It’s a mystery that every therapist in private practice experiences, no matter the setting: The Mystery of the Disappearing Client. A client comes in for a few sessions, you were just beginning to build rapport and make progress, then you never hear from them again. You follow up with a phone call to book another session, leave a message, no returned call. You shoot them an email, no response. You wonder what you’ve done, was it something you said?!? Probably not, but here are some things to think about when this happens:
Schedule before they leave
It’s ideal to make this part of the closing of each session along with taking payment. Unfortunately, that doesn’t always happen: they might have left their calendar at home, they have company coming next week or a busy week at work. Give them your available times before they leave. Make sure you’re not the one dropping the ball on scheduling.
It’s not you, it’s them
More than likely, it’s not anything you did to run them off. Maybe they weren’t ready for therapy. You were just getting to the point where progress was being made…that’s scary. They didn’t realize how much work therapy was going to be or how vulnerable they would feel. Maybe their life just got too busy to fit therapy in. It could be part of the reason they sought counseling in the first place. They will come back if and when they are ready.
But, was it you?!?
There might be some things you can do differently to help retain clients. Ask yourself:
- Is your office is a welcoming and comfortable place to have clients?
- Were you fully present during their sessions?
- Is your therapeutic shield up making you seem detached?
- Do you have appointment times that fit with their schedule?
- Was it a good fit? Do they need a referral for a different therapist?
How much follow up is too much?
There’s a fine balance between following up and being overbearing. You’re trying to balance being proactive and keeping your business afloat with allowing clients to be in control of their own treatment. I typically reach out twice after a client to try to schedule and include open appointment times in messages. Each quarter, I scan my client list and send a letter to inactive clients letting them know I am ‘closing their case’ but to call if they want to come back at any time. At the end of the day, this is your client’s treatment, and they have to be an active and willing participant to make it worthwhile.
Clients who drop out of therapy with no explanation are commonplace, and many therapists in private practice are quick to blame themselves. Take a deep breath and a step back when this happens. Look at things you can improve on, but also recognize that it’s part of the nature of therapy.