A Review of Therapy
One of the values of the internet is that it not only provides opportunities to easily find the services we are looking for, it also gives us a chance to see what others are thinking about those services. While we probably don’t know the people who have written these reviews, we trust that they are mostly honest and fair and, at a minimum, are offering some useful information on which to base our decision as to whether or not to use a given service.
To the extent this might work for some services, many services do not fit this model at all or, at least, only fit with some major caveats. Psychotherapy is an example of a service that fits awkwardly, at best.
For example, something most people do not know, including many therapists, is that a therapist is ethically prohibited from asking someone they have worked with to write a review for them. Some therapists who are aware of this ethical requirement try to get around it by having signatures on their email that include language such as “Like me on Yelp,” which delivers a strong hint that the therapist would appreciate an online review. Arguably, this is not keeping with the spirit of the ethics of the profession.
If you think about this, it is easy to see how being asked to write a review for your therapist can be a conflict. If my therapist asks me to write a review, I might do it to please her or because I want her to like me (or not dislike me!). It might cause me stress when I start to worry about whether I wrote the “right” thing. If I refuse, will my therapist be angry? What if I say something negative? Will it get in the way of the work we are doing? You can see how this can quickly turn into a conflict and potentially take the therapy off course. This is a big reason why our code of ethics prohibits the solicitation of reviews.
In addition, therapy is supposed to be about you, not about your therapist. When a therapist asks (or even hints) that you should write a review, the needs of your therapist are getting in the way of your needs. This is not what therapy is supposed to be about and, in fact, is a violation of ethical standards.
Despite this, some therapists have dozens and dozens of reviews on sites such as Yelp. How does this happen? In some cases, the therapist may not be aware that asking clients to post to social media on their behalf is ethically prohibited and s/he may be unwittingly asking clients to do this. Or the therapist may know that what they are asking is inappropriate but might be assuming that the client doesn’t know the ethical standards of the psychotherapy world so it isn’t a problem. Many businesses routinely ask their customers to review them, so they assume clients will not think anything of the request. In other cases, the therapist may offer classes and workshops and groups and the reviews may be a result of many enthusiastic attendees who have not actually been in therapy with the therapist.
The theoretical orientation of the therapist may play a role, as well. A therapist who primarily works with people for short periods of time on specific issues will have many more people passing through his or her door than someone who primarily works with people who are looking for a longer and more depth-oriented experience in therapy.
Often, the population with which the therapist works may be a factor. For example, a therapist who works with young children may have few reviews because young children are (usually!) not writing reviews and busy parents (usually!) don’t have the time. A therapist who works with older adults may not have any reviews because the people he or she works with are not active on social media.
On the opposite end of the spectrum, a therapist who focuses on services for people in the tech industry may have many reviews because tech people are usually more comfortable with social media. But for most people, psychotherapy is a uniquely private matter, which means that they are not likely to be writing online reviews about their therapist.
In the end, however, the number of social media reviews for a given psychotherapist is dependent on many factors and may or may not be a reliable source of information.
If you can’t rely solely on reviews, what should you do? Read the online profile(s) for therapists and see who resonates with you. Try to be specific when you search on google or look at sites that have profiles set up by therapists in your area, such as Psychology Today or Good Therapy. Consider whether you are you looking for help with a specific issue or whether you want to focus on looking at yourself at a deeper level. Is there a particular approach to therapy that interests you? Has a trusted friend worked with someone who might be a good fit for you? (This can present additional complications, so make sure to check with your friend and with the therapist to make sure everyone is ok with this.) Gather information, contact the therapists who sound like they are interesting and could be helpful, and then talk with them and meet with them in person.
Online reviews can be helpful, but they are just one data point to consider. Don’t let a lack of social media visibility deter you from contacting a therapist who might be just the person you are looking for.
Questions about psychotherapy or about my approach to psychotherapy? Please see my website at www.marlacass.com and contact me at my San Francisco psychotherapy office: 415-218-2442 (phone link works from smartphones only) or at firstname.lastname@example.org.