Should you be able to review your psychotherapist on Yelp?
That’s the question psychologist Keely Kolmes asks in The New York Times the other day, and the answer is — yes, but.
There’s certainly nothing wrong with the idea behind having public reviews of health care professionals, including psychologists and therapists. But as Dr. Kolmes notes, what makes sense for a housekeeper, plumber or restaurant review becomes a bit difficult when dealing with confidential health information — which includes a person’s relationship with a therapist.
A psychotherapy relationship is a very unique relationship. A person can have a bad therapy experience with a perfectly good therapist, and vice-a-versa. The current set of review websites, like Yelp, really aren’t very good when it comes to understanding the unique and complex relationship people have with their therapist.
Dr. Kolmes notes some of the primary concerns with public reviews of therapists:
Of course, no one wants to be the subject of a bad review, but psychotherapy services are special. If you wait an hour for an appetizer, chances are that other diners will have a similarly bad experience. But unless a therapist regularly falls asleep during sessions, patients’ experiences in psychotherapy are more subjective. A certain treatment might help one person but not another. Something that works for one patient at a particular point in therapy might not work for him later, when his needs change. What makes one patient upset enough to write a bad review might not bother — in fact, might even help — another.
Another huge problem is that, right now, there are dozens of websites you can go to review a therapist or healthcare professional. There are only two primary websites for travel reviews — TripAdvisory and Yelp — meaning you’re more likely to get a large amount of reviews on any given restaurant or hotel.
This is not the case with these dozens of healthcare provider review websites. Most have only one or two reviews of a health care professional. Really popular doctors or therapists in large urban areas have more. But most don’t have any. Such data has virtually no scientific validity — it’s no better than asking a stranger on the street. (In fact, I wrote about this very issue of the lack of reliability of health 2.0 websites ratings and reviews four years ago.)
So what are some solutions?
[A good health professional review site] should offer reviewers additional protections when sharing personal information, particularly by allowing them to post anonymously without linking to their regular profiles. This might also allow practitioners more freedom to respond to reviews without compromising patient identity.
The sites could also require users to include more meaningful data, such as the duration of their treatment, what they sought care for, how long they have had their particular health concern and whether they addressed any complaints with the care provider. In addition, it would be useful to know how many other practitioners they sought treatment from, and whether they eventually found successful treatment elsewhere. This information would help those seeking care for a similar problem, as well as put a bad review in context. Finally, the sites should direct visitors to their states’ licensing boards, in case a formal complaint is called for.
I think these are all good suggestions.
However, I also think that you could ask for all of the data under the sun, but until you address the problem of too many review websites out there, none of this is going to help much. Until one or two clear winners emerge in this area (and four years later, we still don’t have one), you just have reviews sprinkled throughout these dozens of doctor and therapists ratings sites.
Worse, people are more inclined to post negative reviews at these sites because of our negativity bias. So people coming to such sites are likely getting an unbalanced and erroneous picture of any given health care professional today.
Generally, companies like Yelp don’t really care about these kinds of subtle and complex issues. They’re only in the business of providing a platform for people to share reviews; their developers never imagined that different professional relationships might actually require a complete rethink of that platform for this kind of use.
So like Dr. Kolmes, I’m all for these kinds of therapist review websites. But they have to get serious about the service they’re providing and recognize that reviewing a plumber is not like reviewing a therapist or doctor.
Read the full article: The Wrong Type of Talk Therapy
40 comments
Hmmm. A longish response I wrote to this fascinating post on Sunday seems to have been lost in the electronic ether. If I have time I’ll try to reconstruct.
Folks should read the original article, and then they should read the comments as well. The comments split neatly into two camps: the health-care providers want to limit the ability of patients to review health-care providers, and the patients, the health-care users, want all the information they can get.
I’m a health-care user.
I find it troubling that the health-care providers are arguing that they are a privileged class, and it is inappropriate for their patients to comment on them freely. The provider position seems entitled and even somewhat narcissistic.
And the constraints which Kolmes, and apparently Dr. Grohol, wish to impose are intrusive and demeaning.
“The sites could also require users to include more meaningful data, such as the duration of their treatment, what they sought care for, how long they have had their particular health concern and whether they addressed any complaints with the care provider. In addition, it would be useful to know how many other practitioners they sought treatment from, and whether they eventually found successful treatment elsewhere.”
I am surprised that a therapist would want to restrict the ability of a patient to speak.
(But I suppose it’s all different when it comes to publicly criticizing a therapist!)
I completely agree with b. Yes, psychotherapy may be subjective – but so are many other professions with which clients/users do available research to come to a more informed conclusion. Before taking children to see a physician or specialist – a prudent parent would not only look into the professional’s credentials, belief philosophy, availability, but also now available on reputable sites (or even the organization for which the professional works) ratings based upon certain categories such as professionalism and trustworthiness, with supporting comments. If a professional has an antagonistic demeanor, is critical or derisive, seems to have a “God-complex” where they do not like to be questioned, or has been known to say one thing but write or go on record with a completely different viewpoint than that expressed confidentially..those are all valid points of concern that any user should know. It is for the user to compile that information along with other research to determine whether the professional is for them or not. Perhaps the professional should help their clients be aware of possible reviews so that the good is expressed with the bad. Minor things obviously carry less weight than major things, and it is the major things that a user is looking to avoid if possible – especially if it happens more than once. Reviews by peers is a much different animal than review from clients, particularly when you are the client. The professional should perhaps make their clients aware of known reputable review cites they list themselves on so that there is closer to equal chance of positive and negative reviews (if that is truly the case) and accurate reporting.
I could not agree more. I have had some awful therapists. I don’t mean style or personality differences. I mean downright rude and unprofessional. I have found someone worthwhile but I had to go through 6 bad ones. I was shown no compassion, put down, had phone calls and texts constantly interrupt my time, told im a victim. I am a late stage cancer survivor and was severely abused as a child. Um, yes, I guess so. Shamed and put down. There should be a law aganist this type of abuse.
Personally, I’m quite disgusted.
Sorry about that TPG… Sometimes something will caught in our spam filter. If you let us know w/in 24 hours, we can usually retrieve it.
b…. I think you’re missing the primary concern here being expressed by professionals — one of patient confidentiality and fairness. What happens when a patient posts a review to one of these services and then wants it deleted 2 years later for privacy reasons? Will all caches also be deleted (since so many reviews are now being cached and saved by Google and others)?
I don’t know, I’m more conflicted on the issue. I think most professions are pretty easy to rate. The plumber came on time, did the work he said he was going to do, didn’t leave a mess, and charge a price similar to the estimate. My accountant did my taxes, got me a refund and I didn’t get audited. My lawyer tried my case in a competent and thoughtful manner, did her research, and seemed to do the best job possible.
But with therapy, where do you begin? Are the review sites asking the right questions? Do they compare therapists who do short-term CBT with psychoanalysts? Do they differentiate between a therapist working in a day program with chronically mentally ill versus those working with the “worried well”? (And should we care if a therapist works exclusively with the most severely mentally ill versus a therapist who only works with mild mental illness? Can you measure that?)
Do the review sites ask if the patient had a written treatment plan with short-term goals? Do they ask if the therapist was empathetic to your concerns, or if the therapist had a strong theoretical basis for their interventions (or were they just ‘winging it’)?
I’m all for such review sites if these kinds of concerns can be addressed adequately. But the current state of doctor review sites is, quite frankly, just a mess.
No, I don’t think I’m missing the point.
You’re arguing that your primary concern is for patient confidentiality and fairness?
How is patient confidentiality served by requiring that patients reveal information regarding “duration of their treatment, what they sought care for, how long they have had their particular health concern and whether they addressed any complaints with the care provider. In addition, it would be useful to know how many other practitioners they sought treatment from, and whether they eventually found successful treatment elsewhere.â€
Your proposed solution requires a massive violation of patient confidentiality. So it is inconsistent to argue that patient confidentiality is one of your chief concerns.
We all know that there are many inept therapists out there, and that falling asleep in session is not the only sign of a poor therapist.
I would argue that restrictions on patient reviews of therapists is a poor idea (as well as unworkable.) Yes, therapists may get the occasional unfair review. So do hairdressers, garage mechanic, and restaurants. Welcome to the real world!
I would argue that a better solution is more information and more education. Perhaps the review sites could include warnings that all reviews must be taken with a grain of salt. (But I think we know that already.)
And I would also argue that therapists should be required to make available information about themselves, such as: training, years in practice, employment history, reasons for leaving various agencies/practices, what is the average length of time that your patients stay with you, what percent of your patients drop out prematurely, how do you define success with your patients and with how many of your patients have you achieved success.
Such information would be very useful for patients in helping patients to choose a therapist.
So, patients post on review sites as they see fit. Potential patients could read these reviews. Then they could use information/metrics re: therapist performance to more fully evaluate the reviews, and make a more educated choice of therapist.
I think that would address your stated concerns.
b………. I agree with your suggestions as well, but don’t think that asking a reviewer how long they’ve been in treatment or sought treatment from other providers violates their privacy or confidentiality (I guess we’re assuming people don’t use their real name for these reviews), since none of it is personally-identifiable information.
Knowing I’ve been in treatment for 10 years and sought treatment from 5 other providers before finding one that worked for me doesn’t really tell you much about me individually, does it?
In terms of professionals making more information about themselves, their type of practice, training, experience, etc. — I’m all for it!!
While this all this provokes thought, it should be remembered that no one reading reviews on therapist or doctors knows what is going on the patient that wrote it. It becomes to easily for a patient with lets say an addiction to write a terrible review of a provider stating that they were inconsiderate of the their anxiety or pain and refused to treat them psychiatrically/medically correct (ie- not prescribing narcotics or benzodiazepines.) When in reality the provider is often saving the patient from themselves. They are attempting to get to the root of the patient’s problem and work through the addictions while the patient is only doctor shopping and is angry at the suggestion of delving into the emotional or physical pain. The prescriber in his/her attempt to give the patient the care they so desperately need has to perform this without continuing the addiction that is destroying the health of the patient from long term prescription drug use. Once the review has been written a care provider cannot write a response to a patient’s claim as any information would be consider a violation of privacy under the HIPPA laws. But with no response there is no balance of truth or accuracy which renders the review useless to readers (though my people believe it to be accurate to some degree.) Especially in psychiatry patients come with expectations to fit their emotional needs. If a patients yearns to have been understood and loved by her mother she may very well seek out a therapist that she feels is emotionally huggy and not too demanding (in her eyes) because the perceived demanding is too reminiscent of mama’s rejection. Does that make the therapist a poor therapist? No, because her husband might find that therapist to be a perfect fit for his more calculated way of dealing with his emotional traumas. Reviews of the therapist will never be able to be objectively rated by their patient’s because the science of psychology is based on each patient’s perception of themselves, their experiences, and their feelings and everyone is different. All those qualifiers (feelings, experiences, self perception) for the rating system would have to be the same for every reviewer. It is comparative to reviewing apples to oranges to watermelons and so on, everyone is an individual and reviewers will never all come from the same baseline.
At the point I am in my life , I know what a good therapist is, and is not. I saw the comment from someone who wrote ” what about the ​”​narcissist​s borderlines” etc…I think people reading a review would be able to tell if something felt off to them. I also want to say that people who have dysfunction also count. You may be paranoid but could still be on someones hit list.
I have been in therapy a few times in my life. Once due to a death, and the last time depression. In my mid-twenties I saw a therapist because I was in a very short marriage that I knew wasn’t right for me. My then husband felt I needed therapy. Even after I divorced I stay​ed​ in therapy for a number of years.
My therapist I see ​, ​is still in practice. That’s sad. She said I was borderline, narcissistic, bi-polar, ​and ​had personality disorder…. yes, all of them.
I dated someone after my divorce. She took him on as a client too. She also took on his then best friend.​
I inherently felt that this was not a good situation and said that to her. Isn’t this conflict of interest? She was not a shy person, and said, no, not at all. ​
​I ended up ​breaking up with him. He was heartbroken about it, and I was too. I just didn’t show it the same way. . She made no attempt to disguise her feelings of disgust with me at my narcissist behavior.
When he had a car accident that I was unaware of, I must have brought him up in session​ and she took the opportunity to inform me. ​
She said in a heavy sarcasm laced voice ” well, x wouldn’t know about that, he just had a very serious car accident where his car was totaled”. I was stunned, shocked, scared.
That was exactly the outcome she wanted. In group therapy I was always “it”. On the hot seat.​ The women in group would put their heads down because even they noticed how obvious she was about her opinions of me.
​ She did this privately as well. I absolutely knew she disliked me. I felt I deserved it. Any job I got she told me I would fail at.
So, here i am. 30 so years later. I have had my own business for 20 years. Very successful, it was my passion, and I ran it from home, while I raised my little boy.
Ive been married 21 years as well. I was never diagnosed subsequently for all of those things, It turns out that I have ADD and Bi-​p​olar 11 which is a much milder form of bi-polerism. My mood swings up and down during a day. I don’t go into a manic period or a deep depressive period. Its like being in a really great mood for an hour then a really bad one. I take one pill and I’ve never looked back. I take nothing for the ADD. I just live with it.
Had I never gone to anyone else, I would have spent my life with this awful therapist’s view of who I am.
— Dina D.
Awesome idea.
Dr. Grohol is absolutely correct in asserting both that therapist review sites would be valuable to the public and in cautioning that to provide useful information the site would have to account for the unique aspects of the therapy situation.
Therapist review sites are especially important because according to recent studies, very few patients feel comfortable expressing complaints to their therapist. Instead, when they encounter significant dissatisfactions they simply drop out.
If a review site could capture complex information such as reasons for termination (for example by providing choices such as: Not-A-Good-Match vs. Didn’t-Like-Their-Approach vs. Didn’t-Feel-Heard’ vs. Wasn’t-Making-Progress) it could benefit both the public and the therapist who could learn from the feedback.
Lastly, as Dr. Grohol states, to be valid, the site would have to draw numerous ratings for each therapist-and that might be the biggest challenge of all.
Guy Winch Ph.D.
Author: The Squeaky Wheel (reviewed on this site)
Many years ago, before I became a psychotherapist, my family went to a psychologist that we absolutely hated. We didn’t feel understood by him, and his manner turned us off. A while later I bumper into a friend who said that she was feeling marvelous thanks to a wonderful therapist who helped her turn her life around. It was the same man!
I would have given him a very negative review and she a positive one. Unless there are criteria for writing the review, let the reader beware!
Gloria Arenson MFT
Where I am I assigned my psychiatrist through the healthcare system- so ranking and choosing is not part of the equation (however I also don’t pay anything).
However, on principle I don’t think asking people to provide all the information noted in the article (ie what you were treated for, for how long, etc, etc.) is appropriate as it could be enough, along with comments to make the person identifiable (at least to the therapist) which is not in line with protecting that person’s identity. It also makes it seem like the person contributing’s worth is being examined.
The reviews of doctors, of professors, etc. are always a very mixed bag, people who are upset are more likely to review, etc. They need to be taken for what they are, rather than a scientific and unbiased assessment of service.
Let me try to reconstruct my earlier comment.
With all due respect to Dr. Kolmes, whom I respect a lot and who knows a great deal about the intersection of psychotherapy and the Internet, I frankly don’t see the problem.
Or maybe it’s better to say, I do see the problem, and I don’t think there’s anything that ought to be done about it.
The fact is, everyone who’s in a business or produces a product where that business, skill, or product can be reviewed believes that there should be special criteria for that review, because without particular specificity, that review could be subject to misinterpretation or worse.
An author believes that every Amazon book review should state whether the reviewer read the book, whether the reviewer had background in the area, whether the reviewer read it quickly or slowly, etc. Every restaurant believes that reviewers aren’t sampling enough dishes, or are coming at an absurdly busy time. Every doctor believes that reviews ought to carry the kind of specificity that Kolmes aspires to for psychotherapy.
Everyone is right, of course. And also, everyone is wrong. To botch the Orwell, everyone is special, and no one is more special than others. Which means that good should not be sacrificed on the altar of perfect.
What’s particularly interesting about Yelp as a review destination is that it is a community. If one has a question about a Yelp review, one can simply query the reviewer, and engage in a dialogue if the reviewer is willing. Therefore, you can always get more information. If the reviewer is not willing to provide that information, then that makes the review less valuable.
Incidentally, Yelp holds itself up to the same scrutiny that it subjects others on its own website. You can literally post Yelp reviews of Yelp. For the San Francisco location of Yelp? Yelpists only give Yelp 3.5 stars, overall.
http://www.yelp.com/biz/yelp-san-francisco
Yelp also makes it clear what the general range of reviews are like, and it doesn’t seem in practice like there’s a negative shift like Dr. Grohol posited.
In answer to this FAQ — “Yelp seems like a place for consumers to vent about bad experiences. Aren’t most reviews negative?” Yelp has the following response:
“We crunched the numbers, and here’s what we found (as of August 2010). As you can see, the vast majority of reviews range from neutral to positively glowing. Distribution of All Reviews – 32% of all reviews have a rating of 5 stars, while 34% have 4 stars. 17% have 3 stars, 9% have 2, and finally, only 8% have 1 star.”
https://biz.yelp.com/support/common_questions#
Now, there’s a whole other discussion to be had about the issue of anonymous reviews, or of clients relinquishing their anonymity to post. Suffice to say that readers and writers of online reviews are not rookies at this. They know how write and they know to filter, they know how to evaluate, they know how to judge. Just because the subject might be psychotherapy instead of pizza, massage, or fitness instruction doesn’t mean that the reader’s judgment goes out the window.
Probably the closest analogous arena is ratemyprofessors.com, the website where college students do what the website says. And they do it anonymously. Most students I talk to find it a very valuable tool. Is it always accurate? Heck no, I’m sure. But signed reviews of motion pictures that run in major newspapers aren’t always accurate in their assessment either.
It was striking to me that Dr. Kolmes wrote her blog post on the heels of another “World of Psychology” post about Six Reasons You Know It’s Time to Dump Your Therapist (or somesuch!). There were a slew of comments that followed that entry, and many of them mentioned therapist behavior that, while maybe not licensing-board-complaint worthy, certainly would be red flags to anyone who might consider entering into therapy with that therapist.
With Yelp, there’s a place to spread the word. Without it? Not so much, beyond a few friends and family. Yes, maybe one day some site like psychcentral (!) could create the ideal review-your-therapist arena. But in the absence of that, I’m glad Yelp is out there.
I am enjoying reading the discussion and comments here. @TPG I love your point that the “problem” may not be a problem at all. You are undoubtedly correct that everyone who provides some service feels that the nuances of their services get missed in the review process. Excellent point.
You wrote:
>It was striking to me that Dr. Kolmes wrote her blog post on the heels of another “World of Psychology†post about Six Reasons You Know It’s Time to Dump Your Therapist (or somesuch!).<
Here is a bit of background information on the inspiration for my piece. I actually wrote and submitted this Op-Ed in May of 2010. The Times waited almost ten months to publish it.
The initial impetus wast was reading the Times piece about Medical Justice and then reading Jason Schultz's subsequent analysis about it.
http://bit.ly/9v4XdL
I was disturbed to learn about Medical Justice and thought there should be a better answer.
Very pleased that you read through this discussion, Dr. Kolmes, and that my main point resonated.
So here’s my question: You got 125 comments to the NYT op-ed, and another dozen or so here.
Have you changed your opinion at all, having read these comments? Sure, every writer wants to revise and extend their remarks. I have a hard time reading anything I’ve written after it has been published — all I want to do is cringe and mark it up with a red pen! But would you write basically the same piece today?
I don’t see why consumers wouldn’t see therapists as anything else we would rate for how they performed their job, were you satisfied, was there anything that could have been better? Rating 1-5. Just the basics, like shown. I think a doctors, and lawyers and therapists should be able to be rated! You’re the one paying the therapist for his and your time. It’s your money, you want the best!
I like the review sites. I looked up my internal medicine physician on Yelp before I went. She got all good reviews except one and the one negative review was by someone who clearly had unrealistic expectations of a physician. They felt they should be called back immediately and it just doesn’t generally work the way that disgruntled patient felt it should.
Anyway, the one negative review had no impact on my decision to see her, because it was goofy. She’s a good doctor, and I’m happy with her.
I don’t have any problem with people rating therapists either. It’s buyer beware. My previous psychiatrist got a good review from a male patient, but he hit on me and another female patient and landed in front of the medical board, so you just never know about those reviews… I think most people realize that it’s a person’s opinion and not necessarily fact.
I think it makes sense to be able to rate any provider of healthcare services, therapists included. Of course it’s not the same as rating a plumber or an electrician, but properly laid out and worded, it could be a great resource for patients.
This is just an anecdote, but I recently looked up an old psychiatrist on yelp and found something like 80 entries on them, 97% extremely negative. I too had had a very negative experience with this psychiatrist and it had serious repercussions on my life for years. It was extremely validating to read so many other very similar accounts, and the idea that my contribution to the site might discourage even one other person from having their life ruined by that particular psychiatrist was satisfying beyond words.
Dr. Grohol, I have to believe that you are being ingenuous in making your statements regarding sleeping during session. Surely you have to admit that there are many other issues that make for bad therapists beyond a bad fit between client and provider? I’ve certainly encountered quite a few of them in the last 20+ years of treatment.
A therapist who holds some particular worldview particularly dear is seldom impartial enough to be able to avoid framing whatever his patient says through the lens of that worldview. If that worldview, for instance, is conservative Christianity, he will in my experience attempt to impose his religious views on the patient and advise him accordingly. If a therapist holds a deep-seated conviction that men are not to be trusted, then she is likely to frame her client’s experiences with men proof of her own convictions. (I have personally experienced both kinds of bias from therapists, more than once.)
Other therapists have a particular agenda that they intend to follow, whether it is particularly well-suited to what the client needs or wants to work on, and the client can just forget working on anything else with that therapist. This seems to be especially troublesome in publicly funded clinics that impose a certain mandated structure on therapy – therapists there have to check off certain items on forms, more than they have to actually show progress any progress with their patients. When I had to rely on such a clinic for my care, any symptoms that might indicate a diagnosis that would be too involved to deal with in the budgeted number of hours was ignored – the “therapist” (assigned case manager) just refused to make any record of such symptoms, so officially they didn’t exist.
Any of those issues makes for a bad therapist, no matter WHO the person is seeing, and they go beyond sleeping during a session! Knowing who to avoid would help people avoid wasting their time and money.
More importantly, it takes a great deal of emotional energy to start a relationship with a new therapist, and it is so very discouraging when the therapeutic relationship doesn’t work out that many people just stop trying. More good, valid reviews could lead to fewer therapy failures. Surely any proponent of mental health would favor that outcome.
@TPG asks whether I have changed my opinion on my Op-Ed and if I would still write the same piece today?
Basically, yes, I would write the same piece today and make the same arguments. I still want to see better review sites that offer better protections and more information for consumers. And I do not believe it is ethical for providers to muzzle their clients online.
These points were the heart and soul of the piece, in my mind. In my original submission, these arguments were the introduction of the piece which I think made them appear stronger. The Times made a number of edits and revisions for “readability.” (All final edits were approved by me, of course–except for the title and tag line which I didn’t see until publication.)
The health care system provides neither health nor care, especially psych services. If patients want to disparage their “providers”, let them. Providers have systematically participated in a malignant system that is set up to fail and abuse people in vulnerable states.
Let the Yelps fall where they may…
If I want to let the world know about my experience with mental health providers via the internet, it’s my own confidentiality I’m “violating” and I’ll do as I please.
You write that, “a certain treatment might help one person but not another. Something that works for one patient at a particular point in therapy might not work for him later, when his needs change.”
A good therapist can join with his/her patients and connect with them enough that he or she knows when is an appropriate time for specific interventions and is aware of change as it occuring in his/her clients. If a therapist consistently pushes for interventions at inappropriate times, or misses key points of change, and consequently drives away patients with insensitive or ineffective therapy techniques, that’s not a “subjective experience”, that’s just a lousy therapist. If you can’t connect with your clients, you’re not doing your job. And if you’re too much of a (insert word for feline) to stand up to some customer feedback (some of which will occasionally be negative), pick another profession. Everyone other business owner deals with customer reviews — psychotherapy may be a little different, but we aren’t so “special” that we’re exempt from criticism or complaint. Get over it guys. Sorry to be so harsh, but geez…
I agree. Too many therapists are overly defensive and the industry is set up in such a way as to protect the reputations of some very, very bad therapists. The advice to “seek therapy” as a way to solve problems is given to glibly. The truth is, that all too often, “therapy” does more harm than good. I was literally verbally abused by one- he swore at me, interrupted me, tried to tell me who I am, what my motives are, what to think, what to feel, and then would tell me that I’m too “Sensitive” if I tried to explain myself rationally. It was devastating and crazymaking. I cannot for the life of me see how this would help another client/consumer. If I can post a review on yelp to shine a light on the abusive practices my “therapist” took part in, I might end up helping a lot of people. To do anything less would be irresponsible on my part.
Unfortunately, I have talked to another therapist that told me that my situation is all too common. Many therapists enter the profession because they are “wounded” and are very unaware of the negative impact they have on unsuspecting clients. Psychotherapists, as a community, need to wake up, stop hiding behind their textbooks, and call their colleagues out on their poor behavior. Doctors do this regularly, I don’t understand why therapists are so defensive.
Dr. Kolmes’ NY Times piece is an unfortunate, living sample of the reason consumers mightily need outlets like Yelp to criticize the psychotherapy profession. The author unknowingly duplicates the same fears and rationalizing that therapists harbor within the dark privacy of consulting rooms. The implication appears that therapy’s “specialness†invalidates feedback, or that clients’ “upsetting emotions†are unlikely to be reality-based.The Times article extends the myth-making that therapy is some unfathomable anointment beyond the comprehension of the unordained consumer. (Though paradoxically, the article inadvertently does expose the woeful lack of any real yardstick for measuring therapy’s success.) The author’s example “falling asleep†as the sole example of professional misconduct is an almost laughable straw man.If a consumers exit treatment so powerless and defensive that they’re moved to “vent†on a website, isn’t that testimony in itself? Where do consumers turn after their prideful therapists nullify feedback, or worse, turn negative responses into weaponry against them? (If you don’t think it’s common, read some consumer chat boards.) Official licensing boards only rarely find for the consumer.Dr. Grohol’s commentary sets up straw men as well. NO review site, be it travel, restaurant, or bookseller has any scientific presentation, nor does they pretend this. Even when opinions are plentiful, the consumers hold the responsibility of evaluating which rants and raves might be relevant, as they do ANY information on the internet, including this page.Unfortunately, therapists can be the last to realize that they harm clients or far oversell their benefits, as evidenced by the dearth of professional material on this subject. If consumers approached the relationship as consumers rather than the acolytes beseeching wisdom from oracles, the whole power imbalance might start to become healthier. Sites such as Yelp just might inject sorely needed accountability into the relationship.
I have gotten good information on Drs. – and therapists only from friends, and even then,I had to learn which friends’ judgments were of any value to me. In short, very spiteful things get said on the internet, and people have a right to say them, but they aren’t too helpful. An example that involved not a therapist, but a veterinarian: A horridly disparaging review appeared,perhaps on Yelp,attacking the vet’s skills and personality. Fortunately, a handful of other “patients” saw it [me included] and posted their own completely different positive opinions.
It does seem that there should be a forum that works, but the poison that is set out because that’s how someone “feels” is upsetting to me. I have myself seen therapists who did not work out for me -and in retrospect, would have welcomed more information about their methods ahead of time, but even tho’ I was disappointed in my own results, I wouldn’t resort to attacks. I sometimes fear that there’s a kind of junior high mentality about these reviews,
I’m unsurprised to see what some might call a “junior high mentality” in an internet review of therapy. These reviews reflect what too often happens in the therapy. Practitioners can be quite childish, needing their magical-thinking role play and creating an infantilized relationship with clients. What some might label a “junior high mentality” is in fact, anger and powerless. Heaping this atop of the client’s original problems is indeed a heavy load.
Thank you. Yes, this is exactly what happened to me. So far I have not spoken out, because the therapist had me doubting my own perceptions. It was literally verbal abuse that I experienced. But I don’t post a review, because who is going to believe that such a “nice guy” would do such a thing? It bothers me that this article discourages people like myself from posting a well-thought out review, one that could possibly help a number of people.
Laura Pembrook – Arlington Heights Il. I went there one time waited 45 minutes, and she talked about herself. I’ve never met a more selfish person,
John W. Howard Layton, Utah L.C.S.W.
Talk about the worst experience one could have. This guy crossed so many boundaries it left me dizzy. Totally focused on his own gratification. Should not be allowed to work with any woman. Is a sexual deviant, and I ended up having him reported to D.O.P.L. and they gave him a reprimand with several ethical violations. He actually asks the patient to solve his own problems. Has too many issues in his own life to resolve, and will talk about those and have you help him. He should not be allowed to practice therapy. He is going to ruin too many lives.
Excellent discussion in these comments.
I was immediately struck by the “too special” argument in the article. I’ve come across it before. Therapy is “too special” for yelp reviews or for rigorous research into its effectiveness. It’s too special even for the clients who pay for and experience the therapy to judge it. So where is the accountability?
Really sorry I was late to this party, but I’m in total agreement with those who think therapists are above reviews, or somesuch.
I saw a woman who would pretty much make herself your best friend, while fabricating things she didn’t even need to fabricate (“I was in my kitchen last night and thought about you” –“I was in an area with no reception so never got your text” [this was a favorite of hers])
She was also ALL about the money –you know the kind: their hand out while they cut your session short by that extra “few minutes”, then give you the “we’ll talk about that next time”? –“next time” only turning into yet another “next time”.
When I tried to stop seeing her, she’d made up some cockamamie story about having to have a “termination session”, which I had cancelled (well within the cancellation period) –and yet, I was still charged for this session I’d cancelled because I was required to attend in order to stop therapy with her.
I didn’t pay it –nor will I and it’s been nearly a year.
I’ve had enough therapy and have seen enough therapists in my lifetime to concur with the moniker of the previous poster to mine.
This article does raise an important point – having few reviews isn’t great and often patients can’t be helped until they help themselves, even if they voluntarily go into therapy. But detailed reviews with sensible protection might be better.
However it’s still not simple. This isn’t the only problem with therapy – some therapists at times assume that patient got issues with therapist = patient wants therapist to help them rather than they help themselves. But the reality is that on top of cases where patients didn’t try help themselves there’s many cases where therapists harm by being sloppy and stupid. Many therapists friends I know complain about this issue and the people that defend this.
Harsh to name him but Andrew Culliss in SW London was dreadful – using scorn as a weapon to face pain is a nice theory, indeed could work if under control, but frankly he had no clue. He was manipulative, I couldn’t trust him and he got so lost in his tirades he started telling me what I think and often got things factually wrong – thing is I started questioning was he pointing at stuff deep inside I was unaware of? But we’re not talking about subconscious thoughts – he explicitly told me to my face I didn’t really know my superconscious thoughts. Crass and inaccurate would sum him up.
My next therapist did ask me to work through the issues I had stewing in me from dealing with him – best thing about it was she didn’t pick sides, challenged me and listened like he never could. This was good as she appreciated that I had learnt to pick out some of the “harsh but true” comments from the “harsh and wrong”. Indeed she was confrontational, but had no time for being aggressive. Ultimately her conclusion was that he sounded like “not a very good therapist”. With her we worked for 1 year and it went very well.
Dr. Grohol, thank you, thank you, thank you for writing that article! I am a therapist who gets great results (I actually measure) with the vast majority of my patients. But I also market heavily online and I don’t shy away from treating personality disorders. I have an honest, but loving style that most clients find refreshing, enjoy, and make progress with. BUT, it makes me more vulnerable to online retaliation. And let’s face, that’s what it is. It’s not feedback. I welcome feedback. I even have a feedback button on my website! Your article raises an very good point that I hadn’t considered before: we don’t have a review website specifically for therapists. So, let’s start one. Call me if you want to collaborate on this! I would live to contribute. Let’s solve our own problem!Our colleagues and clients will thank us!
There’s another reason why therapists don’t have many ratings online, and that’s that they actively have them removed. When trying to complain about a counseling center I went to, I at first thought I’d just write a review and then people would be able to see it. Instead, I got notes from Yelp telling me it ‘wasnt my actual experience’, ‘privacy concerns’, ‘did not provide enough detail’. This was maddening. Overall Yelp deleted nearly 30 reviews. It’s a very demeaning experience to try to complain about transference issues and they just hide it all. I can see how people get sexually used and silenced in this profession. http://notpowerless.com/reasons-reported-to-yelp-for-removing-reviews-of-samaritan-counseling-center/
I realize this is from 5 years ago, but I am in a search for assistance in this issue. If I can save one person from seeing an awful, sabotaging therapist I saw for over a year by writing a review, it will be worth it. Can you please help?
Yes Momof
I came here very late. Of course it’s worth it. I find it interesting that we rate everything from haircuts to plummers to groomers for our pets, but there is a whole discussion on whether or not we can rate our “therapists”? They should be rated first.
We are putting our psyche into their hands. They are not robots, they are not infallible. They are exactly like you and I with 6 or sometimes less years of school . They may even have less wisdom, less compassion and less ability to relate to people. But they have a paper that says they are some kind of therapist.
I have been in therapy for years at different times. I have been helped tremendously and invaluably . I have been in therapy for years with someone who was so damaging that when I left her I was ten times worse then when I went in. She was so awful, and obvious about her dislike for me that I blocked her completely out of my mind.
I re-connected with someone from that period of my life who mentioned her. At first I had no idea who he was talking about . When I remembered, I literally felt a bolt of sickness , shame , and put my arms around myself and just asked that we cut the conversation off. Yes, write it. dina
It is exactly like reviewing a dentist or car mechanic. Why do therapists always think they are so special? They really are not. It is bad enough that you people are able to hide the truth and keep what you do all cloak and daggery – but really – you don’t do anything but sit there and collect money. quit being so precious.
I was just getting ready to post a comment with that same phrase: “so special.” You all think you are so special! What you do is so special!
What makes this author think that the same general types of problems might not recur in the experience different clients have with the same therapist? What about things like not listening, jumping to conclusions, creating double binds (for no therapeutically justifiable reason, assuming that is even possible)? You’re all so special. What you do is so important. And, of course, each and every one of you is not like those poor quality therapists one sometimes reads about. You are all exceptional in your field. No doubt about it.
I personally knownof a licensed therapist that has slept with an underaged, metally challenged client. I also know that at one time she was usiing cocaine!. I jave even seen that on her business website she has deleted bad reviews. Her business is now co-owned by unsuspecting partners. She is also from the St.Clair shores ares of Detroit.
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