Dating as an Occupation for Occupational Therapy

Introduction

Dating in modern society has changed significantly in the Western world. Many cultures still participate in matchmaking and arranged marriages, but with everyone having a smartphone app, online dating has become very popular. 15% of adults in the US reported having used online dating apps in an older report from 2016 from Pew Research.[1]Smith, A., & Anderson, M. (2016). Five facts about
online dating. Retrieved from http://www.
pewresearch.org/fact-tank/2016/02/29/5-factsabout-online-dating/
A survey from 2019 has seen this increase to 30% having used a dating site or app.[2]https://www.pewresearch.org/fact-tank/2020/02/06/10-facts-about-americans-and-online-dating/ Dating, particularly online has become not only more common, but socially accepted. I remember that episode of the TV sitcom Friends in which Chandler was online dating a stranger using his laptop which seemed to be have been portrayed as unusual. But so much has changed.

Occupational Therapy and Dating

So does occupational therapy play a role in dating, particularly with online dating? This change in dating can create a challenge for many people, adolescents, younger adults, or even older adults who face barriers due to access, accessibility, cognitive impairment, or a general lack of skills needed to navigate online dating to name a few.

Occupational therapy can play a role in helping individuals with dating by addressing any physical, cognitive, or emotional challenges that may be impacting their ability to form and maintain relationships with online courtship. An occupational therapist may work with an individual to improve their social skills, address physical limitations that may be affecting their ability to engage in activities with potential partners, or provide support for managing mental health conditions that may be impacting their relationships. Additionally, occupational therapy may also include assistive technology evaluations and training, to help individuals with disabilities to access dating apps or other technological means of communication.

Gender Differences

It seems that online dating is very different for those who identify as males compared to females. At least it was the case for me, anecdotally. This like likely cultural, but online dating for males can be very discouraging. I guess you can say the same about real life too, but online can even be more difficult. It is kind of like applying for a job. You might reach out to many prospects only to get no responses.

Conversely, for females, online dating can be overwhelming. Many have reported on websites such as Reddit males being rude, disrespectful, “creepy”, or overly sexual and inappropriate. Then there’s challenge of safety (for both males and females) of finally meeting someone in person in real life. I would argue that online safety is probably the most important aspect to address for occupational therapy and the clients who are using online dating.

Risks of Online Dating as an Occupation

One study explored whether online daters perceived if online dating was dangerous and risky. Some examples of earlier research of these issues pertained to sexually transmitted diseases, lies, and deceit. Interviews with 29 participants between aged 18 to 70 with 12 being women and 17 men from Australia. Themes that arose included lies and deceit quite often.

…people lie most of the time and a lot of men say they are looking for relationships when infact they want sex. . . . People lie about their age, have different pictures up or pictures that where taken years ago. People lie about if they are married. They lie about what they do for a living, if they have children or not.[3]Couch, D., Liamputtong, P., & Pitts, M. (2012). What are the real and perceived risks and dangers of online dating? Perspectives from online daters: Health risks in the media. Health, Risk & … Reference List

This reminds me of the MTV TV show, Catfish, which it’s entire premise is to uncover people who fake their online identities or profiles such as with other people’s photos. While younger individuals such as teenagers are likely to be aware of this, the question is if other aged groups or even those with conditions and disabilities are aware as well. For example, do those with autism become aware of these lies and deceits due to difficulties in reading social cues?

Aside from these, the more serious risk of sexual violence should also be addressed. This was a theme that came up in the study as well.

…he spikes my drink and tries to blame it on my friend. he claimed it was because i didn’t put out…[4]Couch, D., Liamputtong, P., & Pitts, M. (2012). What are the real and perceived risks and dangers of online dating? Perspectives from online daters: Health risks in the media. Health, Risk & … Reference List

So physical safety is a concern with dating in general, but online dating seems to come with additional dangers as it may be too late before you notice redflags in real-life due to one’s ability to hide many things through purely communicating with text-messages that lack social cues. Stalking is another concern, both virtually and in real-life. Still, dating in general or just being in a relationship with someone has its risks, even someone you’ve known for years. You look at murder cases and they often involve spouses and domestic violence and abuse.

I don’t believe there is [more risk]. At the end of the day you could live with someone for years and not truly know them.[5]Couch, D., Liamputtong, P., & Pitts, M. (2012). What are the real and perceived risks and dangers of online dating? Perspectives from online daters: Health risks in the media. Health, Risk & … Reference List

Research states some realities such as sexual predators using online dating to connect with potential victims who are often vulnerable and trusting.[6]Scannell, M. J. (2019). Online dating and the risk of sexual assault to college students. Building Healthy Academic Communities Journal, 3(1), 34-43. So online dating may seem like a very scary activity and that it should be avoided at all costs. However, many date online and do it safely. Therefore, the primary and first focus that occupational therapists should address and emphasize, repeat many times is safety.

Safety is Key

Safety intervention for online dating with patients can start with education. But education can only get you so far if it does not influence behavior. Clients should also learn to get in the habit of letting others they trust know, if for example, they are meeting someone in real-life. Knowledge of where they will be even as much as getting regular text updates to check-in may seem like too much, but these days safety with dating is such as reality.

Condition Case Study: ASD

As a case study, a common population that occupational therapists work with is people with autism. One article surveyed adults with Autism Spectrum Disorder (ASD) for their opinions of online dating. The most frequently identified disadvantage of online dating for this group was safety.[7]Roth, M. E., & Gillis, J. M. (2015). “Convenience with the click of a mouse”: A survey of adults with autism spectrum disorder on online dating. Sexuality and Disability, 33(1), 133-150. Studies in the past have found adults with ASD, even high functioning ones to have many difficulties with romantic relationships. This was evident from the low percentage of those who have ever dated, those who were in long-term relationships and those who were married. One barrier to dating is the delayed social development of this group, with younger adults with ASD having less success than older adults, even through traditional dating methods.

The challenges for those with ASD through online dating specifically include social rules and norms, e.g., creating an online profile and revealing private information or not, being overly truthful vs. lying, and decoding if a profile is likely to be “fake”. Even more serious, those with ASD may be more vulnerable to behaviors such as sending inappropriate content. Brown-Lavoie et. al found that adults with ASD are 3 times more likely to experience unwanted sexual contact, 2.7 times more sexual coercion, and 2.4 times more likely to experience rape compared to the control group.[8]Brown-Lavoie, S.M., Viecilli, M.A., Weiss, J.A.: Sexual knowledge and victimization in adults with autism spectrum disorder. J. Autism Dev. Disord. 44, 2185–2196 (2014). … Reference List

Theories of Social Barriers for ASD

Many theories have been proposed that attempt to explain the social barriers that those with ASD may face. Consideration of these theories can also provide ideas for how to design and provide occupational therapy interventions in regards to dating. Popular theories include:

  • Theory of Mind: difficulty understanding the mental states of others, such as their beliefs, desires, and intentions. This makes it difficult for them to understand social cues and engage in social interactions.
  • Weak Central Coherence: difficulty processing and integrating information from multiple sources, which makes it difficult for them to understand the meaning of social cues and the context of social interactions.
  • Executive Functioning: difficulty with executive functions such as planning, organizing, and initiating social interactions.
  • Sensory Processing: difficulty processing and responding to sensory information in their environment, which can make social interactions overwhelming or confusing.
  • Social Motivation: individuals with autism may have a reduced desire or interest in social interaction, which can lead to social deficits.
  • Social Communication: individuals with autism may have difficulty with the various aspects of social communication such as non-verbal communication, turn-taking, and understanding figurative language.

Domains of Client Barriers

  • Social awareness (e.g., Autism)
  • Cognitive (e.g., memory, problem-solving, planning, judgement) for conditions that typically have cognitive impairment, developmental delays, or decline. With declines, an example is those who have dementia.
  • Physical impairments that pose additional concerns for safety
  • Development and/or decline
  • Culture, e.g., interracial dating
  • Social norms, e.g., dating age gaps
  • Parental relationships
  • Access to technology
  • Dating history (“I’ve never dated before”)
  • Trauma

General Precautions

  1. Do not use or reveal your real name until deemed safe to do so.
  2. Consider using and sharing alternative phone numbers with Apps and services such as Google Voice.
  3. Withhold certain demographic information such as your address, where you go to school, work, what car you drive, etc.
  4. Be aware of what shows up in the backgrounds of your photos that can provide hints of your geographical location.
  5. Don’t provide any other general identifying information that can be used for online stalking.
  6. Meet in a public space that is well-lit and not too sensory-overloading.
  7. Tell others who you are with and where you are going and be as specific as possible such as your address and the anticipated time of the dates and when it may end.
  8. Provide your own transportation.
  9. Have an appointment or activity immediately after the date, especially for the first dates.
  10. Do not drink beverages such as at the bar if left unattended.
  11. Research your potential date on social media.
  12. Video chat before meeting up in person.
  13. Enlist the help of public staff if you feel uncomfortable such as the bartender or waiter.

How to Even Start

McCarthy, K, an associate professor at the Dominican University of CA (shoutout to DUC!) wrote a helpful article in OT Practice for online dating and how to approach it as an occupational therapist.[9]McCarthy, Karen, “Dating as an Occupation: Swipe Right for Occupational Therapy” (2018). Collected Faculty and Staff Scholarship. 329.
https://scholar.dominican.edu/all-faculty/329
The process can begin with the initial evaluation and asking about dating using open-ended questions. More detailed questions can follow. One of her favorite questions which is light, yet very insightful is, “how’s your love life?”

The OT can then follow up with prompts with “tell me more” such as relationships, dating, beliefs, activities engaged in, or even specific strategies. Above all, I think a good question to also ask or gather information about is the client’s goal and values when it comes to dating or relationships. This is especially important given that the research has shown younger adults with ASD to have never dated before.

Theoretical Frameworks to Consider

  • Social Cognitive Theory: individuals can learn by observing, interpreting, and evaluating the behavior of others.
  • Social Learning Theory (Bandura): individuals learn through observing the behavior of others and the consequences of that behavior; emphasizes the role of reinforcement and punishment in shaping behavior.
  • Social Identity Theory: an individual’s sense of self is formed through their membership in social groups, and that their behavior is influenced by the norms and expectations of those groups.
  • Social Constructivism: individuals learn through their interactions with others and the environment, and that knowledge is constructed through these interactions.
  • Reinforcement Theory: behavior is influenced by the consequences that follow it, either positive reinforcement, which increases the likelihood of a behavior being repeated, or negative reinforcement, which decreases the likelihood of a behavior being repeated.
  • Social Exchange Theory: individuals engage in social interactions based on the costs and benefits of those interactions. It emphasizes the role of social rewards and punishments in shaping behavior.
  • Social Identity Development Theory: an individual’s sense of self and identity is formed through social interactions and that it evolves over time.
  • Social Influence Theory: individuals are influenced by the opinions and behaviors of others and their behavior can be shaped by these social influences.
  • Person-Environment-Occupation or PEOP
  • Trauma-informed care (TIC)
  • PLISSIT

Occupational Therapy Interventions for Online Dating

Here are some ideas I brainstormed for OT interventions with online dating, especially to address the safety aspect. This is a general list and applies across dating ages, conditions, backgrounds, and settings.

  1. 1:1 Education
  2. Group intervention
  3. Social skills training
  4. Role-playing being on a mock date (particularly with risky situations and personalities); practicing conversations
  5. Activity-based interventions
  6. Simulations, e.g. app to app with the therapist assuming the role of a date.
  7. Rehearsal in natural environment
  8. Having a photoshoot (using a camera on their smartphone)
  9. Videotaped practiced feedback (with the consent of the client)
  10. Video instruction and role-modeling
  11. Quizzes for anticipated situational and behavioral responses, e.g. what would you do if this person asked you to have sex but you do not want to?
  12. Saying “no”
  13. Telehealth
  14. Walkthrough of dating apps
  15. How to get an alternate phone number
  16. Dating profile review of other’s live profiles
  17. Teach back of safety tips for online dating
  18. Coaching
  19. Planning ahead
  20. Safe sex education, PLISSIT
  21. How to dress, not to dress for a date
  22. Reading social cues and nonverbal language
  23. Psychosocial to address discouragement, anxiety, depression, low self-esteem such as with CBT or ACT
  24. Mindfulness and meditation to manage anxiety and stressful social situations
  25. What is gaslighting? Examples of them
  26. How to get to or call for safety
  27. Date rape awareness
  28. Assistive technologies such as Apps for dating distress if needed
  29. Homework such as watching shows about dating with Autism (there’s one called ‘Love on the Spectrum on Netflix)
  30. OT should assess for risky and hypersexual behavior from co-morbid conditions such as those with borderline personality disorder (BPD).
  31. OT referral to dating coaches, psychologists, and other professionals as appropriate
  32. Connecting clients with peers who share the same condition and interest in dating, e.g., others on the spectrum.

References

References
1 Smith, A., & Anderson, M. (2016). Five facts about
online dating. Retrieved from http://www.
pewresearch.org/fact-tank/2016/02/29/5-factsabout-online-dating/
2 https://www.pewresearch.org/fact-tank/2020/02/06/10-facts-about-americans-and-online-dating/
3, 4, 5 Couch, D., Liamputtong, P., & Pitts, M. (2012). What are the real and perceived risks and dangers of online dating? Perspectives from online daters: Health risks in the media. Health, Risk & Society, 14(7-8), 697-714.
6 Scannell, M. J. (2019). Online dating and the risk of sexual assault to college students. Building Healthy Academic Communities Journal, 3(1), 34-43.
7 Roth, M. E., & Gillis, J. M. (2015). “Convenience with the click of a mouse”: A survey of adults with autism spectrum disorder on online dating. Sexuality and Disability, 33(1), 133-150.
8 Brown-Lavoie, S.M., Viecilli, M.A., Weiss, J.A.: Sexual knowledge and victimization in adults with autism spectrum disorder. J. Autism Dev. Disord. 44, 2185–2196 (2014). doi:10.1007/s10803-014-
2093-y
9 McCarthy, Karen, “Dating as an Occupation: Swipe Right for Occupational Therapy” (2018). Collected Faculty and Staff Scholarship. 329.
https://scholar.dominican.edu/all-faculty/329
Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.