You found people who need therapy, you managed to attract them, they scheduled appointments, and… Poof. They’re gone. As frustrating as this is, it’s not just you. Studies vary, but anywhere between 20 and 57% of clients don’t return after their first session. 37 to 45% don’t come back after the second. So, what can you do? Here are some strategies to manage client dropout.
1. Establish a Strong Therapeutic Alliance
Building a strong therapeutic alliance at the beginning of the therapeutic relationship is crucial. This means actively engaging with clients, working towards developing trust, and fostering a safe and supportive environment. Research has consistently shown that a strong therapeutic alliance serves as a protective factor against dropout. Creating a positive and trusting relationship makes clients more likely to feel committed to therapy and less inclined to drop out. Of course, you should still set healthy boundaries – a good client relationship doesn’t mean giving in to their every ask.
People go to therapy and counseling for a wide variety of reasons. Sometimes, mental and behavioral health professionals help clients with such difficult issues or trauma that it can be difficult for them to take someone who is in the next session as seriously; for example, after helping a victim of child abuse, it might be challenging to show the same care to someone grieving for a grandparent. But clients can pick up on that lack of empathy. It’s crucial to remind yourself to avoid judgment and comparison.
Sometimes, a clinician may become overly focused on a diagnosis and lose sight of the whole-person care, leading to an approach that feels distant. A client may come for help with their anxiety, but if the counselor only focuses on managing the symptoms as opposed to the client’s life and how it impacts their anxiety, the client might feel frustrated.
2. Assess and Address Motivation
Understanding clients’ motivation for seeking therapy is essential. Some individuals may initially lack motivation or may experience ambivalence about the therapeutic process. By addressing their concerns and collaboratively setting goals, therapists can increase clients’ motivation and commitment to the therapy. Regularly reassessing motivation throughout the therapeutic journey is also crucial, as it allows therapists to identify any potential declines in motivation and promptly address them.
People don’t always have the same goals when they go to therapy. Some people like the idea of a productive “venting session,” but others may be actively seeking a modification of behavior. For example, a client may stop attending appointments because they feel they’re just paying the therapist to listen to them. For another client, that would be the ideal scenario. That’s why you need to make sure you’re aligned with what the person wants out of therapy – and whether that’s realistic.
3. Open Communication Channels
Maintaining open and effective communication channels with clients is key to preventing dropout. Providing clients with clear expectations for therapy, discussing the importance of attendance, and actively encouraging them to voice any concerns or uncertainties are essential steps. Additionally, therapists should ensure that clients have access to various communication methods like phone calls, emails, or secure messaging platforms to facilitate contact outside of scheduled appointments. Leverage the client portal and appointment reminders to nudge clients in the right direction. SMS reminders can reduce no-shows by as much as 38%.
Asking for feedback may feel awkward, but it’s important. If you can, ask clients why they stopped therapy. You might be able to talk them into coming back – or learn you need to make changes. The simple act of following up and acknowledging what the client said can go a long way.
4. Address Practical Barriers
Identifying and addressing the practical barriers that may hinder clients’ attendance is crucial. These barriers could include logistical issues, financial constraints, transportation problems, or conflicting schedules. By working collaboratively with clients to explore and problem-solve these challenges, therapists can help overcome these obstacles and increase the likelihood of consistent attendance.
If a client struggles with transportation or lives too far away, consider doing telehealth sessions instead. Some people may not understand how much their insurance covers, so it might be worth having a chat about what they’ll pay out of pocket. You could even set up a payment plan for clients who can’t afford to pay a larger sum.
5. Flexibility in Scheduling
Recognizing that clients may have additional commitments or unexpected challenges is essential. Offering flexible scheduling options, such as evening or weekend appointments, can help accommodate clients’ needs and reduce the chances of appointment non-attendance. Understanding and being supportive of last-minute changes or rescheduling requests can go a long way in maintaining client engagement and commitment.
Mental and behavioral health providers can also leverage their EHR’s enhanced scheduling functions, like TheraNest’s Advanced Availability feature. This allows practices to optimize their scheduling process and streamline communication with clients. Providers can easily set their availability, including specifying specific appointment types, locations, and time slots. The clients can then go into the client portal and easily schedule with their preferred provider instead of calling and scheduling manually. This level of flexibility enables providers to offer a range of options that cater to their clients’ needs and preferences, thereby increasing the likelihood of attendance.
6. Regular Check-Ins
Proactive check-ins between therapy sessions can be highly beneficial. Regularly reaching out to clients via phone call, email, or secure messaging to inquire about their progress, address any concerns, or remind them about upcoming appointments can help reinforce their commitment to therapy. These check-ins can help therapists identify potential issues early on and provide additional support when needed.
7. Tailor Treatment Approach
Flexibility in therapy approaches can greatly impact client engagement. Recognizing that one size does not fit all, therapists should continuously monitor clients’ progress and adjust treatment plans as necessary. Using evidence-based interventions that align with clients’ preferences and culture can enhance their motivation and increase the chances of therapy completion.
8. Collaborate with Other Professionals
In certain cases where therapists observe consistent dropout patterns, collaboration with other professionals, such as primary care physicians or psychiatrists, may be necessary. Collaboration enables a more comprehensive approach to client care, ensuring that all aspects of their mental health are adequately addressed. These collaborations can help identify underlying issues contributing to dropout and provide the necessary support needed to prevent further relapse.
Dealing with client dropouts is an inevitable challenge in therapy, but mental and behavioral health providers have the power to implement strategies to minimize their occurrence. Remember, each client is unique, and the therapy process should be catered to meet their individual needs. Ultimately, by implementing these strategies, therapists can improve the therapeutic experience and increase the likelihood of successful outcomes for their clients.
TheraNest offers EHR software designed to help therapists and counselors engage with clients. From our user-friendly, HIPAA-compliant telehealth platform to our appointment reminders, we have the tools you need to reach the clients who need you. Start your free 21-day trial and see if we’re a good fit for your practice.
