In praise of number crunching


Do you know the average number of sessions that clients consult you for? Are you taking a note of how people come to hear of your practice? Have you got a record of which referral agencies are making the most referrals? And have you any idea of how your practice statistics compare to your colleagues?
The best business is that which comes via word of mouth. It costs you nothing, and people are more likely to come along with a positive, more trusting attitude than if they find your name via a more impersonal source such as web search. However, the engine for word of mouth referrals is a large number of satisfied clients. No matter how competent you are, this takes a while to build, so unless you have been in practice for a very long time, you are going to need to advertise, and that’s probably going to cost money. Advertisers generally sell their advertising opportunities on face validity, that’s to say we think it seems likely their location and style of advertising will attract us customers, but if we monitor the results and do the maths, we won’t know. It’s easy to imagine the advertising we have paid for is working because we know we have had one or two customers through it, but an impression is not a statistic. No business should spend money without monitoring outcomes. The maths is easy: you just divide the cost of your advertising by the number of clients that come from that source, but if you are not keeping records of who comes from where, you can’t do the maths.
The overheads for a client session where the client is an existing client are much less than for a new client. New clients require clerking in, and being sent an appointment confirmation. Someone needs to take time explaining your cancellation policy to them and dealing with their queries about how your practice runs. This all costs money. Existing clients don’t need to be advertised to and they are admin lite. You can make follow up appointments yourself at the previous session and give out appointment cards. You need to retain clients for as many sessions as you can, consistent with your professional responsibility to market yourself ethically. It’s just as important to monitor how and when people leave your business as how they come to see you in the first place. In a CBT psychotherapy business, I have found that we are not working with a homogenous client base. EAP and insurer referred clients are allocated a set number of sessions. Some agencies are comfortable with the client then choosing to continue therapy at their own cost, and some are not. When they have the option, in my experience insurer referred clients tend not to extend treatment, whereas EAP clients sometimes do. This argues for biasing your practice towards EAP referrals, but this consideration is counterbalanced by the fact that insurance work is generally better remunerated. My experience with self-funding clients is that they have a bimodal distribution in terms of treatment sessions required. There are those who come with a very specific problem. They consult, take the advice, keep their emotional engagement fairly light and leave once they have achieved symptomatic improvement. The second group present with more diffuse psychological problems, invest more heavily in the therapeutic relationship, and tend to return over an extended time.
By its nature, delivering personal therapy in private practice is an idiosyncratic business. We all do it differently. I guess those of us who do it full time and successfully, learn how to make the market work for us: to play to our strengths, with a knowledge of what factors are likely to keep different types of client returning. Only by keeping reliable practice statistics can you do this effectively. When I take the time to sit down and look at my practice statistics I am often surprised by how unreliable general impressions are. The referral agency which seems to be referring the most clients often turns out to be the one emailing the most update requests.

There are plenty of practice management software systems on the market. I guess you are either an enthusiast for electronic bells and whistles, or you aren’t. I don’t think there is that much to choose between pen and paper and electronic systems. Either way, the value lies in recording the information, however you do it, and that requires discipline and the wit to design simple data collection systems. I am indebted to my friend and fellow CBT Psychotherapist Claudia Herrieven who recently shared with me how she monitors the number of sessions each client has had by the simple expedient of keeping a running total on each set of session notes. I am humbled and more than slightly embarrassed that this has never occurred to me.
How do you improve your client retention? Well one way is to give them a taster of something good and then offer them more at the next session… Visit this web page next month and I’ll tell you more (see what I did just then, modelling the technique I’m describing? Clever, eh?).
Adam May is a CBT Psychotherapist based on Anglesey, where he offers face to face and online therapy, as well as supervision and business coaching to other CBT practitioners. Adam also runs CBT Psychotherapist Briefings along with his business partner, Sophie Wood. Sophie’s next webinar will be on Search Engine Optimisation, 6.30-8pm, Thursday, March 28th. For more details, click here