ACA Blog

Guest Posters
Aug 23, 2012

Business Rating Sites Pose a Serious Threat to Counselors and Other Behavioral Health Clinicians

You’re a professional counselor in private practice. You’ve worked hard to build a solid reputation as a caring, ethical provider of top-notch behavioral health services. Then one day you notice a drop in new client calls and referrals. You do a name search on yourself on the Internet, and...low and behold!...someone has posted a nasty review about you that has wormed its way onto a number of “business rating sites.”

Incredibly, most are sites you’ve never even heard of, let alone posted your business profile onto.

Sound farfetched? Then may I suggest you Google your professional name and see what information pops up about you and where it’s posted. I predict the results will be eye opening.

Fact is, there is a myriad of websites that capture counselors’ and other health care providers’ business information from a variety of public sources (e.g.,, managed care provider directories, and other such sources) and publish them without the providers’ knowledge or consent. Many offer an option for consumers to post ratings and comments about providers, and such posts are largely un-moderated and unverified.

How do these sites get away with it? They are protected under Section 230 of the Communications Decency Act of 1996 (47 U.S.C. § 230. Section 230(c)(1)). This federal legislation provides immunity to providers of interactive computer sites from liability for information that is posted on their sites by typically anonymous third parties. The spirit of this law is well intentioned: to protect the rights of free speech in cyberspace.

Unfortunately, it also renders the victims of slanderous content virtually powerless to fight back. For a good overview of this controversial legislation, click on the following Wikipedia link:

I’m not an attorney and so I won’t explore the constitutional nuances of the Act. But as a Licensed Professional Counselor and Licensed Clinical Alcohol and Drug Counselor, I assert that there are problems here both unique and insidious to the counseling profession. Consider the following instances in which negative and misleading content could be posted:

•An official body, such as criminal court, drug court, or your local Intoxicated Driver Resource Center, retains you to do a mental health or substance abuse evaluation of a mandated client. You use due diligence in rendering your treatment recommendation, said client is unhappy with it, and so she retaliates in cyberspace.
•Your counseling client arrives for his session and discloses thoughts of wanting to kill himself. You summon the police to take him to crisis screening, where he is deemed to be a threat to himself and admitted for five days. He feels betrayed by you and decides to tell the world about it.
•You’re counseling a couple with marital issues. Despite your objectivity, one partner begins to feel picked on by you and her spouse. She stops attending and posts a negative review about you.
•An unscrupulous competitor decides to tip the scales in his favor by posting anonymous, negative content about you on a number of business rating sites.

What can you do when negative information like this is posted? For one thing, you can request the host take down your profile and/or the negative comments. Some will do this in good faith, but they aren’t obligated to under the Act. Others, including high-ranking sites such as and, generally refuse. Another strategy is to get as much positive information about you in cyberspace as you can—through blog articles, news releases, responses to others’ blog articles, etc.—in order to push down the negative stuff on search results.

Finally—and this may be out of the box for some of you—write a blog article of your own quoting the negative review, and then explain to your readers why relying on business rating sites to pick a therapist can be misleading. I’m going to put such a link onto my new practice website, which is currently in development.

Whatever you decide, do something! The very nature of our profession renders counselors particularly vulnerable to harm under the immunities granted by this law. Specifically…

•Unlike other, non-healthcare related businesses that aren’t governed by HIPAA privacy policies, we risk violating patient confidentiality if we respond online to negative reviews, even when they are posted anonymously.
•Usually it’s our first and last names, not our practice names, under which these listings are found. This means that not only our business reputations, but also our personal reputations are compromised. Since many employers now do name searches as part of their background checks of job candidates, negative reviews could hamper our ability to secure future employment. Potential lenders may also do this type of search.
•Professional ethics bar us from soliciting favorable reviews from our satisfied clients, information that otherwise would have contributed to more fair and balanced online profiling.
•While I believe that most professional counselors would not compromise their clinical judgment and ethical standards, the threat of negative, retaliatory reviews can create undue pressure to make clinical decisions that aren’t based solely on best practice. For example:

oAssessing a DUI offender as not needing treatment, whereas without the pressure of negative feedback you might have otherwise recommended it.
oOverlooking or minimizing indications or insinuations of suicidality in your client in order to keep him satisfied, whereas you might have otherwise referred him for crisis screening.

Allowing anonymous authors to publish, carte blanche, damaging reviews of counselors and other mental health professionals in cyberspace, in my mind constitutes a public policy issue that sooner or later will have to be addressed since the threat of harm to ethical and responsible members of our profession will only increase with the continuing growth of social media.

What are your thoughts? I’d love to hear from anyone who has an opinion on this subject or who themselves has been unfairly trashed through social media.

Here is a Partial List of Business Rating Sites (New Jersey only) (Staten Island, NY, only)

James Genovese, NCC, LPC, LCADC submitted this post as a guest blogger.

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