Which would you rather use? A plumber you found on Yelp with 5 stars or one without any? How about a restaurant with 5 stars on Google as opposed to a restaurant only rated 1 star? Would you choose a therapist with a 5 star rating over one with none — or worse yet, a negative review?

If you said yes to the last question, you may want to reconsider. While there are certainly some therapists who have ratings from satisfied “customers,” most of us have very few. Is that because we are bad therapists? Hardly. It’s because it is unethical for us to ask our clients to rate us and even more problematic for us to respond to negative ratings. Here’s why.

(1) The effect of “undue influence.” In plain words, “undue influence” means that if I’m in a position of power or trust, I cannot use it to get you to do something that only benefits me. If I solicit a review from a you, it is hard to imagine how the review will benefit you; it’s easy to see how it benefits me. Therapists’ ethical codes protect you from these situations by making sure that your needs are front and center, not ours. What’s more, this applies both when we are currently seeing you as well as when we are no longer seeing you (allowing room for you to return to therapy with us should you need to do so in the future).

(2) Confidentiality prevents responding to reviews. This is very clear: we cannot disclose information about you including your name and identities. Legally and ethically, we cannot even acknowledge, confirm, or deny whether you are, or have been, a client. Therefore, there is no room for us to respond to a negative review posted on line for doing so would acknowledge that you were a client of ours, breaching your right to confidentiality. You can tell other’s you saw us; we can’t.

(3) Therapy is different than eating out. If you go to a restaurant and notice a filthy kitchen, you might safely assume that others will also have the same experience and thus write a negative review. With therapy, what doesn’t work for one person may be perfect for another person. That’s why most therapists will tell you that there is no “one size fits all” approach to therapy. Additionally, therapy is a complex and, at times, difficult process. Though it can be a lot of hard work, the end rewards are often life-changing. But what happens when a client who stops in the middle of therapy — feeling like things have gotten worse, not better — gets on line and writes a review of us? Does his or her negative review accurately reflect what you would experience if you were to see us Probably not. It may not even reflect what that particular client would have experienced if he or she remained in therapy longer. Will you know whether or not someone who writes a negative review of us stopped therapy prematurely? Probably not. And can we let you know that? Definitely not (see #2).

If you are looking for a therapist, rather than putting all your trust in a written review online, consider finding additional ways of determining who would be good for you. Your friends know you better than an anonymous reviewer and are far more qualified to give you a solid recommendation. Why not ask them if they, or someone they know, had a positive experience with a therapist? If you search for a therapist online, you might consider asking a potential therapist if you can do a short initial session before you agree to work together for the long run — just to find out if there is a good fit between the two of you before you make a decision.

After all, in the end, it’s not someone else’s rating of a therapist that matters. What matters is how well you feel you can work with the ideal therapist.

Author: Craig Kain Ph.D.

Craig Kain, Ph.D., is a licensed psychologist who maintains a private practice in Long Beach, California. With over 25 years of experience as a psychologist, and as a graduate of University of Southern California, he is currently serving as private practitioner working with a broad spectrum of clients. He works with both individuals and couples, and specializes in treatment of depression and anxiety, alcohol and drug addiction, relationship issues, and GLBT issues. Craig is an interactive, solution-focused therapist. His therapeutic approach is to provide support and practical feedback to help clients effectively address personal life challenges. He integrates complementary methodologies and techniques to offer a highly personalized approach tailored to each client to help them attain the personal growth they are committed to accomplishing. In addition to being a prominent relationship therapist, Craig has presented at National conferences and to general audiences speaking on various topics.