Guest Post by Therapy Changes: How Therapists Can Manage an Online Presence

Finding the right therapist isn’t always easy. There are more choices than ever when it comes to the type of mental health professional, therapeutic approach and area of expertise. Consumers should be discriminating when choosing a professional to help them manage the most trying times of their lives. With the Internet impacting virtually all aspects of our lives, it has been increasingly more common for consumers to find and vet therapists online. The digital era brings increased vulnerability for therapists with the advent of online reviews such as or Through sites like these, consumers can write reviews, read and rate other’s reviews, and ultimately make decisions based on this information – all without ever having direct contact with the therapist. This process can be helpful or harmful depending on the type of review written.

In the case of psychotherapy, online reviews, particularly negative ones, represent a unique challenge to the therapist. Regardless of the reason for the review–whether the client was legitimately received sub-standard care, or if the relationship was simply not a good fit–there is little recourse available for the therapist. In other words, there are no online fact-checkers and in the digital world impressions mean everything.

First, therapists must be aware of existing reviews. It is possible that a review has been posted online without your knowledge. To stay informed, therapists are encouraged to frequent sites like or and search for his or her name or company name. A second option is to sign up for Google Alerts (available at to be notified of new online content about yourself. For example, by using keywords like as “Dr. Perper,” “Rochelle Perper” or “Therapy Changes” the search engine will notify you via email if a comment containing these keywords has been posted.

What To Do If You Find an Online Review

If a therapist becomes aware of an online review, the most important thing is to stay calm.  Impulsive responses to online posts could cause more trouble with the unhappy client and inadvertently draw extra negative attention to your business. Furthermore, responding to a client’s review requires serious consideration of HIPAA and client confidentiality laws.  When a client posts an online review based on his or her experience in therapy, they have effectively acknowledged a therapist-client relationship and thus waived his or her privacy. Psychologists should be aware that contacting the site directly could be considered a violation of confidentiality laws.

Instead, try addressing the issue clinically and privately with the client. If the review was negative, invite the reviewer to a conversation about the issue and attempt to resolve the problem. Consider extending a sincere apology or a refund, if the review is financially-based. If the review is positive, address with the client the impact of waiving their confidentiality online. According to the American Psychological Association Ethical Principles of Psychologists and Code of Conduct (2002) Psychologists have an ethical obligation to take “reasonable precautions to protect confidential information” (p 12). An additional measure that can be taken is to approach the site itself and state your concerns about your business listing being available for review and request that it is removed. However, it is unlikely that the site will comply to this request, even if an attorney gets involved (D. Leatherberry, Esq., personal communication, February 14, 2012). For example, the position of is not to remove business listing information on the basis that this information is publicly available and protected under law (Yelp user support, personal communication, February 15, 2012). Furthermore, believes that the public benefits from sharing their experiences with local businesses.

What You Can Do Proactively

The most effective way to address negative online reviews is to “drown them out” with an online presence that is within the therapist’s control. Be sure to include information about yourself and your practice philosophy. If you don’t have a website already, consider a one-page static website that requires little maintenance. One option is to utilize the professional profile member feature through For the non-technically savvy, companies such as are available for a monthly fee for Online Reputation Management (ORP) to help businesses look their best on the Internet.

Another approach is to get involved. For example, offers a suite of free tools to help business owners get the most out of their service. By creating a business owners account, you can communicate with your customers via private message, track user reviews, and add photos and a detailed description of your business (Yelp user support, personal communication, February 15, 2012). Psychologists who choose to participate in should never ask a past, current, or likely future client to write a review. Rather, ask colleagues and supervisors to post positive reviews based upon their work and interactions with you. Ofer Zur (2013) suggests the following statement be used in response to negative postings:

Due to concerns of confidentiality and privacy, I cannot respond to postings by clients or even confirm a client’s status. I therefore encourage disappointed or upset clients to contact me directly so we can discuss possible remedies. It is important for me to resolve disputes with integrity and fairness. Additionally, I encourage readers to use this site to review my services on my website at xx and my background at xx. (p. 2)

To minimize the likelihood that clients will revert to online reviews of your business, consider including a “Use of Online Reviews” clause in your Informed Consent Agreement to be reviewed and signed by clients before the commencement of therapy.


Modern day consumers are more commonly using the Internet to search for and vet their therapists. It is commonly understood that not everyone is satisfied with the service they receive – especially with the sensitive population that therapists serve. Rather than pursing legal action, which is unlikely to be successful, therapists are encouraged to address this growing concern with a proactive approach. By increasing the number of positive reviews and visibility of credible information posted by the therapist negative review posted online will not mean the end of your career.


American Psychological Association (2002). Ethical principles of psychologist code of conduct. American Psychological Association.

Zur, O. (2013). Modern Day Digital Revenge: Responding to the Emerging
Problem of Online Negative Reviews by Disgruntled or Discontent
Psychotherapy Clients. Retrieved February 17, 201


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