TikTok and the changing landscape of therapeutic digital spaces of care

The COVID-19 pandemic increased the prevalence of mental health issues across the U.S. While therapists have been able to shift to telehealth delivery of mental healthcare, there has been a recent increase in the number of therapists on social media. Social media as a site of engagement has been feared by systems of power which regulate the ethics of therapists, and despite the influx of therapists online, these ethical guidelines remain under researched. Feminist geographers have explored theories and practices of care within different spaces, and especially in the wake of the pandemic, there is a need to conceptualize how therapists provide care within digital spaces and how this affects the delivery of mental healthcare. This study sampled 100 videos on the social media site, TikTok, for a content analysis using the hashtag #therapistsoftiktok. The videos were analyzed to uncover themes relating to how therapists provided care to the viewer. Four themes emerged in the analysis and showed that therapists provided care both directly and indirectly to the viewers. Direct care included providing psychoeducation to the viewers and offering validations/affirmations. Indirect care included normalizing therapy and humanizing the therapist, and these videos were interpreted to focus more on relationship building and addressing viewers' anxieties about therapy and therapists, which may allow viewers to engage in therapy in the future. This study identified ways that therapists are engaging in care work digitally, despite the admonishments and warnings from professional therapy boards. Ethical concerns still abound, as intimacy and relationship-building can occur across digital spaces. However, rather than simply abstaining from social media, therapists are engaging in resistant and creative ways to provide care and destigmatize mental health issues to a global audience.