When seeking help from a mental health professional for the first time, it can be intimidating to ask friends or family for recommendations. So it makes sense that the internet, specifically Yelp and Google reviews for local therapy practices, would be a good place to start your research. After all, you’d want to know if a psychiatrist slept through an entire $300 session because she took “allergy pills” or if a therapist has a history of ghosting clients and billing their insurance anyway. And you’d definitely want to know if you might get stuck listening to some guy named Ray talk about himself the whole time.
But unlike other businesses that can respond back, address criticisms and resolve complaints on Yelp, therapists are often not able to reply the same way without breaching confidentiality. “I don’t respond to them because it could be breaking their privacy rights,” says mental health counselor Mary Joye, admitting she’s had clients leave negative reviews that she believes are inaccurate. She declined to elaborate further on specific reviews, for the same reason.
“I don’t even answer the good ones back because I don’t want to confirm or deny I know that person,” Joye tells me, adding that clients similarly violate their own rights when they review therapists from accounts that aren’t anonymous. In her opinion, people shouldn’t be able to review therapists in this way because “privacy is paramount and reviews deny people this right.”
The Health Insurance Portability and Accountability Act of 1996, better known as HIPAA, is a federal law that grants these privacy protections, covering most aspects of our physical and mental health care. But per psychotherapist Patrick Turbiville, “Therapists think and talk about HIPAA and confidentiality in ways that you might never hear doctors or others talking about it.”
For instance, therapists might not address clients by name in the waiting room of their office, or couples therapists may have both individuals sign release forms for each other, so they can legally talk about both parties in the same room. “Basically, anything a therapist does that could somehow give anyone any information at all about a client’s treatment, including whether a client is receiving treatment at all or receiving treatment from a specific provider, is a violation,” Turbiville says.
Most therapists take HIPAA very seriously, but the fact that it was established before anyone really had to deal with online reviews, the feedback there exists in a serious gray area. “There are some therapists who play it fast and loose,” and respond to reviews, Turbiville notes. To be clear, he isn’t one of them and estimates that 90 percent of therapists in his professional circle agree.
In order for a responding therapist to get reprimanded for this, the individual leaving the review would have to file a separate complaint with HIPAA online — a sort of private, more official Yelp review, if you will. At this time, there is no option for filing a complaint on another person’s behalf, or a general complaint about a provider.
As for therapists, if the review violates Yelp’s Terms of Service, the platform may be able to remove it. If that doesn’t work, and reviews are tanking their businesses, therapists can consult with an attorney well-versed in privacy laws. That said, “the best approach is to be a kind and conscientious provider who doesn’t do shit people are going to want to rant about on the internet,” Turbiville says.
Turbiville believes that online reviews for mental health care, though professionally inconvenient at times, do more good than bad and people should “absolutely review their therapists.” He also thinks that therapists should suck it up and accept this as part of the job.
So when it comes to shopping around for a new therapist, definitely consult with online reviews. But if there are many glowing reviews and one negative review from someone clearly having a hard time, don’t judge the therapist too harshly — as long as the therapist in question has remained calm and quiet about it, of course. “One bad review wouldn’t bother me,” Turbiville says. “But a therapist who has responded to it would make me wary.”