No matter where you turn, “retention” is the buzzword these days.  From universities to coffee shops, everyone is interested in client retention.  Anyone in business knows how important it is to convert first time clients into repeat customers.  The same is true for mental health providers.

Research indicates that there are a variety of reasons why mental health clients discontinue therapy prematurely. These reasons include financial stress, lack of transportation, and scheduling conflicts.  Some clients discontinue for reasons that are unavoidable.  For example, when clients relocate for job opportunities or when students return home from college.

While it’s true that some clients end therapy early because they were able to resolve a specific challenge quickly, most clients who end therapy early walk away from the therapeutic process long before they are ready. Can anything be done to prevent client dropout?

I’m glad you asked!  There are four factors that contribute to a high rate of attrition on a clinician’s caseload.

Money: If clients do not think they have the finances to proceed, they will often discontinue therapy.  While it is difficult to argue with this perspective, try offering some thoughts for consideration.  Could the client temporarily cut any expenses out of the budget that would enable therapy to continue?  There are, oftentimes, expenses that could (or should) be cut.  You may also try to help clients understand how the small price of remaining in therapy now may reap invaluable rewards later, not just for the client, but also for his or her family, friends, and future relationships.

Community: Does the client believe that there is a genuine connection within the therapeutic relationship?  This isn’t a question of whether you feel there’s a connection; it’s about the client’s feeling of connectedness in therapy.  Clients who don’t feel connected become flight risks.

Perceived Usefulness: Do your clients believe therapy is useful?  If not, why are they there? Part of your job is to help them understand the benefits of therapy.  Help them recognize the usefulness of this professional relationship.  Clients are more likely to drop out of therapy when they do not recognize its usefulness.

Value: Do your clients know their worth? This might be where you thought I was going to suggest helping your clients understand the value of therapy. Remember, you have to view this from their perspective. Do you let them know how much you value their commitment each week?  I’m not talking about a quick, “Thanks for coming!” as you quickly shuffle them out the door after each session.  A genuine, heartfelt affirmation of their value goes a long way; and, it will keep your clients coming back.

Client retention is a significant issue in the mental health profession.  Retention is at its best when both the client and the clinician participate in improving the therapeutic experience.  Understanding the factors that lead to client dropout will help you increase retention.  It will grow your practice, too.

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