I also get the intangible reward of the people who thank me for the impact that the forum and/or my input has had on their lives. Their notes that say that my feedback made all the difference to them gaining a job or a place on training. Or that my workshop helped them convey their competencies more confidently at interview, or find the next step in their career. It means I am quite widely known in the profession, which builds trust and reputation. And, perhaps most importantly, there are people who have met me through the forum have later become friends, employees and colleagues.

At a few points, people have expressed interest in buying the forum off me. Sometimes that has been an easy no – like when the offer came from the owner of the profit-making travel agency that masqueraded as a charity giving people psychology experience in Sri Lanka and other developing nations. But there have been more benign offers, and now I am so preoccupied with my business, and the other moderators who helped me run the site have mainly fallen away, I do feel like the time and resources I have available to pour into it is limited, and there might be advantages in bringing new energy to the community. So I am torn between a plan to reinvigorate the community, and the idea of handing it over to a new owner.

I also wonder about the balance of give and take, and whether passing on ownership would relieve me of an undue sense of responsibility. After all, there is only one of me, and over 9000 members* and I’m also spinning quite a lot of other plates – I’m Mum of teenagers doing their GCSEs, we are in the midst of building work, and I run my own business which could use my time five times over. There is also something strange about running a forum that feels like the service I provide is taken for granted, assumed to be financed by a professional body, or is treated like public property. Sometimes people have quite unrealistic expectations – demanding immediate responses to messages, sending grumpy emails if their account is not activated right away, breaking the minimal simple rules, or complaining about moderation. People post adverts or self-promoting content without permission or payment (even though our charges are minimal and support the costs of providing the forum). It is as if they believe it is their right to post on the forum to get free promotion for their blog/website/book/course or whatever.

It sometimes feels like a lot of people put very little in but expect to take out as much as they want – asking questions but never contributing to any other discussions, or signing up to request a form review or to apply for a place on a low-cost event without ever contributing to the forum or being part of the community. I like to raise money for the charities and to give people access to information, but each form review takes me 30-40 minutes, and I currently have a queue of 47 requests – which will take about a week’s working time out of my weekends and evenings over the next month. I’d be much better off financially if I donated £1000 to the charities myself and spent the time on income generating work!

But the alternative is to give those selling services to aspiring psychologists an open market to exploit, or for me to have a paid tier of forum membership or to sell products and services, which doesn’t sit right with me, as it reinforces the privilege filter that has always biased our profession towards middle class, able-bodied, white women. Given I don’t want a website and forum full of intrusive advertising, and I haven’t got money to throw at it, the alternative is running the forum on a shoestring – which is fine when we have lots of volunteers contributing to keep the discussion lively and assist with the admin, but more difficult the more of the work I need to shoulder alone.

There are echoes of the same theme in decisions I need to make about my business. As we scale I need to decide whether we continue to bootstrap our growth, or we borrow or seek investment to grow faster (making more impact for more children, but with the cost of being pulled towards earning enough to repay a loan, or delivering a financial return for investors). I need to weigh up the value of locking in the mission to the company structure, versus optimising the business for investment. My gut instinct is to lock in our values with a pledge to prioritise impact, and to donate a percentage of profit above a certain threshold to a charitable foundation that can offer access to the tools to those that can’t otherwise afford them. But it might be that keeping a traditional company structure and taking on investment allows us to reach more children and make more impact to a wider population than we would by being too rigid and narrowing the pool of investors that would be interested.

So I need to think more about how I value and prioritise my time. I’m not sure I owe anything more to aspiring clinical psychologists than any other member of the profession does. So I wonder why I felt obligated to take up this mantle, and continue to stubbornly carry it? And why am I willing to sacrifice my leisure time, or the time I get to spend with my family or on my business, to do things with minimal personal benefit? Whilst I love that I live my values – and the way they permeate almost everything that I do – they do have costs, and I think I probably need to prioritise myself and my family a bit more. I’m not sure I’ll look back on my deathbed and think “I wish I sank more time into that website”, or “if only I had offered more professional development support to aspiring psychologists”, or “I should have achieved more with my business” rather than “I should have spent more time with the people I loved, given more focus to my health and wellbeing, and seen more of the beauty of the world”.

*I haven’t pruned off the dormant accounts for a while, so once I do this may well return to the approx 8000 figure where it has stabilised for the last decade.

Why is there always a can of worms?

I’ve run http://www.clinpsy.org.uk for 9 years now, and built it up to 6900 members, 600,000 users and nearly 10 million page views per year. I’ve put enough hours into that site to add up to more than two years of full-time work, and I’m proud of what we’ve achieved. It is an informative, welcoming community that allows people to network and ask questions. It also levels the playing field of information and reduces the impact of personal connections within the early stages of the profession, and I hope that this will in the long-term act to increase diversity in the profession. Over those 9 years, members have written upwards of 135,000 posts on the forum, and our wiki of information and answers to frequently asked questions has been viewed millions of times, with some posts about preparing for interviews, the route to qualifying, formulation, writing a reflective journal, and transference proving particularly popular – the latter having been read over 115,000 times.

In all of that time we have had remarkably little need to intervene in the forum as moderators. We remove the occasional bit of spam, and we have sometimes anonymised posts in retrospect on the request of the author, and from time to time we have to explain to service users that this is not an appropriate place to ask for advice, but we rarely have to warn or ban forum users. I think the total to date is seven banned individuals and one banned organisation. Not bad when we’ve had 10,000+ sign-ups, and 135,000 posts! This is perhaps a reflection of our clear guidance about how we expect users to behave on the forum, and also of the large number of regulars who act as a more informal feedback loop. We also have quite a large number of qualified clinical psychologists who log into the forum regularly and often act to provide information and correct misconceptions. This is a very important function, as the pre-qualification arena can often become an anxiety-provoking echo chamber, where rumours are propagated and exaggerated without being confirmed or refuted. It also allows us to have a (hidden) peer consultation forum, which is a very good place to discuss concerns with peers in a safe environment in which every member is an HCPC registered clinical psychologist.

However,  the few times when intervention is necessary always tell an interesting story. And the strange thing is, that every single time somebody has been a persistent concern on the forum, this has opened a can of worms that makes us worried about wider ethical issues for the same individual. We had someone who was very unboundaried, and at times threatening to their colleagues and other members in the LiveChat space, and transpired to have caused concern with aggressive conduct in real life. We had a member who was somewhat grandiose and wanted to be a moderator, who attempted to delete and vandalise site content. They later had issues in their workplace, with a similar theme of acting beyond their level of competence. One poster lied to persuade successful applicants to share their applications for clinical training and plagiarised them, and when we identified them it transpired they had plagiarised site content into a publication without acknowledgement and had been unprofessional in numerous other ways. Another odd poster used the same username to post topless pictures on another website. And most recently we have had an organisation recurrently attempt to circumvent payment for advertising on the forum by signing up stooge accounts to promote their service, where it would appear that the appearance of an ethical non-profit organisation instead covers a profitable privately owned tour operator.

It has made me wonder whether ethics and professionalism are the kind of thing people have or they don’t, and that show in numerous domains of their life. Or, is the seeming anonymity of an internet forum a place where traits are exaggerated and played out. Either way, the association between inappropriate use of the forum and inappropriate professional behaviour in other domains seems too high to be a coincidence.

Yet the ethical and professional guidance for psychologists has little that applies in our context. We have had to work out our own boundaries amongst the moderating team (we now comprise ten qualified psychologists and a lay member, although many joined the team as APs or trainees). It makes me realise how much unique our position is, on the technological frontier, and how we are learning case by case. For example, we have had to interpret the balance between confidentiality and risk to apply to our unique setting. We settled on a position that is broadly consistent with what I’d do with clients in real life; we would identify and report a member if we felt they were at risk or presented a risk to others, but otherwise aim to respect the pseudo anonymity of using a posting ID, where only a minority of people choose to be identifiable as a specific professional, or in a way that could be recognised in their workplace. Likewise, we have learnt to log everything typed into our LiveChat space, so that we are able to review the usage of particular members, or read the content if a report is made of inappropriate behaviour. I’d like to think that we’ve reached a good place, and have always been transparent in how we behave. It has been an interesting process though, so I’m thinking of presenting some of the ethical dilemmas and our process at the CYPF conference later this year.