Therapists often ask “What client retention strategies help keep clients in therapy longer?” This is often due to desire to effectively help. Or clinicians want to benevolently use those handy therapy tools from grad school. Some clinics want longer-term therapy simply for “the Benjamins”
What therapist resources do we have to understand therapy retention? Research has actually long examined the question of what brings people to therapy and for how long. Those findings shed some light.
Multiple studies show the most frequently occurring number of sessions for individuals attending therapy is 1. That is, if a client goes to therapy 14 times, another goes 36 times, another 5 times, the number that occurs most often is 1 session of therapy. This is the “modal number”, for the statistics lovers out there.
This number may come as a surprise to many. Aren’t therapist resources helpful? Wouldn’t people want to stay longer? Interestingly, more than half of individuals attending therapy found that 1 session was sufficient to help for the reason they went.
Other research from way back even found that 80% of individuals reported improvement after that one session of therapy. They concluded that considering dropout as a “failure” of therapy is not an accurate or sustainable view. One session is natural!
So if you’re newer in the field and wondering why you do not keep more clients, you might be in a normative situation and can rest assured! You might even be helping them! But are there client retention strategies for other clients?
Disingenuously suggesting how bad things will be if clients don’t stay in therapy is obviously highly unethical and not effective if they return. (Unfortunately, some of us have actually seen this attempted before). On the other hand, therapy apps boasting better client retention are only partially effective at this.
Client retention strategies sometimes involve clients’ perceived fit with a therapist. Clients do have the right to “shop” therapists if they do not think there is a fit. But first impressions are not everything and are often biased. So it helps to encourage clients to attend at least a few sessions before switching therapists. This encouragement provides a better and more accurate way for them to assess fit and possibly attend longer.
Another option after one or a few sessions is to offer psychoeducation and guided self-help. Or let them know you are available for questions about self-help resources you provide to open the door for them to re-initiate contact.
For newer private practice clinicians, seasoned therapists speak about how it takes a few years to build a consistent case load. So good old-fashioned time is often the client retention strategy, as in other professional industries. For example, MDs, attorneys, and accountants all require time to build case loads. Timelines might be accelerated with increased marketing efforts to let potential clients know you are there to help.
The one-session phenomenon is an occupational hazard for the business-oriented therapist. Seeking larger-scale contracts (e.g., EAP services from large organizations) or consulting boosts your reach. So does having 1.5 million social media followers. No problem….
Sometimes people just need a little help, some validation, or a nudge. Needing only one therapy session appears to be natural for many humans. It’s a downside for practice maintenance, but at least it’s good news for what it takes to help humanity. Client retention strategies come in when people need continued support.
