Center Institute

Because being a great therapist isn't enough to build an awesome practice.
Because being a great therapist
isn't enough to build an awesome practice.
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Why you need to rethink your cancellation policy, and everything else too

I started thinking about this a few years ago when it occurred to me that the standard 24-hour cancellation policy most therapists have has no connection to anything therapeutic OR business-focused. I mean, really, that amount of time is not only arbitrary, but it is not conducive to continuity of sessions, maintaining consistency or momentum through regular sessions (it would if there were a requirement to reschedule the same week, but most therapists don’t do that, and then the 24-hours is still arbitrary). And then there is the business aspect of it: Can you really fill that slot with a mere 24-hours notice? I can’t.

But the point for me was that my mind kept unraveling the entire system. I started to question EVERYTHING. I started to question the 55-minute session, the once-a-week normalcy, all of it. And what I realized was that the entire system needed to be dismantled and rebuilt from the ground up. Rebuilt on a foundation based on your theoretical orientation and your client population. Therapy practices needed to be built from best practices in a clinical sense AND in a business sense. And what most of us have been doing is not.

So I started with that premise when I began to seriously build my practice – sure I was coming at it from a place of needing a business that worked for me, but it makes sense, right, that the business that does really well is a business that offers the best care: care that is based in theoretical orientation, that is the best care clinically, and that is based on being really clear about who I, as a therapist, am good at helping, and who I am less good at helping… And then offering those people–my ideal clients–care that makes sense. Care that is based on what we know will help them.

I thought about what irked me in the work I had been doing with teens–what wasn’t working, in addition to what was. I thought about what I would do if I had no constraints (honestly, I don’t do everything that I thought of because some of it is just impractical). I began to take those pieces and put them together. I built something that felt aligned for me as a clinician. Something that I felt good about offering to people. Yes, it was scary at first to stand up and say clearly what I was offering — and what I was no longer willing to do (willy-nilly uncommitted therapeutic work, for one).

What would you build for your clients, if you could build anything? I’d love to hear about it in the comments, or send me an email.

Talk soon,

4 Responses

  1. What do you recommend regarding cancellation policies?

    • Evan Center says:

      Amanda, That really depends on your niche and your style of work. The cancellation policy needs to be congruent with what you believe about the therapeutic relationship, how therapy progresses/ what works AND with what needs to happen business-wise. It is something we talk about in the Group Intensive for sure.

  2. Jo says:

    I am seeing a therapist who charges by the 15-min block. Bec I see him at the end of the day he’s willing to go as long as I’d like. Not sure how he handles this during other times of day or manages his calendar generally with this format, but perhaps hearing this will stimulate some additional ideas for the rest of us.

    • Evan Center says:

      Thanks, Dr. Jo! I hope that everyone will start thinking way beyond the bounds of what the therapy world has been doing for so long and start finding creative alternatives that solve the clinical problems with the standards AND the business issues with them. – Evan