Instatherapy: A Content Analysis of Psychotherapists' Instagram Posts and User Engagement

Abstract

Background: Social media is increasingly a source of mental health information and support. Online mental health content accessibility has allowed providers to access large audiences and client bases. Aims: Our aim was to understand information audiences are encountering from psychotherapists on social media. Materials and Methods: Summative content analysis was completed on 10,395 posts from 294 psychotherapist influencers on Instagram. Analysis focussed on two domains: mental health concerns and psychotherapy-related topics. Results: Interpersonal concerns were the most frequently discussed mental health concern followed by anxiety, trauma/PTSD, depression and stress. The most frequently discussed psychotherapy-related topics included holistic approaches, nervous system, cognitive behavioural therapy and internal family systems. Certain codes were associated with more user engagement than posts without those codes. Regarding mental health concerns, posts mentioning substance use garnered more likes and comments, posts mentioning dissociation/dissociative identity disorder garnered more comments, and posts mentioning perinatal issues received fewer likes. Regarding psychotherapy-related topics, holistic approaches garnered more likes and comments, and crisis and couples/divorce garnered fewer likes. Discussion: Findings elucidate content that psychotherapist influencers discuss as well as how users engage with content. Conclusion: This study has implications for ethical guideline development for social media use among psychotherapists.