Think twice, and if you do call, say almost nothing.

Most of the discussion about unreturned calls treats it as a business question — am I losing referrals by not calling back? There is a second question underneath it that is not commercial at all. You do not know whose phone that is. A person reaching out about therapy may have called from a partner's handset, a shared family phone, a workplace line, or a phone they borrowed precisely because their own is monitored. Returning that call can put a therapist's name on a screen in front of someone it was never meant for.

The clinicians who raise this are usually the ones working with family violence and child protection, and they raise it bluntly: it is not appropriate, and possibly unsafe, to ring a strange number to ask whether someone wants therapy.

There is a second objection that is quieter and applies to every caller. You do not have permission to contact this person. They rang you; they did not ask you to ring back. Somebody else may answer. It may not be a private moment. Neither of those is a catastrophe, but neither is nothing.

None of this means never call back. It means the callback is a clinical decision with a safer and a less safe way to do it.

What is the actual risk?

Three distinct ones, worth separating because they have different fixes.

Disclosure to a third party. Someone other than the caller answers, or sees the missed call, or sees the name. This is the one practitioners describe as genuinely dangerous rather than merely awkward.

Bad timing. Even with the right person, you have no idea whether they are alone, at work, or in the car with family.

Contacting someone who did not ask. If the number was a wrong number, a spam dialler or a robocall spoofing a local area code — and a lot of them are — you have spent the call on nobody.

Do you have permission to call back at all?

No regulator publishes a rule saying don't return a call from an unknown number. What they publish is the risk it sits inside, and a duty that lands before you say anything identifying.

The psychotherapy College lists, among the risks a client is to be told about, "inadvertent disclosure of client personal health information due to errors in the recipient's email address/phone number" (CRPO Electronic Practice Guideline). A callback to the wrong handset is that risk in its most ordinary form.

The psychology and behaviour analysis College is the most direct about what to do instead. To reduce the chance of someone impersonating a client, "registrants must take steps to verify the identity of the client using some form of coded identification of the client, in cases where visual verification is not possible" (CPBAO Standards of Professional Conduct, Standard 17.3). A phone call is precisely the case where visual verification is not possible. The social work College asks for the same thing when communicating virtually — "verifying the client's identity when it would be possible for another person to pose as the client" (OCSWSSW, Interpretation 5.3.2).

The privacy regulator's virtual-care guidance supplies the practical move: custodians "should verify the recipient's identity and correctly address emails or messages to avoid misdirection," and "one approach is to send a test message in advance and ask for confirmation to ensure the message reaches the intended recipient" (IPC, privacy and security considerations for virtual health care visits).

Read together, that is the whole answer: verify before you disclose, and until you have, treat it as an unknown number rather than as your caller. The practitioners who have thought about this hardest arrive at the same place from the other direction — they treat a missed call with no message as an incomplete request for contact rather than a completed one.

So what do people do instead?

A text rather than a call. This is the most common answer and the most practical one. A text is quieter than a ringing phone, it does not require the person to speak, and it can be deleted. It still lands on the device, so it does not remove the risk — but a short, unremarkable message is far less exposing than a voice on the line asking for someone by name.

Send something that says nothing identifying. No profession, no clinic name, no reference to what they might have called about. Something closer to "Hi — you called this number. If you meant to reach me, reply here or call back when it's a good time." A person who called you will know what it means. A person who did not will read nothing at all into it.

Do not call back at all, and say so up front. Plenty of therapists have a standing policy: no message, no callback, and the voicemail greeting states it along with an email address or booking link. Several describe adding a line saying they do not return calls without a message specifically so nobody is left guessing, and so first contact moves to a channel that does not require phone tag.

Let the greeting do the safety work. If your greeting invites callers to say whether it is safe to call back, and at what times, you have moved the decision to the only person who can actually make it.

If you decide to call

Keep it short and content-free. Give your first name only. Do not name your practice or your profession until you know who you are speaking to. Do not leave a voicemail that identifies you as a therapist unless the caller has already told you it is safe. If someone else answers, you have a wrong number.

Ask, early, whether now is a good time and whether this number is a good number. The answer to the second question is worth writing down.

The honest limitation

Nothing here solves the underlying ambiguity, and no product does either. The information you would need to decide safely — who owns this phone, who else can see it — is exactly the information you cannot have before you make contact.

What can be reduced is how often you are forced to guess. A greeting that asks for a message and a name, an automatic reply that gives the caller a written channel to answer on their own terms, and a written note of which number and which method a person has agreed to, will between them take most callbacks out of the unknown-number category entirely. The residual cases are real, and the right response to those is caution, not a workflow.

About Rivet

Rivet is a Canadian practice line built for therapists — a separate number for calls, texts and voicemail, with video sessions and clinical tools in the same place. Your data stays in Canada, and transcription runs on Rivet's own hardware rather than a third-party AI service.

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