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| What you need to know about ratings and therapy |
Ratings are everywhere. From finding my dentist and GP to choosing a taxi or a restaurant, online reviews are the standard. Clients looking for therapists want to see them too. When they see a therapist with no ratings, they wonder if something is wrong; a therapist with lots of five-star reviews seems amazing.
It may seem counterintuitive, but if you want a good therapist, look for someone who has only a handful of ratings. This is because therapy ratings are generally misleading and often dangerous. Here’s why.
Privacy, Ethics, and The Data Minefield
We’re getting better about talking things out, but for many, mental health issues remain taboo. Working internationally, I know that being known as a person who is depressed, anxious, or seeking help can affect your livelihood. You can be passed over for promotions, and families may insist on ending relationships if they discover someone is in therapy.
It’s not fair, but it’s how things are. Decent mental health practitioners do their utmost to ensure privacy. I am focussed on keeping things super private: I do all my own paperwork. My peers worry about this, too. They fire gossiping staff and keep client records inaccessible.
This commitment means we are extremely careful with listings. Contact information is fine, but ratings are tricky because they automatically identify clients.
Your Data Is Worth Millions (Literally)
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| Your data is worth money! |
Wellness apps and big companies gather client information to share or sell it for profit. This happens all the time. BetterHelp Mental Health App was fined $7.8 million for selling client information to Facebook, Instagram, and other corporations. They are not the only ones; mental health sites do it, hospitals do it, and online services lose it on a regular basis even in countries with lots of regulation like the UK.
A happy client may fill out a private feedback form thinking it's anonymous, but a week later, the PR department or some drug company is texting or phoning with special offers. The people who design these systems do it for money; they don’t care about our ethics.
Today, therapists must have online profiles, and that means ratings. Clients expect them. It’s natural because they are focused on finding a good therapist, not on the privacy risks. Because of this, it is now part of our ethics to tell clients how reviews may affect their privacy.
The Problem with Misleading Reviews
The Nature of the Work
Psychology is a blend of art and science. Most clients are happy, but sometimes there is an occasional mismatch. Usually, we adjust the approach or I help the client find a better fit. Very occasionally, someone is unhappy. One-star unhappy. Feeling disappointed is perfectly human.
The truth is, therapy means working with people who are often in deep distress, sometimes dealing with anger, personality disorders, or addiction issues. I handle this with professionalism, care, and a good dose of patience.
Fake Reviews and Con Artists
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| I found my dentist and doctor through reviews |
People who are unwell can react in difficult ways when upset. This includes stalking,accusations of mistreatment and so on. It can be quite frightening. Interestingly, it is impossible to tell a fake one-star review from a real one.
For example, a respected colleague had a perfectly proper-looking one-star review that was completely untrue. The client wrote, “he didn’t bother talking to me or listening,” when the case was, “when I demanded drugs, he talked rehab instead of offering to be my supplier.”
There's another issue, too: Con artists coerce and pay for reviews. One of the most notorious con artists in Malaysia has over 100 reviews. He runs his own ‘courses’ and ‘association,’ and if you sign up, you have to rate him at five stars. Because it’s not illegal to pretend to be a psychologist, there’s no stopping him or his friends.
Putting it all together, mental health service reviews are a minefield.
What Can You Do?
To find a safe, ethical practitioner, I suggest:
- Avoid extremes: Too many reviews often signals a con artist or a practitioner who prioritizes marketing over client safety. I avoid anyone who nets more than six reviews a year.
- Look beyond the stars: Consider that some one-star reviews may be inaccurate and reflect a client’s distress, not the therapist’s competence.
- Find their voice: If the number of reviews is reassuringly low, look for a blog or social media account. This lets you see how they think and work.
- Test their ethics: Ask if they want a five-star review in the first session. A proper answer would be a cautious thank you, followed by a short chat about the privacy implications. If they don't offer this, run!
How I Work with Ratings
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| Therapy is about connecting |
I finally listed on Google this year, in 2025, and frankly, I agonised over it. I wrote a note about privacy and told my clients about the listing. I was grateful that many shared the listing, and a few wrote reviews.
I see about 60 to 80 different clients a month and I have 6 reviews. I am still in two minds because I’m very invested in privacy, but I can't work unless I have some reviews. So I’m choosing to be grateful.
To see if my service suits you, I offer a free 15-minute first chat where we discuss your therapy goals, confidentiality, and other terms. That way, you can make an informed decision based on connection, not just stars.
Originally written in 2022 when I was practising in Malaysia. Updated in 2025 to reflect continuing global privacy and ethics issues in mental health including recent UK data scandals and misuse of client information.
