How to Retain Clients Ethically In Your Private Practice
By Shannon Heers
As a private practice therapist, and perhaps also a practice owner, you want to be efficient with your money. And one of the best ways to make your limited funds stretch further is to keep the clients that you already have, for as long as is clinically appropriate.
You all know that acquiring new clients costs money. But once you already have those clients, it costs next to nothing to keep them. Sure, maybe it costs 10 cents per week for a text appointment reminder, or for credit card fees for each appointment payment. Small change. Overall, retaining the clients that you have already acquired just makes good business sense!
What Does Retaining Clients Ethically Mean?
You may be thinking at this point, how can I retain clients in an ethical manner in my practice? And that is the key – yes, you don’t want your clients to stay in therapy past when it is beneficial to them. Or, if you accept insurance, when treatment for the client is no longer “medically necessary”. But what about all that space in-between, from the initial intake appointment all the way through to client termination?
All of that space in-between intake and termination has opportunities for you to continue therapy and spots for your clients to drop out. And that’s how you retain your clients ethically, by focusing on these opportunities and challenges.
Do Not OverPromise
One tip for retaining your clients ethically is to make sure that you make No False Promises. You probably know this already, but it bears repeating. Do not guarantee that your client will feel better, in a certain amount of time! Now, this doesn’t mean that you cannot instill some hope.
You still want to be confident in your skills and share that with your clients. You can say things like “in general, most of the clients I see have some symptom relief by session #4” or “the average amount of time that my clients stay in therapy with me is 6 months”. These are accurate statements based on your past clientele, that doesn’t overpromise how you can help your clients.
Provide Clinically Appropriate Treatment
Of course, you already know this. Your role as a therapist is to provide clinically appropriate treatment to your clients. But what does this mean? Clinically appropriate treatment means that the provider, that’s you, provides the appropriate clinical treatment based on the client’s needs. The provider is appropriately trained to provide this treatment, and has assessed what the client’s needs are through providing a diagnosis and treatment plan, among other documentation.
I use this motto “The Right Client, at the Right Time, with the Right Treatment”. I’m sure someone told me this at one point during my community mental health career, and the saying continues to resonate with me still. Making sure that you are offering the right kind of treatment (e.g., grief and loss, EMDR, play therapy, etc.) is essential, and that you as the provider are appropriately trained in this treatment.
And you want to match the right treatment with the right client, at the right time in their life. If the client has just experienced a traumatic car accident and is coming in for treatment, you don’t want to focus on work-related stress, you want to focus on the trauma treatment.
Ethically Appropriate Treatment Should Be Transformative
While staying within the ethics of clinical treatment with a focus on client retention, you want to make sure that your treatment is transformative. You want to provide some helpful solutions for the client. Regardless of whether you’re a skills-based therapist (think DBT, SFBT, CBT, etc.) or a depth-oriented therapist (psychodynamic, person-centered, etc.), you want your client to come out of therapy transformed.
Providing life-changing therapy and treatment is the core of what you do as a therapist. Remembering this concept and keeping it in the front of your mind will help you with providing ethical treatment, and thus retaining your clients further. The better the therapist you become, the more you’ll keep your clients on your caseload longer, thus decreasing the amount of new clients that you need to bring in to keep your caseload steady and full.
What Therapists Cannot Control
There are many things that you as a therapist cannot control when working with clients. Sometimes clients drop out of treatment early, and there’s nothing you can do about it. Here are some reasons that clients may drop out of treatment before its concluded, even if you are providing ethically and clinically appropriate treatment:
- Move to another state (or country!) where you are not licensed
- Move to another location and cannot commute to see you in-person
- Change in financial situation and cannot afford therapy
- Family changes such as additions (babies), divorce, or loss
- And more
So, despite your best efforts, it’s also important to realize that sometimes, clients just drop out of therapy and that has nothing to do with you.
How we can help
If you’re looking for support and clinical consultation around your clinical work, check out our Clinical Consultation Community, where you can develop professionally within a community of other private practice therapists, just like yourself.
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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.
