Can You Trust Therapy Ratings? Why High Ratings Might Be a Warning Sign

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)

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

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

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. 

 

Understanding And Managing Anxiety: A Survival Guide

WHO: 1 in 8 people suffer from anxiety

Anxiety is a feeling of dread that comes from knowing there’s something difficult ahead. Sometimes it can be an actual event, like an angry customer, an important exam, or a public speaking event. Anxiety can also pop up just because of a random thought.

While it’s normal to feel a touch of anxiety here and there, it can be bothersome. In addition, anxiety disorders are on the rise.

In 2019, the World Health Organisation found that 301 million people were living with an anxiety disorder, including 58 million children and adolescents. During the Covid-19 pandemic, they estimate this number increased by 26-28%.

If you have anxiety, know you’re not alone! Also, you need not suffer. Anxiety can be upsetting but there are ways to manage it.

What Is Anxiety?

Anxiety is a stress reaction. Mild anxiety typically includes quicker breathing, a rapid heartbeat, and tense muscles. Moderate and severe anxiety can also make you feel sweaty, give you an upset stomach, cause rashes and more.

Anxiety can be really useful, like if you’re about to start an exam, it can help you focus. But anxiety can also overwhelm–and it can feel bad!

Why Do We Have Anxiety?

Anxiety is a stress reaction that comes from your brain and body trying to look after you.

How does that work? Human beings are optimized to survive.

Our ancient ancestors lived in caves and huts, battling six-meter-long giant monitor lizards and three-meter-tall cave bears. With giant predators, you don’t want to hang about thinking what to do.

As a result, we developed efficient AUTOMATIC survival systems.

Although we’re not battling giant animals anymore, our brains and bodies have kept the ancient systems.   

How Your Body Works When Anxious

As your stress levels rise, your brain preps for disaster. It works to make you quick and strong.

Peter Weller as RoboCop (1987)

What you may notice is that your breathing speeds up. Your lungs suck in oxygen and dump it into your bloodstream. Your heart pumps fast, powering oxygen-rich blood throughout your body. That oxygen powers your muscles.  

What you don’t notice is that your brain switches off all the systems it doesn’t need for now: digestion, growth and reproduction.

What you do notice is that because your body works away, you overheat–so you sweat to cool yourself down.

Plus, another thing you don’t consciously notice is that your brain dumps stress chemicals into your system. They’re designed to make you super sharp and efficient.

Result: you’re geared up better than RoboCop for trouble. The thing is: there’s no cave bear to fight.

How to Manage Anxiety

You can’t poke your brain with a Q-Tip and tell it to stop.

Luckily, you can disrupt the auto-system.

Step #1 How To Breathe To Fight Panic

The key is to take it really slowly. Inhale through your nose over a count of two or three, hold your breath for a further count of two or three, and then exhale slowly–yes, over a count of two or three.

Remember that at this point your body and brain are trying to hit overdrive. So when you mess with that, your brain will recalibrate and then put on the brakes.

Step #2 Give It Five Minutes

Getting your brain to power down will take time.

Take three or four super slow breaths, then give your body time to get itself together. It may take up to five or even fifteen minutes.

Here are some nice ways to distract your mind so your body and brain can get on with the slow-down back to normal:

·         Have a cup of tea.

·         Listen to some cheerful music.

·         Pet the cat or take the dog for a walk.

Also Step #2 Engage in Positive Self-Talk

When your mind goes into overdrive, it can come with negative thoughts. It’s often part of a stress reaction.

If you like, there’s a video that describes how that works here.

If It’s not a huge issue for you, all you need to do is to center yourself.

As long as you’re not a serial killer, you’re probably a perfectly nice person–not perfect, just all kinds of human.

So an affirmation is the way to go. Here’s a good one:

What I’m feeling now is merely my automated system at work. I’m capable and competent. I can handle this.

Take another slow breath.

Step #3 Finish With A Focus On The Present

As you go about petting the cat, Marie Kondo-ing that drawer, or remarking how good your tea is, your stress thoughts will bounce about for a bit.

When you hear them slow down and go, focus on the present.

Counting fives is useful: five colours in the room; five types of square things you see; five things you’d love to do this weekend.

A nice steady flow of positive thoughts will help to ground you, keep you from getting overwhelmed, and push your mind into happier directions.

Final Thought: When To Seek Therapy For Anxiety

The system above should help you manage anxiety. It isn’t an immediate slam-dunk, it will take some practice, but it’s safe, sensible and effective.

To give yourself an extra boost, do some basic background work to leverage and build your resilience:

·         Surround yourself with people who love and support you

·         Sleep 7 to 8 hours a night

·         Eat lots of fresh food and pile on the vegetables

·         Build daily happiness into your life

But, should your anxiety interfere with your daily life or upset you, then seeking help is a sign of strength. Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation.

Brain image by John Hain from Pixabay

Can't Find Your Keys? Think You're Losing Your Mind? Don't Panic! It May Be Simple Stress

Stress can mess with your memory

When your memory is shot, you might worry you have an attention disorder. However, it's important not to jump to conclusions.

Daphne can't remember a phone number two minutes after hearing it. She also keeps losing her keys. When she goes to the shops, she has to take a list with her because otherwise she buys everything except for the thing she went out to buy.

Daphne is convinced she has ADD/ADHD. Her attention is messed up, right? And from seeing TikTok videos, she knows that attention disorders are sometimes overlooked.

Social media is terrific for raising awareness. It's also helping people open up and talk about mental health, removing the stigma that has haunted so many of us.

However, social media has some negatives that can sabotage good information.

Understand social media

First, fear and drama sell

It's much easier to attract likes by posting about doom, disaster, struggle and anger than it is to tell a simple story about reasonable people coming together to implement reasonable solutions.

Second, information online has to be bite-sized to be popular.

That's a problem because mental health tends to be complicated. You can't condense a 120 minute Tarantino film into a 22 second summary without losing something.

Third, there is often no quality control, no expert review.  

Sometimes that's okay, especially if it's simple stuff, but with the penchant for fear and drama and the condensing, you can get some very poor-quality information trending.

In the first half of 2022 TikTok was hot on attention disorders. But did you know that poor memory is also linked to depression and anxiety?

Research shows that certain kinds of depression can come with poor memory. Also, certain types of anxiety interfere with memory making. It's not one size fits all, though. There are lots of people with depression who have an excellent memory and the same goes for lots of people with anxiety.

However, studies show that when you combine anxiety and depression, the combination typically wreaks merry hell with memory. And the thing is, you don't need to have severe anxiety or severe depression. It can be as simple as a bit of low mood and a punch of life stress.

Putting it together

So, where does this leave Daphne who keeps losing her keys and being stranded in the supermarket aisle?

Given mental health is complicated, I'd suggest she not look for a quick or easy fix. Like the tailors say, measure twice and cut once. Spend a lot of time figuring out exactly what is going on, and only when you're certain, look at management and treatment options.  

If Daphne has the funds and the access, she can go and see a psychiatrist, a medical doctor who specializes in mental health issues. She will have a long chat with Daphne and based on that, will then decide on the proper assessments to figure out what's going on.

This will likely take several hours and two or even three visits. At the end of that, she'll probably have a pretty good diagnosis at which point she can make informed decisions.

If Daphne can't manage that, she might see a mental health practitioner like me.

I'd start by asking questions:

• Tell me about your memory this week
• Tell me about your memory last year
• Tell me about your memory when you were a kid
• Do you have a family history of attention disorders, anxiety, depression or other issues?
• Are you on any medication? Because some meds mess with your mood and memory
• Are you menopausal? Yup, that can do it, too
• Been in any fights? Played rugby? Been in a car accident? Your basic physical trauma questions
• Have you recently had food poisoning? Because gut health is linked to mood and memory
• What kind of work do you do? Because certain chemicals like paint and insecticide… yes, you guessed it! Have an effect on mood and memory!
• What does your family doctor say about your physical health? Because certain physical issues like wonky thyroids can have an effect on mood and memory
• What's been going on in the last 12 months? Because too much change can have an effect on mood and memory. People don't always remember what's going on, so I have a 50+ item list to kick off with
• How's your sleep? Because sleep deprivation is a killer, literally, and it messes up mental health
• Do you overthink things? Do you ever get short of breath? Do you come out in rashes? Because I'm checking for anxiety
• When you were a kid, did you self-harm? Were you bulimic? Because people sometimes don't know they've a history of stress or anxiety and these issues can be related to anxiety
• What are your hobbies? Are you enjoying them at the moment? Because I'm checking for depression and low mood, both of which can impact on memory
• What's your family like? And tell me about your friendship groups. Connections matter. We're social creatures
• How much happiness is there in your week? I'm looking at daily patterns

As I'm not a medical doctor, I cannot diagnose. But at the end of an hour, I should be able to tell you if I think you need to see a doctor.

Also, I will be able to tell you if I think you have anxiety, depression, both or perhaps something else like a form of PTSD or whether you should consult an expert to see if you have an attention disorder.

Speaking personally, I'm fairly conservative when it comes to medication. As mental health is always tricky, I think it's safest to go for talk therapy first and if that doesn't work, to see about other methods to manage. Assuming of course that you're not in a crisis of some kind.

Surprisingly often, classic therapy approaches for managing anxiety and low mood are enough to bring about significant changes for anyone suffering from too much life stress.

Also, it can't hurt you and if we put in solid goals to make sure we can track progress, it's generally speaking a good first option.

I hope you find this interesting and informative. Thanks for reading!

Image by Tumisu from Pixabay

I Think Of Depression As Spots

Figuring out what's wrong is the first step to health

I think of depression as spots. When you have spots, the first thing is to figure out what they are. 

Maybe you have an allergy to a new washing powder. Maybe you are allergic to something you ate the night before. 

Maybe you have dengue or chickenpox or shingles. It could be acne. Maybe it's boils. 

Or a mosquito bit you. Or perhaps a cobra fanged you. It may be a perfectly simple heat rash.

Figuring out what's causing it will lead you to the appropriate action. There's no point in changing your washing powder if you are allergic to eggs or have chickenpox.

Depression is the same. There are lots of different causes and that's why there are various approaches for managing it. There's not one-size-fits-all.

So if you have depression and can't immediately tell why or what to do about it, that's exactly what I help clients figure out. Send me an email at ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 and we'll work it out together.

Why I Offer A Free 15 Min Chat To Potential Therapy Clients

Target, senior executive office snoopervisor

I offer a free 15 min chat to potential therapy clients for three reasons: 

1) we talk online, so we need to make sure the tech works for us,

2) you tell me very briefly what your goals are, so we can decide if it's something we can deal with in therapy (because amazingly, I'm not a super genius who is trained in everything!). Also, what if you don't like me?, and

3) so I can tell you how confidentiality works, including emergency care, etc etc.

I do this because many people have never spoken to a mental health professional. This way, you get the intro quickly and easily. It helps you make better decisions.

Yes, it costs me time which is money. But so what? It's 15 minutes. I consider it a bit of public service.  

If you ask me, it should be an industry standard.  It's on my list of Laws To Implement when I become Mistress of the Galaxy :-)

A bit nervous and wondering what a first session is like? Read this post 

I'm Rebranding! And A Word About The Politics Of Mental Health Practice

I'm rebranding!  I'm the same person in the same place doing the same thing, but I'm changing my logo, website, blog and titles. The rebrand is because we are currently living in Malaysia, but we plan to move to the UK in late 2023.

Why rebrand? Politics! I think you'll find this interesting, so I'll explain.

Psychiatrists are medical doctors who specialize in mental health. Everyone else in mental health, therapists, psychologists, counsellors and so on, are not medical doctors.

While countries agree on legal definition of psychiatrist, they disagree on how to define other titles.

Sooooo, in some countries you can call yourself whatever you like. BUT in other countries, titles are 'owned' by professional associations. If that sounds weird, consider it's the same for certain kinds of engineers, architects and so on.

Here's where the politics come in. Mental health associations that own titles are usually exclusive, meaning they work to keep people out. They typically only take local people or people from a very small number of schools.

Practically speaking, if you work in mental health, your nationality restricts where you can join and the school you go to also restricts who you can join.

For example, in Malaysia, the title 'Kaunselor' is controlled by an association we call the Lembaga. They only accept people with Malaysian degrees.  So you can have a Master's degree in Counselling from Oxford in the UK and not be accepted.

Other titles in Malaysia are not controlled, BUT associations typically don't let foreigners join as full members.

Also, membership is not automatic. You can live locally or even be a local, have local qualifications and still be rejected. It's just like a club.

Note: this is not to criticize Malaysia. Every other country does the same. Mental health is in many ways just like the cartel. (If I am mysteriously killed tomorrow, you'll know why!)

So, as I am British, I am not a good fit for local professional associations. That's why I joined the British Association for Counselling and Psychotherapy. They are the UK version of the Lembaga.

But it left me with a dilemma. In the UK I am a registered counsellor and psychotherapist. But I can't be a Kaunselor in Malaysia.

As we planned to live in Malaysia forever, I branded my work to be in line with local norms and guidelines. On the advice of friends in the profession, I call myself a counselling psychologist. I have qualifications in psychology and counselling, so that works here.

But now we're leaving for the UK in the end of 2023. And guess what? In the UK, the title of counselling psychologist is controlled by an association I'm not a member of! ?? Sod's law, right?

So, I am changing from 'counselling psychologist' to 'counsellor and psychotherapist'. I'm adding in coaching because I've been taking extra courses and planned to add this to my business anyway in 2023.

The rebranding won't happen overnight as it's a big job but I do already have my new logos. Tell me what you think?

Visa Worries, An Expat Therapist Shares Personal Coping Tips

So about our Talent Visa woes: there’s no change yet, but there have been some questions. Next week we lose our permission to work after 25+ years here in Malaysia, unless someone at immigration wields a stamp. The questions have been mostly, “Why aren’t you going nuts?!”

I’d love to say it’s because I’m the greatest mental health therapist in the entire world, and my calm is entirely due to my using my knowledge about depression, anxiety etc to flow through this. Yeah, I should lie like a rug and say Hire Me! 😊

Truth is, the job does help but it’s also partly experience and personality.

The experience says that this is a tough time, but there have been worse times. Nobody is dead. Nobody is bankrupt. Nobody is at death’s door. So the reality is that there is inconvenience and annoyance, but no tragedy. I find that a massive comfort.

Next, from my work: when you’re in a tight spot, look to your rock. Your rock is whatever it is that gives you safety. This can be religion, a place, money etc etc.

For me it’s money in the bank. I believe that money makes you free. My personal minimum target is if you can do nothing in terms of revenue making for a year and still be okay, that makes you pretty much bullet-proof. I’ve got that, so I’m blessed.

Next, it’s working out what absolutely needs to be done. For me that’s Tom who needs another operation at the end of the year, and moving the cats abroad. Everything else is nice but not necessary. I can abandon my books, my things, everything. It’s just stuff. Only Tom and the cats matter. I can arrange their needs, no matter what.  That is a comfort.

As for the rock, a safety margin of cash, I’ve even got a plan for that. If it all goes pear-shaped in 8 days, I get on a bus, move to a nearby country, set up temporarily and keep working while I arrange for the next big move. Inconvenient, but with my work being entirely portable, it really isn’t a big deal.  

What cements is all is choosing to be happy every day. I know what gives me the feels: petting Target, playing with Tic Tac and Inkie, making very nice dinners and sharing them with Tom while watching old films.

So every single day I set aside time to pet and play then I cook and we watch black and white films. Those moments of happiness are mine. They can’t ever be taken away. They’re locked in my mind and they run through the fabric of my life.   

And finally, I think personality has a lot to do with calm. It’s tough times but I’m the type who breathes through and keeps moving forward. It’s useful for me and my job, but I get it can be super annoying.

With all the drama, I’ve had several mates this week exclaim, “How can you sit there and be so calm!!!!!!!!!!” and advising, “Call immigration! Call the Talent people again!! Write in the newspaper!!! Do something!!!!!!!!!”

I really appreciate that love. It’s heaven to know so many people care. But when you’re anxious, action appears to be useful. Reality is that everything that can be done, has been done. And now we just have to wait and see. 

Update 14 November 2022: we got it!  Five years. But we think the writing is on the wall for foreigners in Malaysia, so we plan to move to the UK in 2023. As I work online, it will be business as usual :-)

Image by jacqueline macou from Pixabay