Are you struggling to stay busy in your private practice? Do you ever wonder what happened to your clients? In this post, I will help with problems that could occur during and after the initial contact.
Initial Phone Call From Potential Client
Because this is your first contact with a potential client, it is important to get it right. You need to balance empathy with business practicality. Although you want to be warm and welcoming, you shouldn’t allow the client to go into too much detail. Give hope, but don’t over-promise and never guarantee results. Of perhaps most importance, return phone calls quickly! It’s amazing to me how many therapists don’t bother to return phone calls.
First Session With Client
If you have a lot of first-and-only sessions with new clients, then either they got what they needed during that first session (this does happen sometimes), or it isn’t a therapeutic fit, or you’ve misunderstood their goals, or you made a therapeutic error. Let’s break these down:
- They got what they needed. Congratulations! But…how do you know? By following up, either with a phone call and/or a survey. Check out the outcome research done by Scott Miller, particularly the Session Rating Scale.
- It isn’t a therapeutic fit. Sometimes, our personality style clashes with the client. Or, although clinically appropriate, our style of therapy and/or interventions is not a good fit for the client. These possibilities can be affirmed by paying attention to client reactions, particularly non-verbals. If you are sensing a mismatch, then it is likely the client is as well, and they may be best served by a different therapist.
- You’ve misunderstood the client’s goals. Since we have spent a lot of time and energy learning about human potential, and are generally passionate about what we do, we may have a tendency to want more for the client than they do. Being aware of this bias, and paying close attention to what the client wants, will help eliminate this issue.
- You made a therapeutic error. Generally this will be obvious when it happens because the client will either become very withdrawn or outwardly upset. If your repair attempt fails, or you don’t try one, then it’s likely you’ll lose the client. If you suspect this is happening, then some supervision or consultation is in order.
Follow-up Sessions With Client
If you are averaging only 2-3 sessions with people, and the results from your surveys indicate it’s not because their problems are being successfully addressed, it’s likely there is a issue with your treatment planning. Assuming you’ve done a good job determining the goals from their initial session, you need to create a treatment plan. For each client goal, you should have at least one intervention in mind. And your assessment of the importance of each of the client’s goals should drive the order of interventions. In setting these priorities it is helpful to have the client be an active participant. Lastly, as you are doing the interventions remain alert to information that could change the goals and/or interventions. Your treatment plan should provide structure to the process, but remain flexible enough to change when you receive new or different information.
Yours in the Joy of Knowledge,
Dr. Barb LoFrisco
