Losing Steam: Client Cancellations and Therapy Drop Off

​We are totally getting to that point in the summer where it is vay-cay time!  
 
A sunny day, new work schedule for teens, and the family vacation or three leaves those open spots and cancellations in your week.  I mean - awesome for paperwork, side projects, and organization right? Or maybe some midday scrolling. Either or - no judgement here. 
 
And although sometimes we all need a little loosening up of our schedules, especially when the sun is shining - consistency is key for client retention and engagement. 
 
During an intake recently I asked a family why they stopped seeing a past therapist.  There was the blank stare, the “umm...well...I’m not so sure”.  It was a classic story of one week off for a dance competition, the therapist taking an extended vacation, and then the client had an annual trip out of town and...well...they just never rescheduled. 
 
It wasn’t that they weren’t in need of support.  They just weren’t able to re-engage.  There were too many barriers. And we all have those clients.  The ones that just sort of...disappear in the summer. 
 
I am definitely in favor of placing responsibility for client scheduling on the client, or well, parents if you see children.  Annnnnd at the same time one of the most vulnerable and brave things a client can do is pick up the phone to make an intake appointment, and then to keep showing up.

After a period of a couple missed sessions, sometimes the thought of re-engaging can be exhausting and they pop back into survival mode.  Therapy appointments get shuffled into the pack of other appointments, engagements, trips, and homework.  It’s not until things get pretty severe that there is a fire lit under families to make a call to re-engage.  Sometimes it is months or more than a year. 
 
Other times they might not think you as the therapist are committed to them.  And as we all know, the number one factor for therapeutic change is the relationship and connection you have with a client and their family.  
 
Why does this all matter?  Well firstly it is definitely good client care (and ethical) to do your best to engage a client in a way that is consistent. At the end of the day when they actually engage in therapy they can work towards their goals and mental wellness.  To simplify - meeting goals allows them to live life as the best version of themselves.  
 
So where does this leave us?  You definitely aren’t going to re-schedule that vacation you have been dreaming about forever and that dance competition is still going to be there.  So what now?
 
Well...this might mean that you consider vacation time that doesn't consistently cancel the same clients over and over OR you offer them alternative spots within the week before or after to keep consistency.  
 
One of my favorite strategies is the recurring appointment where they have their same time/day spot weekly or every other week.  That way they know you will be there for them after business gets back to usual.  If they don’t have an appointment scheduled or have cancelled a couple in a row an engagement call can help to show clients that you are committed to continuing their therapeutic work.   
 
Lastly, acknowledging the elephant in the room goes a long way.  Letting your client know that you are sorry that you are cancelling knowing that you missed a couple of other appointments.  This could even mean creating a support plan for when you are out of the office, which might include crisis resources, therapy activities, or other family bonding activities to engage in during the “off time”.  
 
All of this can go a long way to help clients engage in the hard work of therapy and foster the relationship and connection while at the same time juggling life! 
 
And if you are looking for more support around scheduling check out this course HERE designed specifically for therapists working with children! 
 
What about you?  What are your best engagement strategies for the summer lull?  Drop a comment below! 

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