3 Common Mistakes That Impact Client Retention

Navigating the first several sessions with a new therapy client is tricky.

The first few sessions force therapists to build rapport while simultaneously evaluating possible mental health issues.

During this time, therapists also set communication boundaries, share their privacy and therapist confidentiality policies, articulate their fees and cancellation and no-show policies, and work with clients to establish a therapy schedule.

Given all this, it’s almost no wonder that the most common time for clients to leave therapy is within the first few sessions. 

Why some clients don’t return after their first therapy session?

There are many reasons why clients might choose not to return to you for therapy, and many of these reasons have nothing to do with your clinical skills.

Most of the time clients choose not to return for their own personal reasons, and it’s important for therapists to realize that this is entirely OK.

For example, perhaps they realized they’re not actually ready to start the therapy process, or that they can’t afford therapy right now.

Or maybe their lives got suddenly busier, and they had to clear therapy from their schedule. 
Finally, it’s possible they got what they needed from the therapy sessions they already had with you. Therapists enter their clients’ lives at different moments in time, and some clients are only meant to stay for a couple of sessions. 

Not every client will be the right fit or find you at the right time for them. For example, they might be looking for a therapist with a different niche.

Mistakes that might be impacting your client retention

However, sometimes we see a more noticeable uptick in the number of clients we’re losing. When we see a steady rise in the number of clients suddenly leaving our practice, this is a good time for us to take a step back, and do an inventory of what, if anything, we might be doing to affect our client retention. 

Here are three common mistakes that might be contributing to your client retention rate, and how you can overcome them.

1. Implying that the client needs to work with you

One of the things that turns clients off the most is feeling like their therapist is desperate for them to come back for a repeat session.

As therapists in private practice, we walk a fine line between treatment planning and coercion.

Let me share an example: many of the therapists I’ve worked with often end their sessions with the phrase, “When would you like to come back?” 

This question contains the assumption that the client wants and needs to come back.

Simply rephrasing to something like, “Would you like to come back? And, f so, when?” gives the client a sense of agency over their treatment decision and reinforces the idea that they get to decide how often they want to attend therapy. 

2. Bringing your personal issues into the therapy room

Make no mistake, self-disclosure can be a powerful tool in the therapy room.

However, as clinicians we have to always assess whether we’re using self-disclosure to help the client move forward or doing it to serve our own needs.

One easy way to determine whether you accidentally disclose too much to your clients is to join a therapy consultation group. Having a group of colleagues to bounce ideas off of can give us a better sense of how appropriate our self-disclosure is in the therapy room, and if it might be sharing too much. 

In a similar vein, it’s important to monitor what information you share on social media sites.

While many therapists use social media for marketing their private practices, it’s critical to have a social media policy that helps you avoid crossing boundaries with clients online.

Remember, anything you put on a public site can be seen by your clients, so be sure to filter your posts through the eyes of potential or current clients. 

3. Working with clients outside of your niche or specialty

One of the biggest mistakes therapists make involves marketing themselves in too many niches.

Clients want to see a therapist who is an expert in the issues they are struggling with. They want to know that you have the experience and training to help them. All too often, clients start therapy and slowly begin to realize that their therapist is working outside of their scope, and this has an impact on your client retention rate. 

To overcome this barrier, make sure that you are clear about the types of clients that you work best with.

Ask yourself, “When I look back over my past clients, what types of clients had the best clinical outcomes?”

Don’t be afraid to refer out clients who aren’t a good fit for your specialty area. Even though this might seem counterintuitive to keep more clients in your practice, it does actually help your client retention in the long run. 

When we get clear about what types of clients we work best with, that select group is more likely to stay with us longer.

And when we refer out clients whose needs aren’t a good fit for us to our colleagues and peers in our network, those practitioners will often refer clients back our way in return. 

The single most important thing to do if you want to remain a good clinical fit for the clients in your private practice is to develop the ability to self-reflect on your own clinical skills.

A career as a therapist requires us to continuously ask ourselves, “What can I do to serve the needs of this client better?”

When we are honest with ourselves and we are open to make changes, our clients can sometimes have an improved experience with us.  

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