It is important to remember that a bad review (or even two or three) generally will not ruin your practice. While you may not be able to completely avoid negative reviews, you can mitigate the possibility by addressing the issue of online reviews during the informed consent process before your work with the patient begins. By discussing the protocol for complaints up front, you may avoid a situation that might adversely impact the therapeutic relationship.
Whatever you do, refrain from asking your patient to sign an agreement to not rate your services online; they can do so without your permission, and such an agreement is not enforceable. Nor should you encourage patients to post positive reviews. That action may be contrary to the APA Ethics Code, which states, “Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence” (Standard 5.05 Testimonials, Ethical Principles of Psychologists and Code of Conduct).
Pertinent points to cover when discussing online reviews during the informed consent process include:
Remind patients that your relationship with them is confidential and that, by commenting online, they risk divulging the fact that they are receiving mental health treatment. The more information provided in a review, the greater the chance that patients will unwittingly jeopardize their privacy. Make sure patients understand that they risk revealing their mental health treatment, and that the risk exists even if the comment is made anonymously.
Discuss your protocol for responding to complaints by unsatisfied or unhappy patients. Encourage the patient to speak to you privately in the clinical setting first so that you can attempt to resolve any problems the patient perceives. Often a patient just wants to be heard. At some point during treatment, a patient might tell you he or she posted an online review about you or is thinking of doing so in the future. If the patient brings up the subject, your response should reflect the nature of the review.
Here are suggestions for handling the ensuing discussion:
- Good reviews: Respond to the patient inquiry by saying the decision to post a review is his or hers to make. Let the patient know that you are not encouraging testimonials and that positive public comments will have no bearing on your treatment. You may want to remind the patient of privacy concerns and the steps they may take to protect it.
- Adverse reviews: Discuss the patient’s concerns to see if you can address them during the course of treatment. If the issues are not resolved, you will need to consider whether and how the potential or actual negative public review will impact your relationship.
You might experience a complicated reaction if the review is particularly nasty or malicious. In this case, consider consulting with colleagues about the best way to proceed with patient treatment—for example, whether the relationship can continue or if it has been ruptured and is unable to be repaired. A colleague may help you determine how to proceed or whether it is advisable to terminate the relationship. The patient might be better suited to work with another psychologist if your relationship has deteriorated. If the online postings rise to the level of harassment, threats, or abuse, you may need to consult with law enforcement or legal counsel.