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