What should I do if a client leaves a negative online review?

This is one of the most challenging situations in modern practice. Under HIPAA, you cannot confirm or deny that the person is your client, which means you cannot respond with clinical details, correct factual inaccuracies about treatment, or even acknowledge the therapeutic relationship. The ethical approach is to respond (if at all) with a generic statement such as: 'I take all feedback seriously. Due to privacy laws, I cannot confirm or discuss whether any individual is a client. If you have concerns about your care, I encourage you to contact me directly.' Alternatively, you may choose not to respond at all. Never respond emotionally or defensively. Consult your malpractice carrier, as many have specific guidance for online review situations.

Can I look up a client on social media?

This is ethically complex and evolving. Searching for a client on social media without their knowledge raises concerns about informed consent, boundaries, and the introduction of extra-therapeutic information into the relationship. If you discover information that changes your clinical picture (e.g., a suicidal post), you must act on it clinically, which reveals that you were monitoring their social media. Some clinicians disclose their policy at intake: either they never search for clients online, or they may search in specific circumstances (such as a welfare check when a client misses sessions and is unreachable). Whatever your approach, document it in your social media policy and discuss it with clients.

Do I need a social media policy if I do not use social media?

Yes. Even if you have zero social media presence, your clients use social media and may attempt to contact you, leave reviews, reference you in posts, or search for you online. A social media policy addresses how you handle these situations. It also protects you if a client posts PHI about their own treatment publicly and then claims you failed to address digital boundaries. The policy is about the therapeutic relationship's intersection with the digital world, not just about your personal social media use.

Can I use client testimonials on my website or social media with their consent?

This is strongly discouraged and prohibited in many jurisdictions. Even with written consent, using client testimonials raises serious ethical concerns. The power differential in the therapeutic relationship means that consent may not be truly voluntary. Testimonials reveal the person's status as a mental health client. Many state licensing boards and the APA Ethics Code prohibit soliciting testimonials from current clients. Some states also prohibit testimonials from former clients. The safest approach is to never use client testimonials in any marketing context.

Social Media Policy for Therapy Practice

Q: Should I accept friend or follow requests from current clients on social media?

No. The vast majority of ethics codes, risk management experts, and professional guidelines recommend against connecting with current clients on personal social media accounts. Accepting a friend request from a client creates a dual relationship, exposes the client's identity as your client to anyone who can see your connections, gives you access to personal information that may complicate the therapeutic relationship, and blurs professional boundaries. If you maintain a professional practice page (such as a Facebook business page or Instagram for your practice), a client following that public page is generally acceptable, as it is no different from visiting your website.

Practice Forms|12 min read|Updated 2026-03-20|Clinically reviewed

What Is a Social Media Policy for Therapy Practice?

A social media policy is a written document that defines how a mental health practice navigates the intersection of the therapeutic relationship and the digital world. It addresses the clinician's approach to social media connections with clients, online searches for client information, response to online reviews, digital communication boundaries, and the use of social media for professional purposes.

The need for a social media policy has grown from an afterthought to an ethical imperative. Clients can find their therapist on Instagram in seconds. They can leave a review on Google before the session's copay clears. They can post about their therapy experience to thousands of followers. They can send a direct message at 2 AM when they are in distress. Each of these scenarios presents ethical, legal, and clinical considerations that clinicians must address proactively.

Professional ethics codes are catching up to the digital reality but remain incomplete. The APA Ethics Code addresses multiple relationships and boundaries but was not written with social media in mind. The NASW Technology Standards provide more specific guidance but cannot anticipate every scenario. State licensing boards are increasingly issuing guidance on social media, but requirements vary. In this evolving landscape, a well-crafted practice-level social media policy fills the gaps and protects both the clinician and the client.

Without a clear policy, clinicians make ad hoc decisions under pressure — accepting a client's friend request in the moment because declining feels rejecting, responding to a negative review in frustration, or discovering a client's suicidal social media post and not knowing how to address it therapeutically. A written policy eliminates the need for improvisation in these situations.

When You Need It

At intake with every new client, as part of your informed consent packet
When a client attempts to connect with you on a social media platform
When a client or former client posts an online review of your practice
When you are deciding whether to create or update professional social media accounts for your practice
When you discover information about a client through social media
When establishing digital communication policies (text, email, messaging apps)

Key Components / What to Include

1. Social Media Connections with Clients

State your policy on accepting or declining friend/follow requests from current and former clients on personal social media platforms (Facebook, Instagram, LinkedIn, Twitter/X, TikTok, etc.). Distinguish between personal accounts and professional/practice pages. Explain the clinical and ethical rationale.

2. Online Searches for Clients

Disclose whether you will or will not search for clients on social media or search engines. If you may search under specific circumstances (such as a safety concern), describe those circumstances and how you will handle information you discover.

3. Digital Communication Boundaries

Define which digital communication methods are acceptable for clinical communications. Many practices permit email or secure messaging for scheduling only, not for clinical content. Address texting, direct messaging on social media, and video messaging.

4. Online Review Policy

Explain how you will handle online reviews — both positive and negative. State that you will not confirm or deny any individual's status as a client in any public forum, consistent with HIPAA. Describe your approach to responding (or not responding) to reviews.

5. Client Social Media Posts About Therapy

Address the possibility that clients may post about their therapy experience on social media. While clients have the right to discuss their own treatment, they should understand the privacy implications — including the permanence of digital content and the risk of inadvertently revealing other clients' information (especially in group therapy settings).

6. Therapist Social Media Presence

If you maintain professional social media accounts, describe the nature of the content you post and the boundaries you maintain. State whether you will follow or interact with clients on professional platforms.

7. Former Client Considerations

Address how the policy applies after therapy ends. Many policies maintain social media boundaries for a specified period after termination (commonly 1-3 years) or indefinitely.

Social Media and Digital Communication Policy

[PRACTICE NAME] SOCIAL MEDIA AND DIGITAL COMMUNICATION POLICY

Therapist: [Clinician Name], [Credentials] Effective Date: January 1, 2026

This policy describes how I handle social media, online interactions, and digital communications as they relate to our therapeutic relationship. Please read this policy carefully and discuss any questions with me.

1. Social Media Connections

I will not accept friend or follow requests from current clients on any personal social media platform, including but not limited to Facebook, Instagram, Twitter/X, Snapchat, TikTok, or LinkedIn.

This is not a personal rejection — it is a professional boundary that protects your privacy and the integrity of our therapeutic relationship. Here is why this boundary matters:

Privacy: Connecting on social media could reveal to others that you are my client, violating your confidentiality.
Boundaries: Social media blurs the line between our professional relationship and a personal one. Accessing each other's personal posts, photos, and opinions introduces information into the therapy that can complicate treatment.
Clinical impact: If I see your social media posts, I may form impressions or learn information outside of our sessions that affects how I understand you clinically — without your knowledge or consent.

Professional practice pages: I maintain a professional page at [platform/URL]. You are welcome to follow this page if you choose, as it is a public page with educational content and practice information. Please be aware that if you interact with posts on my professional page (liking, commenting, sharing), this may be visible to others and could suggest a connection to my practice.

2. Online Searches

I will not search for you on Google, social media, or any other online platform as a general practice. I believe that information relevant to your treatment should come from you, in the context of our sessions.

Exception: If I have a genuine safety concern — for example, if you miss multiple sessions, are unreachable by phone, and I have reason to believe you may be in danger — I may search for publicly available information to assess your safety. If this occurs, I will discuss it with you at the earliest appropriate opportunity.

If you would like me to review specific online content (such as a blog post you have written or a social media exchange that is relevant to our work), you are welcome to bring it into session for us to discuss together.

3. Digital Communications

Email: You may email me at [email address] for scheduling, cancellations, and brief administrative questions. Please do not include clinical content, sensitive personal information, or crisis communications in email. Email is not a secure or confidential communication method despite reasonable precautions.

Text messaging: [Choose one: "I do not communicate with clients via text message" / "You may text me for scheduling purposes only at [number]. Do not use text for clinical content or emergencies."]

Social media direct messages: I do not respond to clinical communications sent via social media direct messages (Instagram DM, Facebook Messenger, etc.). If you contact me this way, I will not respond through that platform and will address it at our next session.

In an emergency: Social media messages, emails, and texts are not monitored continuously and are not appropriate for emergencies. If you are in crisis, please call 988 (Suicide & Crisis Lifeline), go to your nearest emergency room, or call 911.

4. Online Reviews

I value your feedback and welcome it directly — in session, by phone, or in writing to my office. However, I want you to be aware of how online reviews intersect with confidentiality:

If you choose to leave a review of my practice on Google, Yelp, Psychology Today, or any other platform, you are choosing to disclose that you have received services from me. This is your right, but it cannot be undone once posted.
I will not respond to reviews in a way that confirms or denies that the reviewer is my client. Federal privacy law (HIPAA) prohibits me from disclosing your status as a client, even in response to a public review you have posted.
If you post a review and then change your mind, you will need to remove it yourself through the review platform — I cannot remove it on your behalf.
I encourage you to discuss any concerns about our work together directly with me before posting a public review. Many concerns can be resolved through direct conversation.

5. Your Social Media Use and Therapy

You are free to discuss your own therapy experience on social media — it is your experience and your right. However, I want you to consider:

Digital content is permanent. Posts, even when deleted, may be cached, screenshotted, or archived.
If you are in group therapy, do not reference other group members, the group facilitator, or the group's location in any social media post.
If you share specifics about your therapy, future employers, insurance companies, legal adversaries, or others may find it. Consider whether this level of disclosure aligns with your long-term interests.

6. Former Clients

My social media boundaries with former clients are the same as with current clients. I do not accept friend or follow requests from former clients. The therapeutic relationship creates a lasting dynamic that does not fully resolve upon termination. Connecting on social media after therapy ends can:

Complicate a potential return to therapy in the future
Expose previously private information about your treatment
Create a dual relationship that is difficult to undo

This boundary applies indefinitely, not just for a set period after termination.

7. My Professional Social Media Content

I may post educational content about mental health on my professional social media pages. This content is general in nature and is never based on any specific client's situation or treatment. If you see a post that feels relevant to your experience, this is coincidental — I do not create content based on individual client material.

Acknowledgment

I have read and understand this Social Media and Digital Communication Policy. I have had the opportunity to ask questions and discuss any concerns.

Client Signature: _________________________________ Date: __________ Printed Name: _____________________________________

Therapist Signature: ________________________________ Date: __________ [Clinician Name], [Credentials]

This is a sample for educational purposes only — not real patient data.

How to Implement It

Step 1: Include the policy in your intake packet. The social media policy should be provided at the start of treatment, alongside your informed consent and HIPAA notice. Do not wait until a social media issue arises to establish your boundaries.

Step 2: Discuss the policy in the first session. Briefly explain the key points — no friend requests, no clinical content via email/text, and the HIPAA constraints on responding to reviews. This normalizes the boundaries and prevents clients from feeling rejected if you later decline a connection request.

Step 3: Set your own social media privacy settings. Before implementing a client-facing policy, review your own social media accounts. Set personal profiles to private. Remove identifying information from personal accounts that could allow clients to find your personal social media. Consider using different names or separate accounts for personal and professional use.

Step 4: Prepare a response for friend requests. When a client sends a friend request, decline it and address it in your next session. A simple script: "I noticed you sent me a friend request on [platform]. As we discussed at intake, I maintain a boundary of not connecting with clients on social media. This is about protecting your privacy and our work together, not about my personal feelings toward you. I'm glad you feel connected to our work — let's talk about what prompted the request."

Step 5: Monitor your online presence periodically. Search for yourself on Google and major review platforms quarterly. Know what clients see when they search for you. This helps you address issues proactively and maintain awareness of your digital footprint.

Step 6: Consult before responding to negative reviews. If a negative review appears, resist the urge to respond immediately. Consult your malpractice carrier's risk management team. They deal with this frequently and can advise you on the safest approach for your specific situation and state.

Common Mistakes

Having no policy and making ad hoc decisions. Without a written policy, every social media interaction becomes a clinical and ethical judgment call made in the moment. This leads to inconsistency and increases the risk of boundary violations or HIPAA breaches.

Responding to negative reviews with clinical information. Even if a client posts inaccurate claims about their treatment, you cannot correct the record publicly without confirming the therapeutic relationship and disclosing PHI. This is a HIPAA violation, full stop. The impulse to defend yourself is understandable but must be resisted.

Accepting friend requests from "just one" client. Making exceptions to your social media boundary policy undermines the policy entirely. If you connect with one client and decline another, you create a dual standard that is difficult to justify ethically. Apply the policy uniformly.

Ignoring the digital footprint of your own social media. Clients will search for you. If your personal Instagram features photos from parties, political posts, or personal life details, this information enters the therapeutic relationship whether you intend it to or not. Manage your own digital presence as carefully as you manage your office decor.

Failing to address social media in group therapy. Group members connecting on social media creates significant confidentiality risks. Your group therapy agreement and your social media policy should both address this explicitly. A group member who follows another group member and then reveals their participation on social media has breached confidentiality in a way that is very difficult to undo.

Not keeping up with new platforms. Social media evolves constantly. A policy written in 2020 may not address platforms that are popular today. Review and update your social media policy at least annually to ensure it covers the platforms your clients are actually using.

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