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How To Reduce Client No-Shows

Updated: May 31, 2022

No-shows can be frustrating, let’s be sure your clients don’t flake!


How To Reduce Client No-Shows!


It is so frustrating when a client does not show up to a scheduled session, and in some cases it happens far too often. If you are just starting out it can potentially make or break your practice. But how can you be sure that someone shows up for a session?


Well I hate to be the one to break it to you but you can not be sure anyone will actually show up to the session. However you can try these tips to help the process of reducing no shows altogether.


Why Do People Not Show Up?



Let's get started with why people do not show up to their sessions. There are a few main reasons and understanding those may help you to include the following tips.


They Simply Forget - Let's think about how trauma can affect a client for a second. Lisa has 2 kids and runs a business. She struggles on a daily basis to be her best self and knows she needs help. She is willing to go to therapy and has made the decision to commit even though she knows the road ahead will be hard and maybe even scary.


Because she has suffered from childhood trauma Lisa tends to forget things often. Sometimes she even forgets things that are really important to her. It isn't something she does on purpose. She actually beats herself up when she forgets something and is very hard on herself in general. Lisa had an appointment scheduled for Tuesday at 1pm. She had every intention to show up to her appointment.


In fact she beat the feelings of being scared and told herself it was the first step to being a better me. Unfortunately, Lisa had a busy day Tuesday with back to back client calls and before she knew it the day went by and she completely forgot to show up for her appointment.


The thing is she didn't even remember until 3am in the morning when she woke up from a bad dream that had her feel like she was reliving her trauma all over again. Suddenly she remembered, "I showed up for everything and everyone else yesterday but I did not show up for myself".


Not everyone has the same intentions as Lisa. Some people forget because they are not committed or other things are just more important. However, below I will outline how you can help clients like Lisa to remember to show up for herself.



They Are Not Committed - Some clients are just not into therapy. Let's take a look at John. John is married to his high school sweetheart. He has a very demanding but high paying dream job. Or so he thought. His wife has noticed some personality changes and encourages him to go to therapy.


John does not think he needs therapy and he feels as though it makes him feel weak and resents his wife for even saying he may need therapy. However John's wife calls to schedule an appointment for him anyways. John is not happy but goes along with it anyway hoping his wife will eventually let it go.


The day of John's appointment he had an argument with his wife about the situation and has confirmed in his mind that he will not attend the appointment. John may not know it now but the decision to not show up to the appointment was made long before the day of. He did not fill out his paperwork and he did not schedule the appointment.

We will go over how we can identify clients like John and what to do to avoid the no show.


- Not Feeling The Connection - Alexis has known for some time now that she needs therapy. She has actually been looking for a therapist for 3 months now but feels like there isn't anyone out there that can help her. She is very anxious about the whole situation and doesn't know if therapy will even be successful for her.


She took the leap anyway and called who she thought was the right fit. When she called she was anxious and a bit timid. The person that answered the phone sounded annoyed and a bit aggressive. Alexis immediately felt she made the wrong decision but did not want to back out now because she knew she needed help.


She continued to schedule her appointment. She received an email to confirm her appointment with a link to fill out her paperwork. She was confused and didn't understand what she needed to fill out. She thought to call the office but then she remembered the feeling she had when she spoke to the semi aggressive scheduler.


So instead she told herself she just couldn't do it and did not show up to her appointment.


This happens more than you think and it truly is a sad situation. Not only will coming up with a solution to this problem help practice owners but it will also help the clients that are faced with this situation get the help they need.


Client Appointment Reminders - People forget things! Period. Sometimes it is a symptom of a mental illness. Sometimes people just forget because they have a busy life or things come up. Some people just need a little bit more reminding.


I get it you are their therapist not their parent. However, simple reminders can be beneficial for both sides. They will feel like you really care about their mental health journey and you will most likely keep the client for longer.


Remember it is less cost effective to keep a client than to get a new client. Here are a few non time consuming ways to remind clients of appointments.


Set Automatic Reminders - This is something that should be asked in the first call. Something along the lines of How would you like your appointment reminders? Most therapists use an EHR system. In these systems you can set up automatic reminders. It takes 2 seconds and can truly make a difference. Lisa probably would have showed up to her appointment if she had a reminder. Remember she didn't miss the appointment on purpose she just got carried away with her day.



Be Clear With Your No-Show Policy - This should also be stated on the first call. It should also be included in the welcome email and in the intake forms and also in the 15 minute consultation. I know it seems to be a bit much but if you clearly state your expectations when it comes to showing up for their appointments it will make a difference. Maybe John would have at least called and canceled ahead of time.


Give Them a Reason To Show Up - This tip is a suggestion. If you are looking forward to something you are more likely to show up so on the welcome email give them a question to answer in the first session. It can be as simple as thinking of a past experience that you tried that made you feel brave or courageous. This is a positive prompt that will make them feel excited for the first session. It will also help you to get to know them in a non awkward way. It will also help people like Alexis to not feel so intimidated by the first session.


Last Minute Reminder - So this isn't something that is typical but some of the therapists I consult said that they will text a client 5 mins into the appointment if they do not show up and say they have 10 more minutes to attend the appointment then they will need to reschedule. You can also point out the cancellation policy if you feel necessary. However the text normally helps without pointing out the consequences.


Identify if they are committed to therapy - This is a hard task. However there are some identifiers that can be spotted very quickly. If someone does not call to schedule an appointment for themselves this could be a red flag. Or they could be busy. If they also neglected to fill out the forms needed to attend the first session they may not be serious about therapy in general.


Another great way to make sure someone is serious about therapy is to have a free 15 min consultation with them. I know most therapists have decided that offering 15 minute consults is something they feel isn't necessary but I have seen that it actually helps to identify if the client is serious about therapy and if they are a right fit for your practice. This is also a great time to lay out all expectations for therapy in general like cancellation policies, requiring a credit card on file and anything else that can make or break a client's progress.


If John had a chance to speak with the therapists before the actual appointment then maybe he would have been more encouraged to show up to the appointment and get the help he discovered he needed during the consultation. Just 15 minutes with each potential client can make the difference.


Make a connection - Coming to the conclusion that you need to seek guidance from a professional is a hard decision on its own. The best way to validate this decision is to feel welcomed when scheduling an appointment. If the person answering the phone has a compassionate tone and offers all of the help and details needed for a smooth scheduling process then it will validate the client's decision to seek help in the first place.


As I am sure you know there is not some magic wand that we can wave at a client to make them magically attend their sessions. But hopefully some of these tips will help you avoid unnecessary no-shows.


Not Sure How To Start?


We understand that setting boundaries for clients can be difficult, even for you!


At Growing Your Private Practice Virtually, we can help you set proper processes and procedures that tailor to YOUR private practice and your clients!


Set up a call with me today! Let’s get you set up for success!


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