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Dec 27, 2013

For Counselors, Online Reviews Present Perplexing Challenges

From Yelp, to Google Places, to Angie’s list, to Facebook’s new review system, companies today are more impacted by customer reviews than ever before. For some, this is a great opportunity. Business is booming at that hole-in-the-wall Mexican place after customers started rating them 5-stars, and word spread about their super-sized, extra-salty, margaritas.

In fact, results of a study published in the Economic Journal show that every ½-star bump in a restaurant’s rating on Yelp is likely to increase sales 19%[i]. These kinds of results don’t apply only to food. Today, people are reaching for their smart phones to check ratings on movies, dry cleaners, landscapers, housekeepers, plumbers, hairdressers, and (you guessed it) mental health providers. For the savvy consumer, it makes no sense to risk a bad experience on a business with a 2-star rating (or no reviews) when there’s a 4-star competitor just a couple blocks away.  

Social marketing expert Gary Vaynerchuk calls today’s marketplace the “thank you economy.”  In a thank you economy, businesses that don’t listen to their customers lose. However, businesses that care about their customers (or clients), listen to them, and provide services that exceed expectations will win. And win big! A study in 2012 showed that 7 in 10 Americans (that’s 70 percent) are willing to spend on average 13 percent more with companies they believe provide excellent customer service.[ii]


This is an opportunity for sure, but not an easy opportunity. Counselors face some unique challenges in the thank you economy.  

  1. On average, a happy customer tells 9 people, and an unhappy customer tells 16.[iii] When it comes to online reviews, your angriest customers may be the first to login.
  1. Many approaches to counseling involve some confrontation, as counselors ask clients to look at blind spots, evaluate thinking, and consider new perspectives. While effective, not all clients have a positive therapeutic experience.
  1. Some of your best clients might not want to leave a review because counseling is a private endeavor. As a side, I’ve heard plastic surgeons have the same problem.
  1. A known risk of counseling is that sometimes people leave feeling worse. At my practice, the informed consent reads, …in some cases persons have reported feeling worse after a counseling session. Clients understand that healing and growth is difficult, and some discomfort will likely be a part of the counseling process.” Even if a client is briefed that counseling can be an emotionally difficult process, he or she may still express their frustrations online.
  1. A bad fit can equal a bad review. As counselors, we know that not every counselor and client is a match—and this is normal. Clients, on the other hand, may feel that a bad clinical match deserves a negative review.
  1. There are many cogs in the healthcare machine; from scheduling, to insurance benefits, to coordinating psychotherapy and psychiatry care. If one part doesn’t run smoothly, don’t be surprised if a client feels rotten about the whole process.
  1. Some reviews can be overly harsh, inaccurate, or downright untrue. Not long ago, a picture went viral of a menu board outside a restaurant that read, “COME IN AND TRY THE WORST MEATBALL SANDWICH THAT ONE GUY ON YELP EVER HAD IN HIS LIFE!”
  1. According to the American Counseling Association (ACA), asking a client for a review violates the ACA ethics code. Even if you have a client who would be happy to write a positive review, you still can’t ask.[iv]


There is no easy or quick solution to earning positive online reviews. That said, here are some ideas:

1)     Notification, not request.

Let clients know in a non-invasive way that they can review the business online. For instance, a small sign that reads “Find us on Google Places” or “People Love us on Yelp” doesn’t include a call to action, and doesn’t violate ACA’s ethical code. However, it does remind persons that the business is listed on review websites.

2)     Office staff.

While it’s unethical for a counselor to ask for a review, it may be acceptable in some instances for a receptionist to mention it. Hospitals solicit feedback all the time by mailing patient questionnaires. They use that data (presumably) to improve their services, and also publish statistical findings for marketing purposes.

3) Promote Engagement.

No one should ever feel pressured into writing a review; even Yelp discourages direct requests.[v] Instead of asking for a review, promote engagement by posting a “check-in offer.” At my practice, anyone who checks in receives a free copy of the book “The Art of Possibility.”

4)     Respond to negative reviews.

Not all bad reviews are unwarranted. If you get a bad review, respond to it and make improvements to your practice. In the long run, a bad review can be good for your business. Also, if you’re really lucky, you might get another chance with that person who wrote the bad review, and he/she might even revise their review later.

5)     A non-counseling service.

Perhaps your business offers services other than counseling, such as executive coaching, massage therapy, yoga, acupuncture, or career services. Customers will be more likely to review a service that is less private than counseling. Such reviews could still be helpful for people seeking counseling services, as they may reference your clean office space and friendly admin staff. Also, it never hurts to have 5-stars next to your brand name.  

6)     Never write fake reviews.

Don’t get caught up in the mess of fake reviews. The Federal Trade Commission (FTC) has started prosecuting companies that post fake reviews. Also, Yelp has started publically shaming companies that they catch posting fake reviews. Nice guys might finish last, but slow and steady wins the race.

Whether you like it or not, it’s likely that your practice is already listed on numerous review websites right now (seriously, go look). As much as many counselors would prefer to opt out, participation isn’t optional. You can ignore it, but your clients (and potential clients) won’t.



[iii] This statistic varies depending on the source, but the principle remains the same. Return on Behavior Magazine cites the White House offer of Consumer Affairs:

[v] Yelp also suggests that business don’t “ask for reviews”, but encourage engagement. They explain their policy here. In contrast, Google does not prohibit asking for reviews.
Anthony Centore is a Counselor, Private Practice Consultant for the ACA, and helps counseling practices across the US thrive. For more information on private practice and insurance panels go to

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