Client Retention 101: 4 Tips for Keeping Your Clients Engaged in Therapy
By Chris Campassi
As a therapist, are you having trouble building your caseload of clients? Or maybe you are doing well with getting clients scheduled for intakes but struggling to retain clients over time? Are you noticing clients dropping off your calendar, or not following up to reschedule?
I know that marketing and building a solid client base can be very challenging, especially in private practice. Most clinicians focus on strategies for getting clients in the door, but equally important to maintaining a solid caseload over time is working on strategies to keep clients engaged and consistent.
In doing so, you can develop stronger relationships with clients, deepen your work with them, and help them commit to being fully engaged in therapy. In these ways, your clients can get the most out of the work you are doing together. Read on below for 4 tips to improve client retention.
Build a Relationship, Not Just Rapport
This might sound like semantics, but I do believe there is a stark difference between building rapport and building a lasting relationship with your clients. Of course, we can all agree that at minimum, establishing rapport is an integral part of working with the client. In doing so, the client begins to feel more comfortable in the relationship, and will naturally feel more comfortable sharing at a deeper level and working on issues that are more difficult to talk about.
Building a relationship, however, is much deeper than just rapport. I think of rapport as enough to get the client comfortable, but at times not enough to truly trust the therapist. As you build strong relationships with your client, they not only trust that you can help them, but they feel like you actually KNOW them. That you respect their culture and value systems and understand the full dynamics of their past and present struggles. Only then are your clients able to challenge themselves to address issues that they have avoided.
In building a relationship, you can often see a client’s blind spot or defense mechanism showing before they are able to. Also, they can listen to your feedback without feeling judged. Another benefit of building a sound relationship is that you can work with that client for life, if they so choose. We often think about therapy in episodes of care, with a clear start date and a clear termination at some point.
However, in building strong relationships with your clients, they are likely to come back to YOU when they are in need, rather than seeking out another therapist that does not know them. I tell every client I work with that I hope to build a relationship with them so that they can use therapy in a way that is most helpful to them. I want them to know that I am always a phone call or text away from scheduling an appointment with them if they need it.
Cultivate Professionalism
Being a professional is another indicator of client retention. In addition to trusting the therapist as a person, clients want to feel confident that their therapist is responsive and reliable. Ensuring that you are on time to appointments, communicate any changes, and following up on any of their concerns instills a sense of confidence that is important to most clients.
When a client feels that the therapist is unreliable or unresponsive, they may develop a sense of suspicion or distrust about the therapist as a whole. Then they may be hesitant to express their own needs, or at a level that would be beneficial to their therapeutic process.
Simple communication when something arises, and acknowledgment of mistakes when they are made are really important. No client expects their therapist to be perfect, but most do expect some basic level of professionalism.
Work Through Scheduling Challenges
I tell most of my interns and supervisees that scheduling can be one of the most challenging aspects of our work as a therapist. Clients often cancel or ask to reschedule. Holidays or time off can really disrupt your routine, and throw off your weekly or bi-weekly client schedules. And of course, your own lives and personal obligations have to be considered at times.
While it is nearly impossible to give every client a standing appointment, I do try to work with clients early in our therapy together to find a consistent cadence, day and time. I have found that this often takes several weeks to find the right day and time, as people are always adjusting their schedules with us. But once a client has found a routine that works for them, they are less likely to forget, double schedule or no-show, as it becomes a regular part of their week.
Likewise, some clients need a lot of flexibility, as they may travel for work, their work schedule may not be consistent from week to week, or they just operate differently. In these cases, they need you to work with them in a way that works for them. Identifying this early in the work with your clients and trying to adapt (within reason) to their scheduling needs will not only help build the relationship, but allow the client to feel empowered and valued in the relationship.
Meeting the Client Where They Are At RIGHT NOW
A big topic that comes up a lot with my supervisees is the tension that is felt when the client is seemingly not “progressing” or is seemingly “resistant” to the therapist’s interventions. I don’t personally love the word “resistant”, as it often has negative connotations, suggesting that the client is actively working against the therapist.
I view “resistance” as a natural indicator that the client is not ready to work on a certain area, RIGHT NOW. When I notice an incongruence between my interventions and the client’s motivation, I tend to go back to the basics of the Stages of Change model.
Oftentimes the tension or impasse therapists feel with their clients is a result of working with a client who is in the pre-contemplation or contemplation Stage of Change, and the therapist is using Planning or Action Stage interventions. If you notice this happening, step back and reflect, and adjust to where your client is, RIGHT NOW.
Remember that it is normal for clients to show some progression towards change, only to regress when feeling anxious, depressed or when hitting barriers. This is NOT a setback, but rather an opportunity to revisit treatment goals, develop resilience around progress made, and help the client learn that they can tolerate setbacks and adversity.
In taking this approach where you as a therapist align your interventions with the stage of change that the client is in, the client often feels heard and understood. They develop a greater sense of trust in the therapist, and are able to get to deeper issues when they are ready.
You will also find that this helps clients have more realistic expectations about how the change process works. Finally, this will allow clients to feel less judgment towards themselves and more able to try new things, which will lead to the change they are looking for, and will strengthen their engagement in therapy.
Lasting Thoughts
I often remind my supervisees that we work in the customer service industry. And I have also heard a lot of people say that they didn’t get their Master’s degrees to do customer service. Like it or not, you provide a product, and your customers have a choice as to whether they want to spend their money on your product.
This is not to suggest that the customer is “always right” or that we should do anything unethical or unhelpful to our clients. It is quite the opposite.
By holding yourself accountable to providing ethical services, being professional but also flexible when appropriate, and building a lasting relationship of trust with your clients, you will not only provide a higher quality service, but you will be rewarded by clients who want to work with you ongoing.
As you continue to provide quality services, more people will want to work with you, you will be in demand in a way that allows you to work more with your, you will feel more satisfied in the work you do, AND you will have built a robust and successful business as well.
How we can help
Check out our Firelight Supervision Community for all of your individual, group, and triadic supervision needs! We also offer additional professional development benefits when you join our community. Check it out if this sounds like something you need!
Author Bio
Chris Campassi is an Approved Clinical Supervisor (ACS) and Program Coordinator of Firelight Supervision. He is a licensed psychotherapist in Colorado and North Carolina, blogger, and clinical supervisor for provisionally-licensed and independently licensed therapists. Chris enjoys helping men, medical professionals, and former athletes manage their anxiety and stress so they can live fulfilled and balanced lives. Follow Firelight Supervision on Instagram and Facebook.
