Tuesday, December 20, 2022

Can You Trust Therapy Ratings?


What you need to know about ratings and therapy
What you need to know about ratings and therapy
Ratings are part of business but they’re a minefield for mental health services

Ratings are everywhere. In a taxi, at a restaurant, if you buy anything online. Ratings are important for deciding if we buy goods or services, and a recent experience prompted me to consider how they affect mental health practitioners.

Frankly, because of the nature of the industry, ratings are generally misleading and sometimes dangerous. Here’s why.

Privacy and Ethics

We’re getting better about talking things out but for many, mental health issues aretaboo.

In Malaysia, being known as a person who is depressed, anxious or seeking help for a mental health issue can affect your livelihood. You can be passed over for promotion or good jobs because bosses decide you can’t cope.

If you’re young, it can affect your relationships. It’s not unknown for families to refuse an engagement or to insist a relationship is ended because they’ve discovered someone is in therapy.

It’s not fair but it’s how things are. Therefore, decent mental health practitioners do their utmost to ensure privacy. Me, I do my own paperwork. I’m very keen on keeping things super private.

As for my peers, I know they worry about this too. They fire secretaries who gossip and they make sure that their paperwork can’t be accessed by random nosy staff.

It also means that we are very careful when we list our businesses. It’s fine to put contacts information but we never invite ratings. This is because ratings automatically identify clients. It outs them.

Even if there is an anonymous rating option, the system remembers email. And many systems gather information and share or sell it.

ransomware image by Pete Linforth
Your data is worth money!

Sounds farfetched? I’m afraid this happens all the time. Mental health sites do it, hospitals do it, and online services lose it on a regular basis even in rich countries.

Anyone who uses a business will have their details scraped and sold.  The people who own and design the system do so for money; they don’t care what their end users’ ethics are.  

So a happy client thinks they’re writing a nice anonymous note but six months later the PR department or some drug company is texting or phoning with special offers.

As we know this, careful mental health practitioners encourage clients not to leave reviews or ratings. This is one issue but there are more.

Mental Health Service is Tricky

Psychology is more art than science, especially if you’re working outside of Western, educated, industrialized, rich and democratic (WEIRD) societies. Also, with it being such a broad field, it can be tough to figure out a good match.

I offer a free 15-minute first chat so we can see if it’s likely we can work together.

Therapy is about connecting
Therapy is about connecting

Typically, I refer 1-2 out of ten new people to different professionals as they want help with issues I’m not trained in.  There will be another 1-2 who change their minds or go elsewhere. The uptake for me is roughly 6-8 out of ten.

Out of those new clients, not all will be happy with my service. (I KNOW!  Shocking, isn’t it? But there you go.)

Most know by the second session if we’re going to work out. Me, I’m a bit slow, I like to leave it to the third session.

If by then it’s not going well, we have a chat. If it can’t be done, I try to help them find someone else that suits them better.

Occasionally, someone is unhappy. One star unhappy.

If it’s just deep annoyance, the ‘it’s not fair’ emotion, that’s perfectly human. It sucks to pay for a service and to find it’s not what you hoped for. This is why we point out before we start that it may not work out but still, grumph!

However, it is the nature of our business to deal with troubled people, including anger, personality and addiction issues. And that’s tricky.

Fake One Star Reviews Are Hard To Spot

Fake One Star Reviews Are Hard To Spot

Troubled People and One Stars 

People who are not well can react in difficult ways when upset. This includes stalking,accusations of mistreatment and so on. It can be quite frightening.

Also, part of the reaction can include one-star reviews.

Curiously, it is impossible to tell a fake one-star review from a real one. I’ve seen some reviews written by people I know that look perfectly proper but that are completely untrue.

Think, “he didn’t bother talking to me or listening” when the case is, “when I demanded drugs, he talked rehab instead of offering to be my supplier.”

There’s another issue, too.

Cons and Twits Pay for Reviews

One of the most notorious con artists in Malaysia has dozens and dozens of reviews. He runs ‘courses’ for his own ‘school’ and has his own ‘association’ so if you sign up, you have to rate him at five stars.

Awesome, right? I sometimes wish I had no morals or ethics. I should start a cult.

Anyway, because it’s not illegal to pretend to be a psychologist, there’s no stopping him or his friends. One consequence is that this bad behaviour has spread.

People who have professional qualifications but who aren’t too bright in the ethics department see his fancy car and his billboards (I’m not kidding!) and they are now also soliciting reviews. They think it’s okay because they leave out the surname.

Putting it together, mental health service reviews are a minefield. 

What can you do?

I’d listen to gossip. Talk to your friends and find a personal recommendation.

Better still, hire me!

If you don’t want to do either, you should know that my therapist died last year and so I’m shopping for someone new.

My approach is this:

·         Too many reviews = con artist or dodgy practitioner. I avoid anyone who nets more than 5 reviews a year.

·         I consider that a poor review may be inaccurate.

·         If the number of reviews is reassuringly low, I look for a blog or social media account. That will let me see how they think and work, and I’ll take it from there.

Also, I plan to ask in the first five minutes about leaving a review. If the person says they’re awesome, I’m going to run!

What Prompted This Post?

I find some personal ratings problematic. I won’t rate a Grab driver, the clerk in the post office, or the bloke who delivers my groceries. People are much more than my very short interaction with them.

However, I love ratings for shops and services. I bought coffee online last week from ArabicaEstate Academy Sdn Bhd based on their five-star ratings, and Tom bought a computer, also based on five-star ratings, from Lenovo CertifiedStore-Brightstar. Both were totally awesome. Well worth it.  

I found my dentist and doctor through reviews
I found my dentist and doctor through reviews

I found my dentist and general practitioner doctor through online reviews too. I’ve written rave reviews for Tom’s eye doctors, my hairdresser and every restaurant we love.  

But with so many companies cheating online customers, especially those overseas, ratings also work to keep us safe.

I got cheated by a Dutch company recently, for an order of Euros100 (RM500), so I’m miffed. 

They used to be good, I’ve been a customer for years, but I didn’t realise their recent reviews are loaded with one-star ratings for non-delivery.

I’ve added my one star to them. I’m now looking at ratings first, even with companies that are old friends, just in case they’ve changed. Thankfully, I paid with PayPal so I should be able to get my money back.

I thought my mum wouldn’t get her Christmas present on time this year because of that but to my joy, another company that I used to deal with, one that was recently bought over by new owners, just texted to say they’re up and running again.

What’s even better is that they’re letting customers place an order and they only charge once it’s all confirmed. So whoohoo! I’ve put in an order.

I’ll let you know how it goes 😊

One star by mcmurryjulie from Pixabay 
Five star by mcmurryjulie from Pixabay 
Meeting of Minds and Connect images by John Hain from Pixabay 
Cyybercrime by Pete Linforth from Pixabay