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Most "how to get more Google reviews" advice doesn't apply to therapists. It actively shouldn't.
The standard playbook — automated SMS to recent clients, follow-up reminders, bulk review requests at scale — is straightforwardly unethical for psychologists, licensed counselors, and clinical social workers. The APA Ethics Code prohibits it. The NASW Code of Ethics prohibits it. The ACA Code of Ethics prohibits it. Every major mental health licensing body has explicitly recognized that the therapeutic relationship creates a power imbalance that makes client testimonial solicitation inherently problematic.
That doesn't mean therapists are stuck without a path to building online credibility. It means the path looks different — and the therapists who build a thoughtful, ethics-aligned online presence end up with stronger, more durable trust than the ones who try to apply standard small-business marketing tactics.
This guide is the practical playbook for mental health practices: what the ethics codes actually say, what reviews you can solicit (and from whom), how to handle reviews that arrive unsolicited, and how to build credibility through the channels that don't require asking clients for testimonials.
An ethics note up front, not buried: This post is informational, not legal or ethical advice. The ethics rules outlined below come from the APA, NASW, ACA, AAMFT, and state licensing board frameworks, but the application to specific situations is fact-dependent. Before launching any review-related practice marketing, run it past your professional ethics consultation resources, your state licensing board's published opinions, and (if available) your malpractice carrier's risk management team. The cost of getting this wrong includes licensing complaints, ethics board investigations, and harm to clients — orders of magnitude more serious than the marketing benefit of a few additional reviews.
This is the part most marketing-blog content for therapists glosses over. Be precise about it.
"Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence."
The 2024 draft revision goes further, with language under consideration that simply states: "Psychologists do not solicit or accept testimonials from current clients/patients/recipients or anyone with whom..." — a stricter standard.
The phrase that does most of the work is "or other persons who because of their particular circumstances are vulnerable to undue influence." Ethics committees have consistently interpreted this to include former clients in many circumstances, given that the therapeutic relationship has lasting psychological dynamics — power, transference, gratitude, dependence — that don't end at the final session.
The National Association of Social Workers Code of Ethics has parallel language prohibiting clinical social workers (LCSWs, LMSWs) from soliciting testimonials from current clients or others vulnerable to undue influence.
The American Counseling Association Code of Ethics applies similar restrictions to licensed professional counselors (LPCs, LMHCs, etc.):
"Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue influence."
The ACA language is the most explicit about including former clients in the prohibition.
"Psychologists do not disclose in their writings, lectures, or other public media, confidential, personally identifiable information concerning their clients/patients..."
This applies directly to review responses. A therapist who responds to a Google review in a way that confirms the reviewer is a client (even by acknowledging "thank you for being our client" or addressing them by name) has potentially disclosed identifying information in public media. We'll come back to this in the response section.
In addition to the professional association ethics codes, every state licensing board has its own standards. Most parallel the relevant professional code, but some are stricter. A few states have specific advertising rules that apply on top of testimonial restrictions. Check your state board's published rules and any opinion letters before deploying any review-related practice.
You cannot, ethically:
You can, ethically:
The rest of this post is about how to do the second list well, given that the first list rules out most of the standard small-business review playbook.
A common conclusion mental health professionals reach when they read the ethics rules: "Then I just won't engage with online reviews at all."
This is understandable but increasingly unworkable. Prospective clients searching for therapists in their area will check Google reviews. A practice with no reviews — or with only one or two unfavorable ones from disgruntled former clients — looks worse than a practice that has thoughtfully built its online presence through ethical means.
A practice with no Google reviews and a thin profile loses prospective clients to practices with stronger, ethically-built online presences. The clients who would have found you and benefited from your work end up somewhere else, sometimes somewhere worse. The "do nothing" approach has real costs to client welfare too — they're just less visible than the costs of the testimonial-solicitation approach.
The right framing isn't "should I engage with online reviews?" but "what's the ethical version of engagement?" The rest of this post answers that question.
There are several legitimate paths to building online presence that don't violate the testimonial prohibitions.
The single largest ethical exception is reviews from professional colleagues. Other therapists, supervisors, training program directors, peer consultation groups, and clinicians who refer cases to you can ethically write Google reviews of your practice — as long as they're not also your clients.
These reviews speak to your professional reputation, training, ethics, clinical thinking, and reliability — which is exactly what prospective clients want to know about anyway. A review from "Dr. Maria Chen, LCSW, PhD, who has referred clients to Dr. Patel for five years" is more credible to a prospective client than a generic client testimonial would be — and it's ethically clean.
How to ask:
A well-built practice can typically generate 15-25 colleague reviews from their professional network, which is enough to make a Google Business Profile look credible to prospective clients without ever soliciting a client testimonial.
If you teach, supervise interns, run training programs, give CE talks, write for publications, consult to organizations, or interact with people in non-therapeutic professional capacities, those people are generally fair to ask for reviews. They can speak to your professional capabilities without there being any therapeutic relationship that creates a power imbalance.
Examples:
The line is whether a therapeutic relationship exists or has existed. Where one hasn't, the testimonial restriction generally doesn't apply.
This one is genuinely complicated. The ethics codes prohibit solicitation of client testimonials. They don't prohibit clients from leaving reviews on their own — and clients sometimes do.
When a client leaves an unsolicited Google review, you're not in violation of Standard 5.05 (you didn't solicit it). But two related questions apply:
Can you respond to it? Carefully. Standard 4.07 prohibits you from disclosing identifying information about clients in public materials. Even a "thanks for being our client" or "we're so glad we could help" response confirms a therapeutic relationship — which itself is identifying information you may not have permission to disclose. The safer response is generic, doesn't confirm a relationship, and doesn't reference the content of the review.
Can you display it on your website? Even more carefully. Some interpretations argue that using an unsolicited testimonial in marketing — even if you didn't ask for it — converts it into "use of testimonial" that triggers ethics concerns when combined with the practice's own marketing efforts. Conservative ethics consultations generally recommend not republishing client reviews on a practice website, even if the client posted them voluntarily on Google. Other interpretations are more permissive. Get specific guidance from your state board or ethics consultation before republishing.
What practices generally feel safe doing:
This is the path most ethics consultations recommend as the primary online-presence strategy for mental health practices, because it doesn't depend on anyone else's testimony at all.
You can ethically build credibility through:
Standard 5.04 specifically addresses this: psychologists can make public statements about their work in print, internet, and media, as long as those statements are based on professional knowledge, are consistent with the ethics code, and don't indicate a professional relationship with any specific recipient.
The credibility built through your own writing and professional content is, in many ways, more useful to prospective clients than testimonials would be — they get a direct sense of your thinking, your approach, your expertise. Many practices that have built strong content presences find that they convert prospective clients at higher rates than practices relying primarily on reviews.
Even with ethical solicitation off the table, reviews will come in — from colleagues, from clients you didn't solicit, from people you've never met (which sometimes happens), and occasionally from people misrepresenting their relationship with you.
The response framework that protects client confidentiality:
A safe template:
Thank you for taking the time to leave a review. We appreciate it.
That's it. Don't confirm the person is a client. Don't reference what they said. Don't thank them "for trusting us with your care." Each of those steps creates the implication of a therapeutic relationship that may itself be a confidentiality concern.
If the review is from an obvious colleague or non-client (someone who identifies themselves clearly), a slightly warmer response is fine:
Thank you for the kind words. It's been a pleasure to work with you professionally.
The clarifying phrase "professionally" or "on consultation" or similar makes clear this isn't a client relationship.
This is where the temptation to respond is strongest and the risk is highest. The reviewer may or may not be a client. They may be making accusations that are factually inaccurate. They may be sharing details of a clinical interaction that you remember differently.
The right response template:
Thank you for sharing your feedback. Federal and state confidentiality regulations, along with our profession's ethical standards, prevent us from discussing any individual's specific situation publicly. If you'd like to discuss your concerns directly, please contact our office at {phone number} so we can address them in an appropriate setting.
Notice what this template does:
If the negative review is from someone who is clearly not a client (which sometimes happens — disgruntled former employees, business disputes that aren't clinical, occasionally outright impostors), a different response may be appropriate. But even then, err on the side of generic — confirming details you remember clearly may invite later allegations that you broke confidentiality.
The single most common ethics violation in mental health review responses isn't a malicious one — it's a well-meaning therapist who confirms a relationship in the act of trying to be polite. Generic responses are the safer pattern.
Given everything above, a fair question: does a tool like TrueReview have any role in a therapy practice?
Yes — but a different role than in other industries, and one that respects the ethical constraints.
What it can ethically support:
What it should NOT be used for:
The reasonable framing: a review tool is useful for the parts of the workflow that aren't prohibited (monitoring, response management, colleague review collection, multi-platform tracking, website embedding), and shouldn't be used for the parts that are.
Synthesizing everything above into something you can deploy:
Step 1: Audit your current online presence. What does your Google Business Profile look like? Your Psychology Today listing? Your firm website? Are there reviews already in place that you didn't know about? Are there responses needed to existing reviews?
Step 2: Set up review monitoring. Use a single tool to monitor reviews across Google, your specialty directories, and other platforms. You want to see new reviews within 24-48 hours of posting so you can respond thoughtfully.
Step 3: Develop response templates. Have your ethics consultation or attorney review template responses for positive and negative reviews. Use them consistently.
Step 4: Build colleague review outreach. Identify 15-25 professional colleagues, supervisors, and referral partners who could ethically write reviews. Reach out individually, explain the request, provide your direct review link.
Step 5: Build content presence. A blog with substantive articles on your areas of focus, video content explaining your approach, professional directory listings on the platforms relevant to your specialty. This is the foundation of online credibility for mental health practices, and it doesn't depend on testimonials at all.
Step 6: Consider what you embed on your website. Colleague reviews can ethically be displayed. Unsolicited client reviews are a gray area — get ethics consultation before republishing on your firm site.
Step 7: Document everything. If your state board or your professional association ever raises a question about your online marketing, you want a clear record of what you've done, the ethics consultation you sought, and the rationale for each decision.
A few practices that show up in mental health marketing and should be avoided:
Asking your front-desk staff to ask clients for reviews. This routes around the direct-solicitation prohibition only superficially. The ethics code applies to actions taken through agents.
Leaving review request cards in your waiting room. Same problem — even passive solicitation in your office space is solicitation.
Auto-emailing termination clients a request for feedback. Combining "feedback survey" framing with a Google review link doesn't escape the prohibition. If the request is ultimately about generating public reviews, it falls under the testimonial restriction.
Republishing unsolicited client reviews on your website without ethics consultation. Even if the client posted voluntarily, using their words in your firm's own marketing material is a separate ethical question that needs case-specific review.
Responding to negative reviews defensively. The instinct to set the record straight when a former client has posted something inaccurate is understandable, and it's exactly what the rule is designed to prevent. The harm to your reputation from a polite, generic response is far less than the harm from a confidentiality violation.
Engaging with anonymous reviews you suspect are fake. Some negative reviews are from people who were never clients (former employees, business disputes, occasionally bots). Don't accuse the reviewer of fabricating — it sounds defensive, and you may be wrong. Use the standard "we can't discuss specifics publicly" template and flag the review with Google for evaluation against their own policies if it appears to violate them.
Using AI-generated content that purports to be a client testimonial. This is now a real concern with the rise of AI-generated content. Some marketing services have begun offering "synthetic testimonials" that aren't from real clients. For any business this is at minimum a Google policy violation and an FTC issue. For a mental health practice it's also an ethics violation. Don't.
A mental health practice running a thoughtful, ethics-aligned online review program has all of these in place:
Practices that build this foundation tend to develop online credibility that's both ethically defensible and genuinely useful to prospective clients. Practices that try to apply standard small-business review tactics often end up either with thin online profiles (because they're afraid to engage at all) or with ethics complaints (because they crossed lines that aren't always obvious until after the fact).
Ready to set up ethical online review management for your mental health practice? Start your free 14-day trial of TrueReview — review monitoring across Google and specialty platforms, AI-assisted response drafting (with your final review on every response), colleague review collection workflows, and embeddable widgets that respect the boundary between professional and clinical relationships. No setup fees, no contracts. Run any deployment past your ethics consultation before going live.
