Therapist Reviews: A Guide for Counselors and Practices

Therapist reviews are the ratings and comments clients or others post about psychotherapists, counselors, social workers and therapy practices on sites such as Google, Yelp and healthcare directories. Therapists face tighter limits than most businesses: professional ethics codes restrict soliciting testimonials from clients, and confidentiality rules, including HIPAA for covered providers, mean a reply must never confirm that someone is or was a client. In practice, that means keeping your profiles accurate, replying rarely and only in general terms, reporting reviews that break platform rules, and building trust in ways that don’t depend on client reviews.

This guide is for licensed therapists in private practice, group practice owners and clinic managers. It gives general information, not legal or ethics advice. Your licensing board and professional association have the final word on what you can do.

Why therapist reviews are different

For most businesses, the advice on reviews is simple: ask every customer, reply to every review. For therapists, both halves of that advice run into problems.

• The relationship is confidential. Simply being in therapy is sensitive information. A reply that says “thank you for trusting us with your care” tells the world that the reviewer is a client.
• There’s a power imbalance. Clients may feel unable to refuse a request from their therapist, which is why ethics codes treat soliciting testimonials from clients as a risk of undue influence.
• Reviews can be written in distress. A client who is angry about a boundary, a diagnosis or a referral may write a harsh review, and the therapist can’t publicly explain the clinical context.
• Some reviewers aren’t clients. Family members, former partners of clients or people who only had a phone consultation may post, and you still can’t discuss who they are.

What the ethics codes say about asking clients

The major professional codes in the US address testimonials directly. In broad terms:

• The American Psychological Association’s Ethics Code says psychologists don’t solicit testimonials from current therapy clients or from others who are vulnerable to undue influence.
• The American Counseling Association’s Code of Ethics says counselors who use testimonials don’t solicit them from current clients, former clients or others who may be vulnerable to undue influence.
• The NASW Code of Ethics for social workers says social workers shouldn’t solicit testimonial endorsements from current clients or others vulnerable to undue influence.

Whether a request for an online review counts as soliciting a testimonial isn’t always spelled out, and many ethics advisers treat the two the same way. State licensing boards may also have their own advertising rules. Before you ask anyone connected to your practice for a review, check the current code of your professional association and your state licensing board’s rules, and consider calling your association’s ethics consultation service if it offers one.

What you can do instead of asking clients

If you can’t, or choose not to, ask clients for reviews, you still have ways to show prospective clients that you’re a good fit.

1. Keep every profile accurate. Claim your Google Business Profile and any directory listings. Correct your name, credentials, license type, location or telehealth status, specialties, insurance and whether you’re taking new clients.
2. Write a clear, human profile. Explain who you work with, your approach in plain language, what a first session looks like and practical details like fees policy and cancellation policy. Many therapist directories focus on this kind of profile rather than client ratings.
3. Build a helpful website. Short articles answering questions prospective clients ask (“What happens in a first therapy session?”) show your approach better than stars do.
4. Use professional credibility. Training, supervision roles, published work, talks and professional memberships are legitimate trust signals.
5. Get referrals from colleagues. Relationships with physicians, psychiatrists and other therapists usually matter more for a therapy practice than review counts.
6. Let reviews come unprompted. Some clients will leave reviews on their own. That’s their choice, and it doesn’t involve solicitation by you.

If your practice isn’t subject to these codes (for example, a wellness coaching business), the ordinary rules still apply: no fake reviews, no incentives tied to positive reviews under the FTC’s 2024 rule, and no review gating.

How to respond to therapist reviews

Many therapists decide not to reply to individual reviews at all. That’s a reasonable default, because almost any personal reply risks confirming a relationship. If you do reply, the reply must work whether or not the reviewer was ever a client.

Replying to a negative review

Thank you for your feedback. To protect confidentiality, our practice doesn’t confirm or discuss whether anyone is or has been a client. We take concerns about our services seriously. Anyone with a concern is welcome to contact our office directly.

Replying to a positive review

Even a warm thank-you can imply a relationship. Many therapists leave positive reviews without a reply. If you want to acknowledge them, keep it neutral and avoid anything that sounds like you know the person:

Thank you for taking the time to share your thoughts.

A general policy statement

Some practices put a short statement on their website explaining that, to protect confidentiality, they don’t respond to online reviews. It helps prospective clients understand why they see no replies, and it can be linked from your profile where the platform allows.

Don’t contact the reviewer about the review outside of therapy, and don’t raise it in session with a current client unless you’ve thought carefully about the clinical and ethical implications, ideally with a supervisor or ethics consultant.

For wider guidance on replies across healthcare, see our guide to patient reviews.

What to do about an unfair or harmful review

1. Don’t reply in the moment. Take time, and talk it through with a supervisor or colleague if it’s upsetting.
2. Check it against the platform’s rules. Reviews with threats, hate speech, personal information about others, obvious conflicts of interest (such as a competitor), spam or content about a different provider can be reported. Our guide to removing fake Google reviews covers Google’s process.
3. Report without disclosing client information. Stick to the policy the review breaks. Don’t tell the platform “this person was my client and here’s what happened”.
4. Get advice on serious allegations. If a review alleges misconduct, contact your malpractice carrier, and talk to a lawyer before responding anywhere. A board complaint, if one follows, is a separate process with its own rules.
5. Be very cautious about legal action. Suing a client or former client over a review can raise confidentiality problems and draws attention to the review. A lawyer can tell you whether a defamation claim is realistic.

Honest negative reviews usually stay up. Section 230 generally shields platforms from liability for what users post, so they rarely remove content simply because it’s critical.

If you run a substance use treatment program, additional federal confidentiality rules (42 CFR Part 2) may apply on top of HIPAA. Your compliance lead can confirm what applies to you.

A worked example: a solo counselor with one harsh review

This is an illustrative scenario. A licensed professional counselor in private practice has a Google Business Profile with three reviews: two positive and one one-star review calling her “cold and unprofessional”. She’s upset and drafts a reply explaining that the person attended only one session and didn’t follow through.

1. She doesn’t post the draft. It would confirm a client relationship and disclose details of care.
2. She checks Google’s policies. The review doesn’t contain threats or personal information, so it doesn’t qualify for removal.
3. She calls her professional association’s ethics consultation line to ask about review requests, and decides not to solicit reviews from clients.
4. She updates her profile with a clear description of her approach, photos of her office and a link to a short website page explaining that she doesn’t respond to reviews to protect confidentiality.
5. She writes two plain-language articles on her website about starting therapy and what to expect.

The one-star review stays. New inquiries mention the website articles more than the reviews, and some clients leave reviews on their own over time.

Common mistakes

• Replying with clinical context. It can breach confidentiality and your ethics code, however unfair the review.
• Asking current clients for reviews. Most therapy ethics codes restrict it. Check yours.
• Having friends or colleagues post reviews. These are fake reviews under the FTC rule and platform policies.
• Thanking reviewers warmly by name. It implies a relationship.
• Letting profiles go stale. Wrong insurance or availability frustrates the people most likely to book.

Therapy practices that want help keeping profiles accurate and handling reviews within these limits can see our healthcare reputation management page, or our review management service for reply policies and monitoring.

Frequently asked questions

Can therapists ask clients for reviews?

It depends on your profession and state. The APA, ACA and NASW codes all restrict soliciting testimonials from current clients or others vulnerable to undue influence, and many ethics advisers treat online review requests the same way. Check your licensing board and professional association code before asking anyone.

Should a therapist respond to online reviews?

Many therapists choose not to. If you do reply, the reply must not confirm or suggest that the reviewer is or was a client, and it shouldn’t mention any detail of care. A general statement about confidentiality is the safest form.

Can I get a bad therapist review removed?

Only if it breaks the platform’s rules, for example by containing threats, personal information or content from someone with a conflict of interest. Report it without disclosing anything about a client. Genuine negative opinions usually stay.

Are therapist reviews on Google covered by HIPAA?

HIPAA doesn’t stop a client from posting about their own experience. It limits what a covered provider can disclose, so your reply can’t confirm that someone is your client or reveal health information. Your ethics code adds confidentiality duties of its own.