Ask Tiffany: How Should Therapists Respond to Negative Online Reviews?

negative online review

Online reviews have transformed how we make decisions. Whether we’re booking a restaurant, purchasing a product, or seeking healthcare, chances are you’ve checked out online reviews to gauge what to expect. In an era where information is just a few clicks away, the impact of online reviews on therapists and their practices cannot be avoided. In many niches, customer reviews can be a powerful tool to attract new clients and build trust. However, there’s one aspect of the internet that can send a shiver down the spine of even the most seasoned professional: and that’s how to respond to negative online reviews.

The reality is standard marketing strategies do not apply to the field of psychology (we explain this in more detail below). But that doesn’t change the fact that your online reputation matters and it’s not uncommon for a business (as a therapist, you are a business owner) to receive a negative review from a dissatisfied client. How you handle these reviews can significantly affect how potential clients perceive you and your practice. It is essential that you understand the significance of negative reviews in shaping perceptions so that you can equip yourself with effective strategies to manage them. 

In this article, we’ll take a deep dive into the world of online reviews, exploring the legal and ethical considerations of responding to feedback (whether negative or positive) and providing practical advice on how to respond effectively. So, if you’ve ever wondered, “I got a negative review, now what?” – read on.

To respond, or not to respond?

So, you’ve received a negative online review. Your initial reaction might be to defend your practice, explain the situation, or even express frustration. However, unlike most businesses on Yelp, therapists and other health professionals face unique limitations when responding to online reviews. Before you hit that “reply” button, it’s crucial to consider the legal and ethical implications, particularly those related to the Health Insurance Portability and Accountability Act (HIPAA) and state patient privacy laws.

HIPAA and patient privacy laws are in place to safeguard the confidentiality of individuals seeking therapy and protect PHI (Protected Health Information). These regulations ensure clients can trust therapists with their most personal and sensitive information. Consequently, responding to online reviews (even positive reviews) in a way that inadvertently reveals a client’s identity or details of their therapy can potentially breach these confidentiality requirements.

Moreover, responding to comments, whether positive or negative, can introduce risks:

  • Risk of confidentiality breach: Responding, even in a non-specific manner, opens up the risk of breaching confidentiality.
  • Defensive tone: Responding may come off as defensive, potentially not taking into account the patient’s point of view.
  • Potential escalations: Responding can lead to escalations, especially from clients experiencing severe mental health issues. Adopting a policy of not responding minimizes these risks.


Most professional organizations, including the American Psychological Association (APA), the National Association of Social Workers (NASW), and the American Counseling Association (ACA),
discourage soliciting and/or responding to client testimonials. They emphasize the potential conflicts of interest, power imbalances, and the importance of maintaining confidentiality.

For instance, the APA Ethics Code provides specific guidance on confidentiality, testimonials, and the avoidance of patient harm. Standard 4.07 states that psychologists cannot disclose information in public media in ways that could identify the client to others without the client’s explicit permission. Along those lines, Standard 5.05 dictates that psychologists cannot solicit testimonials from current or past clients who may be vulnerable to their influence.

That said, therapists are far from defenseless when it comes to reviews. In this case, the best defense is a good offense.

woman with black glasses and red lipstick wearing a black shirt showing her bicep

How to respond to negative reviews with care

Negative reviews can pose challenges for therapists, requiring strategic responses that adhere to ethical standards, maintain patient confidentiality, and safeguard your legal interests—especially when dealing with litigious patients. It’s crucial to recognize that your responses can have implications, so tread carefully. Here are some thoughtful techniques to consider.

Become an online thought leader

Building a robust online presence is one of your most powerful tools for tackling the impact of negative reviews. Patients often prioritize the substance of reviews over their quantity, as many counselors have observed.

Focus on boosting your online footprint through thought leadership (e.g., publications, videos, podcasts). When people search for you online, ensure they find a wealth of your work and expertise. Alongside academic pieces and multimedia, consider crafting blog posts and tweets that showcase recent research or relevant news articles in your field. Fill out your Yelp, Google, or ZocDoc profiles and share a welcoming photo of yourself. These efforts play a vital role in reinforcing your online reputation.

Keep tabs on online feedback

It’s crucial to stay in the know about how patients view your services. Keep an eye out for recurring themes in their review – this insightful information can be your compass to fine-tuning your practice and identifying areas for growth. Consider using notification services such as Google Alerts and Mention.com to anticipate potential negative feedback. These handy tools will shoot you a quick heads-up whenever fresh reviews pop up, keeping you in sync with your online reputation at all times.

Share aggregated data

While it’s crucial not to solicit or interact with reviews that might breach confidentiality, it’s a good practice to gather summarized data on treatment satisfaction and outcomes. This data can be shared with clients or potential clients through your professional website.

In addition to commercial review platforms, consider collecting scientifically validated data based on actual patient experiences within your practice. By providing a link from the review site to your website, you ensure easy access to this information and demonstrate your commitment to scientific accuracy and professional integrity. 

For example, you may offer your patients an opportunity to fill out a general health questionnaire on a bi-annual basis. This could serve as a tool to help you and your client discuss how the treatment is progressing, as well as provide aggregate data that you can provide about your practice.

Of course, when doing this, you must take into consideration your therapeutic modality, along with the impact on the clinical relationship. For high-achievers or “people pleasing” clients, a regular assessment may feel like a “test” and create pressure to “get better” in order to demonstrate they are doing a good job in therapy. It is your responsibility to be thoughtful about gathering data. Be cautious about using these types of assessments simply to combat negative reviews, especially when it may not serve the best interest of your client.

Discuss online reviews with patients (only if they bring it up)

Many people rely on online reviews when selecting healthcare providers. It’s smart to invite patients to openly talk about any online information related to you that might affect your therapeutic relationship. This covers online reviews, news articles, or content from your social media profiles.

Make your position clear in places where people first learn about your practice. Whether it’s during informed consent, in your social media guidelines, or even during therapy sessions, assuring patients that they can discuss online info with you promotes transparency and trust.

Can I remove a negative review?

In many cases, you may have to accept the negative review as part of your online presence.

Oprah Winfrey shrugging as if in response to a question

However, there are exceptions, particularly when a review violates the terms of service of the review website. This typically occurs when the review contains factual inaccuracies and does not align with your practice’s true nature. In such cases, you can contact the website with relevant information or a letter to address the issue. Furthermore, if a review contains inflammatory or prejudicial content, you can report it for potential removal. Online platforms such as Google take these guidelines seriously, enabling businesses to flag and request the deletion of harmful reviews.

However, it’s essential to uphold ethical obligations. Therapists cannot claim that a review is inaccurate, especially regarding a specific patient’s therapy. Publicly responding to reviewers or asking them to retract their comments is also prohibited, as it breaches the confidentiality of the patient-therapist relationship.

Fortunately, there are ethical ways to mitigate the impact of negative reviews, as discussed above. It’s worth noting that most clients don’t expect practitioners to have uniformly positive reviews and understand that reviews are subjective. A recent study in Practice Innovations found that many clients who read negative online reviews of their therapist stated that the review didn’t significantly influence their feelings about treatment.

Clients can balance negative reviews with their personal experiences with the therapist and their judgments about the credibility of the review and the reviewer.

negative online review response

Summing it up

In a world driven by online information and reviews, managing your online reputation as a therapist is crucial. Negative reviews can be disheartening, but with the right approach, you can turn them into opportunities for growth. While therapists have unique limitations when responding to online feedback due to confidentiality concerns, there are ethical and effective strategies to navigate this digital landscape.

Remember that your online presence is a powerful tool. Building a robust and informative digital footprint can help offset the impact of negative reviews. Share your expertise through publications, videos, podcasts, blog posts, and tweets to showcase your commitment to your field.

Monitoring your reviews and staying informed about patient feedback is essential. Recognizing recurring themes can guide you in refining your practice and ensuring you provide the best possible care.

Transparency is key. Encourage your patients to discuss any online information about you that may affect their therapeutic relationship. Clear communication in informed consent, social media policies, or during therapy sessions fosters trust and open dialogue.

While you may not always be able to remove negative reviews, there are exceptions when they violate review site terms. In such cases, you can reach out to the website to address the issue. Remember to uphold ethical obligations, avoiding public responses to reviews that breach patient confidentiality.

Ultimately, most clients don’t expect therapists to have perfect reviews. They value their personal experiences and assessments of your credibility over online feedback. By approaching online reviews with professionalism, transparency, and ethical responsibility, you can maintain a strong online reputation and continue providing exceptional care to your clients.

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About the Author

Hey, I’m Tiffany McLain, LMFT, and I teach you how to charge good money for the good work you do.  I’m the founder of Lean In. MAKE BANK. Academy, a group program that empowers therapists and social workers like you to reimagine your relationship with money, offering the tools and community support to not just earn more but to fundamentally change your life and the lives of those you serve.

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