Should Counselors Solicit Testimonials on the World Wide Web?
DeeAnna Merz Nagel
Many directories are available online for professionals to list services. Many counselors in private practice create profiles in directories such as the most popular offered by Psychology Today. What about using websites like Yelp.com and Kudzu.com to list one’s services and additionally, provide a forum for ongoing client testimonials? A counselor can create a profile to such a site allowing current and former clients the opportunity to rate the counselor and give feedback. I use sites like TripAdvisor.com when I travel so that I can see ratings for hotels and restaurants. So what is wrong with a consumer logging on to Yelp, Kudzu or another similar site and choosing a potential counselor based on the counselor’s Five Star rating and client feedback? Even though the counselor may not directly solicit the client for a testimonial, it seems like a slippery slope to me and I am not so sure I like the idea, frankly.
Counseling and psychotherapy is a time of discovery for clients. Sometimes the client may have negative feelings toward the counselor as a normal progression toward growth. Other clients may feel compelled to offer a positive statement either during the course of therapy or after termination as a way to endear themselves to the counselor. In fact we could talk about a gazillion ways any comment, positive or negative, can be seen as a part of the therapeutic process. Clients may even comment on current therapeutic content between the counselor and the client on such sites. For instance, what is to be done if a client, after a very intense session, logs onto such a site, looks up the counselor, posts immediate feelings about the counselor and also posts verbatim content from the morning therapy session? Does the counselor then respond openly on this public forum? And if the counselor responds, is the exchange considered part of the therapeutic record open and unprotected for all to see?
Allowing your client or former client to rate you may be fraught with a host of ethical compromises. Some would say though that the client is taking the initiative to reveal the information therefore, it is acceptable. I say that we as professionals have a responsibility to our clients to protect client confidentiality and the possibility of client exploitation. It is our job to understand the potential risks and benefits to our clients when we set up listings in such directories. With the advent of Web 2.0, these are the sorts of issues that counselors may need to address with clients as part of informed consent.
Why am I talking about this? Because it is here, it is happening and clients are commenting about their experiences. I have read some public threads in which the counselor engages in an online dialogue with the client or former client to make amends or to offer suggestions about the client’s concerns and comments. It gives me pause. What do you think? Let’s talk about it.
DeeAnna Merz Nagel is a clinical counselor, teacher, workshop presenter, sat on the ACA Cyber Technology Taskforce, and is co-founder of the Online Therapy Institute.
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I cannot think of a way for a therapist to directly respond to client testimonials without it being a breach of confidentiality. I think it would be extremely unwise for a therapist to publicly reply to to a client’s testimonial. Contacting the client privately to allow for processing or resolution of an issue is another matter. This is easier done if it is a current therapy client. Past therapy clients would, I think, require more in-depth consideration and consultation.
I agree with you that advertising oneself on rating sites is a slippery slope. I believe that it can create the appearance of soliciting testimonials. I wrestled with this issue long and hard and had the experience of other therapists sharing that they were shocked to discover clients themselves had posted their practices on Yelp, along with testimonials. Some clients thought they were doing a good deed for their therapist. One dilemma created by this is that even if Yelp (or the client) deletes the review, once you are listed on Yelp, you cannot get Yelp to remove you. I don’t know about other sites, but Yelp, in particular, combs Google and will put your practice on their site, even if you don’t list it yourself. They will not delete you, as they say it is all publicly available information.
I had initially decided that if someone ever posted a review, I might follow-up with a generic post about my preferences and concerns aobut client privacy. But I eventually decided that I’d rather be preemptive, since responding after a testimonial was posted could be perceived as a reaction to a particular testimonial. I took ownership of my own Yelp page for the sole purpose of being explicit about my preference for clients not to post reviews of my practice. I also wanted to make it clear that if clients decided to review my practice anyway, that I’d hope they would take measures to protect their privacy.
I also posted a blog post on my site discussing my concerns.
I agree with you that this is a serious issue!
So, as much marketing concepts I am learning these days, I think this “rating system” as described is how business people think of clinicians and what works for “public perceptions”. I see the concerns that Ms. Merz Nagal and Dr. Keeley raise and greatly appreciate it.
How about a specific badge like “Health On The Net”? If “Therapist A” meets some number standards, s/he are certified to do therapy XYZ, i.e. therapy online. The badges are often sold as site licenses renewable for annually, etc.
Yes, you can have people to have home-made badges… But if you bring forth collaborative and diverse groups, then you set minimum standards/evaluations/progress reports that justify the badge usages. You would have a standing committee overseeing proper use through annual audits. And as I understand it if you make these badges a “renewable widget” it can be removed from time to time. Similar to BBBonline/TrustE/Verasign sites.
I want to develop one because the participants on my site are African American women who already are a health disparity and refuse to seek professionally licensed treatment, online or real-time–anywhere. And as they get sicker, they wonder why they are suffering. I can use coaching strategies that promote positive choices uplift their pre-contemplative state to just think about talking to someone. But, I do NOT want them to encounter my past experiences with bigoted therapists who cannot treat me when some of my mental health issues are about racial incidences, like Dr. Henry Louis Gates. If I had a verifiable badge handy, I could direct my participants to “safe-free-zone” therapists who are cultural competent, sensitive, licensed, trained to understand mental health conditions in diverse communities.
I am very serious about setting up something like this within the next 3 months with the clinician I know personally. But I want to see what a therapists take on it would be?
Sincerely,
Dr. G-