When you search for almost any service online, restaurants, dentists, personal trainers, reviews and testimonials are everywhere. They’ve become a primary way that consumers decide where to spend their money. But if you’ve looked up a psychologist, clinical counselor, or clinical social worker,  you may notice something different: reputable therapists rarely post client testimonials on their websites or professional profiles. This is not an oversight; it’s an ethical requirement.

The professional codes of ethics that guide psychotherapy, such as the American Psychological Association (APA) Ethics Code, the National Association of Social Workers (NASW) Code of Ethics, and the American Counseling Association (ACA) Code of Ethics, explicitly restrict or prohibit the use of client testimonials in marketing. These rules are in place for several important reasons.

Power Dynamics and Coercion

The therapist–client relationship is built on trust and a clear power differential. Clients come to therapy in vulnerable states, seeking support for deeply personal struggles. Because of this imbalance, any request for a testimonial could feel coercive, even if it is framed as voluntary. A client may fear that saying “no” could damage the therapeutic relationship or that their therapist’s perception of them might change.

Even subtle pressure can compromise a client’s autonomy. Ethical guidelines therefore bar therapists from putting clients in the position of having to “endorse” the person responsible for their care.

Confidentiality and Privacy

Another major concern is confidentiality. Even if a client were willing to write a glowing review, doing so publicly discloses that they are in therapy, a fact that is protected health information under HIPAA. Posting a testimonial could unintentionally reveal sensitive personal details, even something as simple as their name alongside the acknowledgment that they are in treatment.

Because protecting confidentiality is foundational to psychotherapy, soliciting testimonials poses too high a risk of breaching privacy.

Accuracy and Misrepresentation

Testimonials also create the risk of misrepresentation. Therapy outcomes vary widely depending on the individual, the presenting concerns, and the therapeutic relationship. A testimonial that describes “life-changing results” could create unrealistic expectations for future clients, misleading them into thinking they will achieve the same results.

Ethical codes require therapists to present their services accurately and avoid false or misleading claims. Testimonials, especially those curated selectively, undermine this responsibility.

Boundary Integrity

Therapists are expected to maintain clear professional boundaries. Asking for a testimonial blurs these boundaries by shifting the therapeutic relationship into a transactional one. It asks the client to do something “for” the therapist, which conflicts with the principle that therapy is entirely for the benefit of the client.

How Can You Tell if a Therapist is Good Without Reviews?

If therapists cannot solicit testimonials and reviews are therefore unreliable, how can you evaluate whether a therapist is right for you? Here are some practical guidelines:

• Credentials and Licensure: Verify that the therapist is licensed in your state. Licensing ensures a baseline of education, supervised training, and adherence to ethical standards.
  
• Specialization: Look for experience with your specific concerns (e.g., trauma, anxiety, couples therapy). Many therapists list their areas of expertise on professional profiles.
  
• Professional Memberships: Membership in organizations such as APA, NASW, or ACA signals commitment to ongoing ethical and professional standards.
  
• Consultation Call: Most therapists offer a brief phone or video consultation. Use this to get a sense of their style, how comfortable you feel speaking with them, and how they approach your concerns.
  
• Referrals from Professionals: Recommendations from trusted physicians or other healthcare providers can be more reliable than online reviews. Psychology Today is an online directory where you can search for therapists. The ‘endorsements’ shown there are written by other therapists as a professional nod of confidence, not as client reviews.
  
• Your Own Experience: Perhaps most importantly, pay attention to how you feel in the first few sessions. Do you feel heard, respected, and understood? The therapeutic alliance, the quality of the relationship between you and your therapist, is the single strongest predictor of positive outcomes in therapy.
  

The prohibition on soliciting testimonials isn’t about secrecy, it’s about protecting clients and ensuring that therapy remains a safe, private, and client-centered space. While it may feel unusual in today’s review-driven culture, these restrictions reflect the values of integrity, confidentiality, and respect that define ethical psychotherapy.