Online Reviews for Therapists and Mental Health Practices

By the Expert Reputation team · Updated October 26, 2026

Therapists, counselors, psychologists and psychiatrists face stricter review rules than almost any other business. Google lets businesses ask for reviews, but the major mental health ethics codes bar soliciting testimonials from current clients and others vulnerable to undue influence. And because simply confirming someone is a client reveals that they're in treatment, replying to reviews carries more risk than it does for a dentist or a dermatologist. This guide quotes the actual ethics standards, explains how the main directories work, and lays out what a practice can ethically do instead.

What the ethics codes say about soliciting testimonials

Each of the four major codes has its own testimonial standard. Here is the wording, taken from each code as published.

A few details matter in practice:

• The ACA standard is the broadest. It names former clients as well as current ones.
• NASW covers reusing what a client already said. Asking a client for permission to repost their unsolicited compliment counts as solicitation under 4.07(b).
• The AAMFT code was revised. The current code took effect January 1, 2026, and the testimonial rule now sits in Standard 9.2. Older articles may cite the earlier code.
• The ACA code is being revised. ACA's revision page says a final revised code will be published in fall 2026. Check whether C.3.b has changed before relying on the 2014 wording.
• APA also limits in-person solicitation. Standard 5.06 says psychologists do not engage, "directly or through agents," in uninvited in-person solicitation of business from therapy clients or others vulnerable to undue influence. "Through agents" is a reminder that handing the ask to front-desk staff doesn't change who is asking.

What about psychiatrists?

Psychiatrists who belong to the American Psychiatric Association follow the Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry. The association's Ethics Committee opinions (2025 edition) address testimonials in Opinion A.11. That opinion involved approaching patients to appear in videotaped testimonials. It says the scenario "evokes problems of confidentiality, respect for a patient's autonomy, potential exploitation, and conflict of interest," and that the use of patients' names and photographs in marketing "has the potential for exploitation and therefore requires careful attention."

Do online reviews count as testimonials?

None of these four standards mentions online reviews by name. A review that a client posts on their own, unprompted, isn't something you solicited. The question is what happens when you ask.

The reasoning behind every one of these standards is the same: clients may find it hard to say no to their therapist. That concern applies to a review request just as much as to a request for a website quote. The cautious reading, and the one we recommend, is to treat asking a current client to post a public review as soliciting a testimonial. Your state licensing board may have its own advertising rules too. When in doubt, call your professional association's ethics consultation service or a healthcare attorney before starting any review program.

The FTC's review rule (16 CFR Part 465) still applies on top of the ethics codes. It bans fake reviews, incentives tied to a positive or negative review, and review suppression.

How Psychology Today, Google and Healthgrades work for therapists

Psychology Today

For many therapists, Psychology Today is the most important directory, and it works differently from review sites. The listings we checked show no client star ratings or reviews. Cards can show a "Verified" badge, which the directory says means the therapist's license or primary credential has been verified by Psychology Today, and an "Endorsed" count. On the profiles we looked at, the endorsements came from other mental health professionals. Since clients can't rate you there, a complete, specific profile matters more than anything else you do on the site.

Google

Google is where clients most often leave public reviews of a practice, whether or not you ask. Google's policy allows merchants to solicit genuine reviews without incentives, and it bans selectively asking happy customers. But Google's permission doesn't override your ethics code. Claim your Business Profile, keep it accurate, and expect occasional unsolicited reviews.

Healthgrades and physician directories

Healthgrades says it "aggregates information related to provider practices from publicly available sources," and its policies "prohibit complete removal of this information." Psychiatrists, like other physicians, may find profiles there whether they created them or not. Claim the profile so the details are right. Our Healthgrades guide covers the steps.

Why replying to reviews is riskier in mental health

In most of healthcare, the rule is "don't confirm the reviewer is a patient." In mental health, the stakes are higher, because confirmation alone reveals that a person sought psychiatric or psychological care.

HHS's Office for Civil Rights has already acted on this. It settled with Manasa Health Center, a New Jersey practice that "provides adult and child psychiatric services," over a complaint that the practice disclosed a patient's protected health information when it posted a response to the patient's negative online review. Manasa paid $30,000 and agreed to a corrective action plan.

The ethics codes point the same way. ACA Standard H.6.d says counselors "take precautions to avoid disclosing confidential information through public social media." APA Standard 4.01 says psychologists "take reasonable precautions to protect confidential information obtained through or stored in any medium." AAMFT Standard 2.2 says marriage and family therapists "do not disclose client confidences except by written authorization or waiver, or where mandated or permitted by law."

Safer options for responding

• Don't reply to a specific review at all. For many mental health practices this is the safest default.
• Post a general statement instead. In Opinion A.22, which concerns reviews from people a psychiatrist evaluated for a court, the American Psychiatric Association's Ethics Committee said it "is not advisable" to make a public response to a specific individual's review, and pointed to its 2019 resource document on responding to negative online reviews for the treatment setting. It suggested a general posting that doesn't address any particular review, and gave sample language beginning: "Out of respect for the legal and ethical obligations of physicians to maintain patient privacy, I will not respond publicly to any individual review."
• If you do reply, keep it generic. Never acknowledge the person, their diagnosis, their sessions or their attendance. A neutral line that doesn't refer to any specific person or treatment is the most you should post:

Thank you for taking the time to share feedback. Our practice's privacy obligations mean we don't discuss any individual's care online. Anyone with concerns is welcome to call our office at [Phone].

More wording that stays inside HIPAA is in our HIPAA-safe review reply templates, and the background is in HIPAA and online reviews.

What not to do

• Don't reply with clinical details, even to correct a false statement.
• Don't contact the reviewer outside the clinical relationship to pressure them to remove it.
• Don't threaten legal action over an honest negative review. The FTC rule bans using unfounded legal threats or intimidation to get reviews removed.
• Don't post fake positive reviews or ask friends to, which is both an FTC and Google violation.

If a review is fake or breaks the platform's rules, you can flag it through the platform's normal process without discussing anyone's care. Our guide on whether you can remove a review explains what platforms will and won't take down.

What a practice can ethically do instead

You can still build a strong online presence without asking clients for testimonials.

1. Build an excellent directory profile. On Psychology Today and similar directories, describe who you work with, your approach, fees, insurance and availability in specific, plain language. That's what prospective clients compare.
2. Keep your Google Business Profile complete. Accurate hours, address (or service area for telehealth-only practices), phone, categories and photos of the office help people find you.
3. Use private feedback channels. An anonymous, optional feedback form or a satisfaction survey lets clients tell you what's working without anything being posted publicly. Make it clearly optional, and don't use it to decide who gets pointed to a review site. See patient satisfaction surveys.
4. Publish useful content. Articles that answer questions clients ask build trust in a way testimonials can't.
5. Ask colleagues, not clients. Professional endorsements and referral relationships are a natural fit for therapists. Psychology Today's endorsement feature is built around them.
6. Monitor what's posted. Even if you never ask for reviews, check Google and directories regularly so you can catch fake reviews and fix wrong information.
7. Put a policy in writing. Decide how your practice handles reviews (monitoring, flagging, whether and how to post a general statement), and train every staff member on it.

Common mistakes in mental health review management

• Copying review-request scripts written for dental or medical offices.
• Asking front-desk staff to "just mention" Google reviews to clients at checkout.
• Replying "We're sorry your sessions didn't help," which confirms treatment.
• Reposting a client's glowing email on your website without considering your code's permission rules.
• Treating the absence of reviews as a problem to solve by any means. For many therapists, a thin review count is normal, and a strong profile matters more.