Are Your Clients Leaving Too Soon? How to Improve Your Client Retention in Private Practice
By Shannon Heers
Do you sometimes wonder if your clients are dropping out of treatment too soon, as a private practice therapist? Perhaps you wonder why some of your colleagues consistently remain full, with the same clients, month after month and even year after year. And you are struggling with keeping your clients engaged in treatment and coming back to sessions regularly. If so, then this blog is for you.
Retaining your clients in an ethical manner is important for many reasons in therapy. If your clients end therapy prematurely with you, they may not reach their treatment goals or get the maximum benefit from counseling. Client retention is also important in managing your schedule, forecasting your finances, and gaining confidence in your clinical work. Read on to learn some strategies for implementing client retention practices in your clinical work.
Understanding Client Retention
Client retention can be measured using various different metrics. Basically, client retention is the measure of clients returning to see you and continuing counseling with you. In the context of private practice, client retention can be as simple as the total number of sessions that any one client completes with you before they discharge.
Other indicators that you can review that relate to client retention are the number of clients who stay beyond their intake, beyond 4 sessions, and beyond 8 sessions. When clients stay in therapy beyond 8 sessions, they tend to be closer to reaching their treatment goals, have better satisfaction in their treatment, and are able to make some lasting change other than just symptom reduction.
There are many common reasons for early departure in treatment by clients. Here are a few reasons that may not have anything to do with the therapist:
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- Change in payor source (insurance)
- Addition of a family member
- Relationship split
- Vacation, illness, or family leave
- Moving out of the area/state
And, there are some reasons for client drop-out that do involve the therapist. This includes:
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- Poor client-therapist fit
- Lack of progress with treatment goals
- Therapist expertise (or lack of it)
While you cannot control all of the factors that lead to early client termination or drop-out, you can work on the items listed above that you have some control over.
Building Strong Therapeutic Alliance
First and foremost, the most important thing that you as a therapist can do with your client(s) is to build a strong therapeutic relationship. Establishing a deep connection with your client(s) is paramount in almost all theoretical approaches and is often thought of as a basic counseling skill. However “basic” it is for the therapist to work hard at developing the client-therapist relationship, it is still essential to focus on consciously and consistently.
From the very first contact that you have with your client, you want to work on creating a strong connection from the start. This can help set the tone for long-term engagement and clients less likely to ghost you. And ongoing throughout your clinical work, you always want to be thinking first about the relationship and how to deepen it.
How do you create rapport with your clients, both initially and ongoing? You probably already know the importance of active listening, showing empathy, and consistency in your style. But how do you go above and beyond in valuing the relationship development? You might review your intake paperwork to make sure it is client-friendly and trauma-informed. You can offer personalized care in a boutique-style way. Or a myriad of other things you can do to make your clients feel they are cared for in a non-judgmental way.
Setting Clear Goals and Expectations
A primary tactic for keeping engaged clients is to make sure that you collaborate with them to set treatment goals and expectations. Of course, you know the importance of including your client when you are creating their treatment goals. Going beyond this, ensure that you talk with your clients about what to expect with treatment, symptom reduction, deeper relationship healing, and even session frequency.
Regularly reviewing treatment goals and presenting concerns with your clients can actually help both with deepening your therapeutic relationship as well as increasing their investment in the therapy process. Providing both formal and informal progress “updates” to your clients can be incredibly powerful motivators for them to continue to return to treatment.
It is also imperative to have flexibility in changing and updating your clients’ therapy goals as their therapy progresses and clients evolve. If a client comes in initially for one thing but you find out there is an additional, hidden component, you’ll want to incorporate both into your treatment. If you’re able to pivot with your clients’ needs, that gives them additional information that you are on their side and for them to continue with treatment with you.
Improving the Client Experience
Your clients want to have a good customer service experience when they engage in therapy with you. Many things contribute to having a good client experience. First, if you offer in-person therapy, you want to make sure that your environment is a warm and welcoming space where they can feel safe. If you are a telehealth therapist, you’ll want to make sure that your set-up is well-lit, clear, and your background is free of clutter.
Engaging in your own professional development as a therapist directly links with the client experience. Knowing the most effective treatments that are evidence-based for your clients’ particular presenting concerns is essential. No matter if you’re more of a generalist or a highly niched practitioner, you want to be up-to-date on different modalities and interventions. And not just the theoretical knowledge, but also the practical application of this knowledge.
Finally, tailoring your approach to every client(s) that you work with will just add to the client experience. Pulling from different techniques and theoretical approaches, based on your clients’ unique needs, is much better than a one-size-fits-all approach. You have the power to develop and implement all of these things to create a better client experience, and thus improve your client retention, in your practice.
Encouraging Commitment and Engagement
How can you as a therapist motivate your clients to return to therapy, week after week? First, you want to educate your clients about the therapy process in general. What do you talk about in sessions? How should the client prepare for the sessions? And why is it important to remain engaged in therapy rather than just have a one-off session? These questions are great to answer in your initial session with clients.
If you are more of a skills-based therapist, you may assign homework in between sessions. Combining self-help strategies with more therapeutic exercises, you can help your clients build skills to manage their symptoms. Encouraging activities outside of therapy sessions helps with self-growth and reinforces progress made within the sessions.
It is also important to instill hope in your clients that things can change, that they can change. Remember to celebrate the small victories, celebrate milestones, and recognize client progress and achievements. There may not be anyone else in their lives that does this, so you as a therapist may play a crucial role in your clients’ lives.
Client retention in your practice is important for many reasons, and the better therapist you are, the more you’ll be able to retain clients so they can get the most out of their treatment with you. It is possible to have an impact on your clients’ motivation for treatment. Building strong therapeutic alliances, setting clear goals and expectations, improving the client experience and encouraging commitment and engagement will all play a role in elevating your client retention.
How we can help
If you are interested in hearing more about Client Retention, check out our Client Retention Training, available for group practices or teams within agencies. Contact us today to learn more about this training experience that can impact client outcomes and your financial bottom line!
Author Bio
Shannon Heers is a psychotherapist, approved clinical supervisor, guest blogger, and the owner of a group psychotherapy practice in the Denver area. Shannon helps adults in professional careers manage anxiety, depression, work-life balance, and grief and loss. Follow Firelight Supervision on Instagram and Facebook.
