What a Conversation with TheraSaaS's Brent Stutzman Taught Me About Google Reviews (And Why We Need to Talk About This More)
By Kate Fish, LMFT, PMH-C | Kate Fish Consulting
I love a good conversation that starts in one place and ends somewhere you didn't expect.
Recently, I had the pleasure of connecting with Brent Stutzman, the owner of TheraSaaS, and what began as a broader conversation about practice operations turned into a genuinely engaging deep dive on a topic I find myself returning to again and again: the ethics of Google reviews in behavioral health.
It's one of those subjects that sounds straightforward on the surface — of course we want good reviews, of course we want potential clients to find us — until you sit with it for a few minutes as a licensed clinician and realize the ground is far more complicated than it looks.
"Can't I Just Ask My Clients?"
This is the question at the heart of it, and the honest answer is: for most of us, no.
Brent and I talked through the reality that we operate in a review economy. People Google everything. A practice with 47 reviews and a 4.9 rating is going to get the call before the one with 3 reviews and no photos. That's just how it works now. And when our colleagues in coaching, fitness, or wellness can freely ask their clients to leave reviews, it can feel deeply frustrating to be sitting on the sidelines with our hands tied by ethics codes we chose to uphold.
But those constraints exist for real reasons — and walking through them out loud with someone like Brent, who understands both the business and the clinical side of practice, made them feel less like a cage and more like a framework worth honoring.
What Our Ethics Codes Actually Say
Here's the landscape as it currently stands across the major counseling and mental health organizations:
ACA (American Counseling Association) holds one of the broadest positions: counselors cannot solicit testimonials from current or former clients, or anyone who may be vulnerable to undue influence. If you're a licensed counselor, former clients aren't a workaround.
NASW (National Association of Social Workers) prohibits soliciting testimonial endorsements from current clients or those in circumstances that make them vulnerable — and importantly, this includes using a prior statement a client made as a testimonial without their explicit consent. The act of solicitation is the problem, not just the ask.
AAMFT (American Association for Marriage and Family Therapy) frames this through the lens of exploitation and undue influence. MFTs cannot solicit from current clients or those who may be vulnerable — though the code has historically been less explicit than ACA on former clients.
APA (American Psychological Association) mirrors the language closely: no soliciting from current therapy clients or those vulnerable to undue influence.
NBCC (National Board for Certified Counselors) goes the furthest with specificity, explicitly prohibiting solicitation from current clients, their families, and close friends — and establishing a two-year waiting period after termination before former clients are considered fair territory.
The outlier worth noting: the American Psychiatric Association takes a more permissive stance, opining that indirect solicitation is acceptable as long as the same invitation is extended to all patients without coercion and no one is directly asked. That's a meaningful distinction from the other codes.
The Problem That's Specific to Google
One thing Brent and I landed on that I think gets underappreciated: Google reviews carry a HIPAA dimension that other testimonials don't.
When a client leaves a Google review, they're publicly disclosing that they are — or were — in treatment with you. That's protected health information. Even if the review says nothing clinical, the act of a named person associating themselves with your practice is a disclosure.
And here's the part that really ties our hands: responding to reviews. Even saying "thank you so much, it was a privilege to work with you" in response to a glowing review can constitute a HIPAA violation — because it confirms that the reviewer was your client.
Here's the thing though — silence isn't really an option either. Responding to Google reviews matters for two concrete reasons: potential clients and referral sources are watching to see if you're engaged and responsive, and Google's algorithm rewards activity on your business profile. A practice that never responds looks abandoned. So we need a middle path.
The answer is a response that neither confirms nor denies any clinical relationship. Here's a template that works:
"Thank you so much for taking the time to share your experience. We are committed to providing a welcoming, high-quality environment for everyone who walks through our doors, and feedback like this means a great deal to our team. If you'd ever like to connect further, please don't hesitate to reach out."
A few things to notice about that script: it thanks the reviewer without acknowledging who they are, it speaks to the practice generally rather than the individual, and it doesn't reference treatment, therapy, or any clinical relationship. You can adapt the warmth and wording — just make sure you're never saying anything that would confirm or deny that the person leaving the review was your client.
The same principle applies to negative reviews. Resist the urge to explain, defend, or clarify — even vague clarifications can inadvertently confirm a clinical relationship. A grounded, neutral response focused on your practice's values is almost always the right move:
"We take all feedback seriously and are committed to continuously improving the care and experience we provide. If you'd like to discuss your concerns directly, we welcome you to contact our office."
The safest approach is a consistent, templated response applied to every review — positive or negative — so that no single reply reveals anything by contrast.
So What Can We Do?
This is where the conversation got energizing rather than just cautionary. Because there's quite a bit of ground that's ethically clear:
Colleagues, referral partners, and supervisors can absolutely leave Google reviews. They can speak to your professionalism, your clinical approach, your responsiveness as a collaborator. That's fair game — and it's meaningful.
Making it easy for people outside the clinical relationship to find your review profile matters. A link in your email signature, a button on your website footer — these are invitations without coercion.
Unsolicited reviews from former clients aren't something you're obligated to remove or discourage. The ethics issue is solicitation — the ask. If someone chooses on their own to leave a review, that's a different ethical situation.
Internal satisfaction tools — anonymous surveys that stay internal and are never used for marketing purposes — are still a valuable way to gather feedback and improve your practice, even if you can't publish the results.
Why This Conversation Matters for Group Practice Owners
If you lead a group practice, this isn't just your concern — it's your whole team's concern.
Clinicians on your roster may not know these distinctions. They may be asking clients for reviews right now, with the best intentions and no awareness that it's an ethics violation. As the practice owner, your informed consent documents, your team culture, and your offboarding processes all play a role in how this issue plays out across your practice.
It's worth having the conversation explicitly — not as a gotcha, but as part of building a culture where ethical marketing and client protection go hand in hand.
A Note on Brent and TheraSaaS
What I appreciate about Brent is that he brings a thoughtful operational lens to the business of running a practice — and he's not afraid to sit with the complexity of what it means to do this work well, not just efficiently. Our conversation was one of those that left me with more to think about, more to share, and a renewed appreciation for the people in this space who are genuinely trying to do right by clinicians and clients alike.
If you're not familiar with TheraSaaS, it's worth a look — especially if you're thinking about the systems and infrastructure side of running a sustainable group practice. You can check it out here: TheraSaaS
Transparency note: The link above is a referral link, which means I may receive a benefit if you choose to sign up. I only share tools and resources I genuinely believe in and would recommend regardless — and this is one of them. As always, my recommendations are rooted in what I think will actually serve you and your practice well.
The Bottom Line
Google reviews are not off the table. But the path to them is narrower than most of us realize — and the risks of getting it wrong extend beyond an ethics complaint into real harm to real clients.
The framework I keep coming back to: build your reputation through relationships, not ratings. Referrals, community presence, quality clinical work, and a team that feels supported — that's the foundation. Reviews can sit on top of it. But they can't replace it, and they can't be built on the backs of the people who trusted us with their care.
More conversations like this one with Brent are exactly what our field needs.
Free Google Review Request Template
Building your Google presence as a therapist can be challenging when ethical guidelines prevent us from requesting client reviews.
This free template provides a simple, professional way to ask referral partners and trusted colleagues to share their experience working with your practice.
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