Yelp, Facebook, Google, and Angie’s List are just a few places where customers and clients speak their minds; leaving reviews—both positive and negative—that can raise or crush the reputation of a business.

For some, this is a great opportunity. Counseling practices with little money for advertising, but great reviews, might find that potential clients are calling, referred by another client’s 5-star experience posted online. In fact, a study published in the Economic Journal found that, for restaurants, every ½-star bump on Yelp increases sales 19%. These kinds of results don’t just apply to food. Today, people check ratings on everything from landscapers, to chiropractors, to (you guessed it) counselors! For some savvy consumers, it makes no sense to risk a bad experience on a 2-star rated business (or a place with no reviews), when there’s a 4 or 5-star option.

Easier Said Than Done

When it comes to online reviews, counselors face some unique challenges. Here are seven of them.

  • On average, a happy customer tells 9 people about their experience. An unhappy customer tells 16. This means that your angriest customers (or clients?) are usually your most vocal.
  • Because counseling is private in nature, satisfied clients might not want to leave a review. However, those with negative experiences might not have the same reluctance to post general complaints that someone was rude, the office was dirty, their counselor was late, or their bill was too high.
  • A risk of counseling is that some people can leave their session feeling worse. Indeed, personal growth is difficult! Even when clients are warned that counseling can be emotionally challenging, some may still express their frustrations online.
  • There are many cogs in the healthcare machine; from benefit checks, to insurance billing, to coordinating with medical providers, etc. If one part doesn’t run smoothly, a client might feel negatively about the whole process.
  • 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, “TRY THE WORST MEATBALL SANDWICH THAT ONE GUY ON YELP EVER HAD IN HIS ENTIRE LIFE!”
  • 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 can’t ask.
  • For confidentiality, when responding to negative reviews, counselors shouldn’t confirm that the reviewer is a client. For example, if a client complains that he didn’t get his full hour, you can’t respond by saying “Ed, your session was brief because you arrived 40 minutes late,” because that response would confirm Ed as a client.


You Got This

There’s no easy or quick solution to a positive online reputation. It’s an endeavor that will always take time and attention. That said, here are 6 to-dos to get started:

1) While counselors cannot ask for reviews, it might be possible to inform clients of the existence of online reviews. For example, a small sign on your door that reads “Find us on Google Places” or “People Love us on Yelp” doesn’t include a call to action and shouldn’t violate ethical rules.

2) While it’s unethical for a counselor to ask for feedback, it might be okay for others at the practice to do so. For example, hospitals commonly solicit feedback by mailing patient questionnaires. They use the data (presumably) to improve their services, and also publish statistical findings for marketing purposes.
3) No one should ever feel pressured about writing a review; even Yelp discourages direct requests. Instead, encourage engagement by posting a “check-in offer.” If someone checks in at your office, the practice will send them a free copy of a Brene Brown book (or whatever).
4) If you get a bad review, learn from it and make improvements to your practice. In the long run, a bad review can be good for your business. Seriously. Also, if you’re really lucky, you might get another chance with the person, and he/she might even revise their review later.

5) If your practice offers services other than counseling, like yoga, acupuncture, or career coaching, clients might be more likely to review one of these other services. Such reviews could be helpful to your practice at large.

6) Never write a fake review. The Federal Trade Commission (FTC) prosecutes companies for this, and Yelp publicly shames companies they catch posting fake reviews. It’s also slimy and unethical.

Like it or not, your practice is probably already listed on numerous review websites (seriously, go look). Participation isn’t optional. You can ignore online reviews, but potential clients won’t.