Considerations for Surrogate Partners Engaging with the Media

DISCLAIMER: Just as in Surrogate Partner Therapy itself, SPs are constantly making choices about how to shape their practice.  Engagement with media is no different.  While the Embrace team is not in the role of endorsing any SPs or enforcing standards, we always strive to engage the community in discussions that advance the field, deepen ethical practice, and protect clients.  The following was crafted to support SPs who are considering showcasing their work in the media in considering how to do so ethically and in ways that maximize benefit and minimize potential harm.  In this still-small field, our visibility carries tremendous weight and has the potential to impact the rest of the SP community on the whole.  Let’s make wise choices.

REPRESENTATION OF THE MODEL:

Is it actually SPT?  The current standard of practice is that all SPT is done in the triadic model, where decisions are made triadically through consistent communication between the client, SP, and collaborating clinician.  Consider what you are teaching a general audience by how you frame what they see.  Is it SPT, intimacy coaching using a tool from SPT, a snapshot of a SP-client session, a demo of a specific technique?  The framing of what is presented will impact how the audience interprets what they see.  

What might an audience learn about SPT given the way it is shown in the project and how can any misconceptions be corrected?  Within any case or demonstration of SPT, choices are made. It is appropriate to adapt approach and pacing for the needs of the client/participant and will also inherently reflect the SP’s style.  Whenever a case or an activity is shown, consider how any adaptations or “off-roading” are framed and described.  Where possible, consider including the clinical reasoning and specify how the depiction may vary from the traditional approach of the exercise or activity.  Where SP style is in the forefront, consider how to distinguish SPT holistically from your approach to SPT.

ROLE CLARITY:

What is the SP calling themselves and what does it imply?  On occasion SPs are seen represented with the title Surrogate Partner Therapist.  While this is not technically illegal, as ‘therapist’ is not a title-protected term, it is very misleading.  Therapist is a broad title for Master’s level clinicians who have a license for their jurisdiction (be it LPC, LCSW, LMFT, etc) and are beholden to a licensing board for ethical practice.  Surrogate Partners share none of those common factors with therapists, so it can be confusing to state they are therapists.  Many feel clinician carries the same implications, whereas the term practitioner is considered to be much broader and applicable to SPs. Similarly, SPs are often referred to as “Sex Surrogates.” While this has historical relevance, the sex-forward nature of this title often feeds into the propensity of media to latch onto the perceived salacious nature of the work and completely bypass relational or therapeutic aspects of this work. Labels matter!

PARTICIPANT CONSIDERATION: 

Who is going to participate and what are the ethics around that?

Often there is interest in filming the somatic work of SPT.  Consider who is engaging in that process.  Options include using actors (like the Sessions), only surrogates (like IPSA's Intimate Portraits), or engaging former clients after they had fully completed the process (like This is Life with Lisa Ling).  While there seems to be high appeal for having real-time participants who want and need the work as they through it for the very first time, it engages a more vulnerable participant and is by far the most difficult to do ethically. SPT should always be done in service of the client’s work.  Shifting “who is it for?” to include entertainment value…or even education…can dramatically shift the client’s experience and bring new variables into already challenging work.

INFORMED CONSENT and PROTECTING PARTICIPANT AUTONOMY (if using participant/s): 

Has the participant been made fully aware of all elements of the project and how this will impact any care they receive?

Consider vetting participants whose needs and readiness match the structure of work being offered to them.  Keep in mind that if you’re involving real-time participants who want and need the work for personal growth, the work should be for them. It is a gift if they are open to sharing their journey, but that journey should be made for them and their needs.  What measures can you put in place to ensure that they are still protected from pressure in pacing or intervention choices that are not right for them. 

When considering informed consent, it can also be helpful to use the base framing of internal review boards for medical trials.  Their job is to find the balance of appreciative compensation while not letting the benefit be so great that the person will consent to something they were not already willing to do. If a participant is offered therapeutic care for free, effort must be made to ensure that the financial availability of that care does not impact their decisions (about structure of the work, being taped, etc). It is our position that new clients are rarely able to balance the nuanced feelings including scarcity/urgency, limited financial resources and access, and abstract notions of how they may feel during the work. These skills are honed during the work. Therefore it is unlikely to obtain truly informed consent from individuals who are receiving the work for the first time for the purpose of creating media.

Are standards of care and consent within the work remaining in place? 

Within the SPT the client should be informed of options for activities ahead of time and collaborate in all decisions about what they are ready for and how to approach it.  They also need to have the ability to end any activity if they become uncomfortable.  For that to be effective, that communication must be readily available to the participant and they must have established trust that their wishes will be respected by their professional team. This professional team should not only include collaborating clinician and SP, but also the production team.

How much autonomy do participants get in the final outcome of the project?

SPT is beautiful work, but in part because it is also hard, heartbreaking, and terrifying at times for clients.  Can participants preemptively agree that an unknown emotional journey is something they are comfortable with sharing so publicly?  We strongly recommend considering an approach where participants can complete the SPT process entirely before giving that consent.  To the maximum degree possible, participants should also be included in decisions about which parts of their story and journey are shared and how they are framed.  Remember that any limitations to participant autonomy (in final product, pacing, etc) are factors to consider when determining who may be appropriate participants.

Are you navigating an opportunity to represent SPT in the media? Want to talk about it? Join a Surrogate Partner Community Call.