Show Notes

Welcome back to The Designer Practice Podcast, and I’m your host, Kayla Das.

In today’s episode, Jennifer Garcia, licensed mental health counselor, trauma therapist, and clinical business consultant will share strategies for how to build client engagement in the first five sessions.

Hi Jennifer. Welcome to the show. I’m so glad to have you here today.

Thank you for having me, Kayla. I really appreciate it. It’s so great to be here.

Jennifer, before we dive into today’s episode, please introduce yourself, where you’re from, and tell us a little bit about your own practice and business journey.

Sure. My name is Jennifer Garcia. I’m a licensed mental health counselor located in sunny Palm Beach, Florida. I’m primarily virtual and I do a lot of trauma work, EMDR, and work with families and that have a lot of relationship issues, parenting issues, but also childhood trauma themselves. I work with a general population between 18 and really senior citizens, which are very a different subset of trauma within themselves.

I’ve also expanded my practice and included two Facebook groups with Therapist Growth Network, and I do a lot of business trainings, private practice consultations, and helping other providers grow their business because we didn’t go to school for that.

So I am leading the charge in a different type of medium where it’s more accessible than just paying a coach thousands of dollars, which a lot of people don’t have. So I’ve been creating programs and processes that are more affordable to help them create their business that will actually succeed. So I’m very proud of that.

Amazing. So when we think of client retention, what are some of the biggest mistakes therapists make in the first few sessions that cause clients to disengage from therapy and potentially not even come back?

So a lot of times when clients come in, they’re very anxious already. They’re scared of talking to somebody. They don’t know how to start the session, so guiding them is really important.

The intake process should not be robotic. A lot of times therapists just follow the prompts of the bio-psychosocial, and that removes the connection with the client. The first session is all about them feeling understood, but if you’re just reading off a script, they don’t feel that, and so they lose hope pretty quickly.

When we look at client behavior or people behavior, you have to look at it as more of a conversation with the client, and having that connection is more important than just capturing everything right away. Essentially, you will capture almost everything that you need in that conversation, and they have hope, which is what goes into session 2, 3, 4, and five.

When you are ending, come up with a treatment goal. You have it in your notes, but let them know in a different way of saying, Hey, I heard you have parent issues, or I heard you have relationship issues, and I know that’s not what you came in for, because that’s important, an Easter egg, you have to look for the Easter eggs. They might be coming in because they have anxiety about work, but you have a whole subset of relationship issues, childhood issues, trauma, and so when you don’t tap into those, then you are limited on what you can work on.

When you tap into them in the initial session, you can say we have the anxiety about your work, but also I heard you have a lot of trauma, you have anxiety issues, socialization issues, and could it be possible that some of these issues are bleeding into your occupation?

Now we got them more interested in the session because they didn’t recognize that was part of their issue. So piecing it together for them, the first session is really important to engage for them to come to session two.

When session two through five happen. The goal here is to keep them engaged by actually giving them advice, questioning them a lot more. A lot of times therapists just listen actively, which is great, but clients want advice. That’s why we’re here. They want to learn things, educate them, ask deep questions that’s intriguing to them. People in life just don’t get asked questions. They’re not seen or heard. But when you ask a question, you’re evoking a different part of the human brain.

When you ask a question, that brain starts to signal this person cares. This person sees me, they care enough to ask me the question. Now they know they’re in therapy, but think about it as we’re surrogate to their lives. Nobody asks them questions and no one care to. Now we are we getting paid to do it? Yes. But they’re also here to make a connection.

A lot of therapists miss that part entirely, is that we become the surrogates in people’s lives, replacing a lot of what they don’t have until they build it through us. Then we start to slowly become less an extension of their life, but more just the person that they go to continue their journey in healing. But our job is to create extensions for them.

I really like that you’ve mentioned the roboticness, because I actually think that some of our trainings teach us to leave yourself at the door, and we often interpret that as we as humans cannot be in the process.

And the number one question I get asked all the time is, do you think AI is going to take over therapy? And my answer is always no, because we need to create that connection. But if we go from the lack of connection and go from, oh, I’m going to keep myself at the door and never engage and never bring myself into the room at all, AI can also do that.

They can also give resources. It can also give kind of tips, but what makes us different is that human connection that brings people coming back and helps with recovery. And research shows that when it comes to success in therapy, more times than not, it’s the connection that is going to be the success indicator.

And so when there’s no connection. There’s no results and they’re not going to come back to even get those results to begin with.

That’s correct. AI is a big topic in our community. There are therapists who won’t go near it, and there are therapists who embrace it. The reality is that this is the way it’s going. It’s not here to replace us, it’s actually going to enhance the care that we give our patients. That wasn’t available to us before. A lot of times therapists are afraid to engage in AI for various reasons, and if you utilize it the way it needs to be, which is resourcing homework. Processing different ideas, researching books for them, and allowing yourself to really engage the AI to support your care. You have no idea the type of retention you can have because of that.

And also building on that, AI has revamped how I do my business and has created a six-figure type of monetary ability, because of the way I scaled it using AI, where it would’ve taken me years, it took me six months.

So it’s a really powerful tool that really you shouldn’t be afraid of, but more embrace because not only are clients getting benefit, but we are also getting benefit.

Now, if you want to hear more of the replacement conversations, you will find it online. People’s fears, people’s judgments about it. That’s called reticular activation and confirmation bias. So when you fear something, you’re going to see it everywhere.

What would happen if you were to embrace it? You would see the other side to it as well. And so that’s part of what we teach clients too, is reticular activation of what you want to see is what you’re going to get. And so when we shift the idea of one thing or another, our clients follow what we’re afraid of too.

I love that. So what are the key elements therapists should focus on in the first five sessions to build a strong therapeutic alliance, and of course client retention with that.

First, you need to show confidence in your skill. You have to show that you are not afraid to take on what they’re giving. A lot of times therapists might show a sense of trepidation because it is a big case.

The other part is to listen in between the lines. They’re talking to you, but it doesn’t necessarily mean that’s all the information. In between the lines really has a lot more weight to it. So if I have a client talking about their parent and all the trauma that they endured, I might listen for other cues that the client is saying. So this is where the questioning comes in. Tell me a little bit more about how your parent came to that conclusion. How often did this happen? So now I’m having them trace back their timeline to start fitting in puzzle pieces that maybe weren’t there before. And when I do that, it allows for them to look back at their relationship and start finding these behaviors that they ignored because that’s their parent.

I had a client who I had questioned multiple times. Tell me more about what your mom did. Tell me how you ended up homeless with her. Tell me what she’s doing now and started to really get him to look at different parts of his life. When I did that, not only did it engage the client, it also helped me figure out more treatment goals to create as we’re questioning.

So now I’m in session 6, 7, 8, and nine. I have a whole backlog of all the things that I discovered just in one session. So a lot of it, the mistakes is not asking deeper questions, not engaging with the client in a story that has a lot of Easter eggs that you need to figure out where it came from.

I love that. And I also want to go in where you mentioned session 6, 7, 8, and nine, and there might be some listeners thinking, wow, that’s a lot of sessions to be working with someone. When we think of client retention, and I wanna bring in kind of the business aspect of it as well, is often we’re really focused on marketing, meaning bringing clients into the practice. And of course that’s important, we need to bring clients into the practice. But I’ve noticed that retention is even more important than marketing when it comes into keeping clients into your practice. Because even the most successful practice that’s bringing in clients consistently cannot continue to invest into marketing if the retention is not there.

We don’t talk about client retention enough, and we talk a lot about the marketing, but if we can retain our clients and like what you’ve mentioned by being able to create this connection, this the client is committed to the therapy or asking these questions they’re going into avenues they never thought that they would, potentially even go into. This is what keeps bringing them back. And then your effort in the marketing, you don’t need to put in as much because you have a caseload that continues to come back.

 So that puts me into the second part of retention, and that is how you structure your calendar. How you get them to have therapy as a part of their routine. The reality is that all of my clients have been with me for a very long time, and it’s not because they have continual problems, they enjoy it. It’s part of their routine, and a lot of them have been me for 2, 3, 4 years, weekly. They absolutely love it.

And it’s because it’s become part of their life. They look forward to it. They have someone to talk to and they go through a lot in their week and they’re like, oh, good, I get to talk about it.

So it is that strategy of let’s make it a part of your life. That’s when the calendar comes. You keep them the same slot. They live there, they own it. They don’t move. If they need to reschedule, there is no slots because I’m completely full and they know it. So they work around their schedule. They make sure that when things happen, I can’t, I’m sorry. I have therapy. People work during your lunches in their cars. They don’t miss a beat and they refuse. If they do cancel, it’s because it’s absolutely necessary and they just can’t move things. But they get very oh my God, I’m not going to see Jen for two weeks. So it is a disruption when they don’t attend.

It’s not that I wanted to be a disruption, it’s because that is their life now. This is a part of their journey. And it’s beautiful because these are people who went from not being able to get out of the house. To some of them, I got them to making six figures in executive company. Now we’re just moving and they just enjoy that movement all the time.

So they’re like, okay, I hit this part, what more can I do? Then there’s that hope. Wow, I got this far. Let’s keep going. Because to me, there is no ceiling. Let’s keep going.

I love that. That’s amazing. So how can listeners structure early sessions so clients feel both supported and motivated to continue treatment?

The first is asking them what the best time for them is because they’re going to live there. Now, I word it that way for a reason. Understand that neurolinguistic processing NLP is about where you place the words in your sentence structure. So the brain picks it up.

Human beings are nesters. We like things the same. Have you ever gone to a conference and you sit down and you’re there for a couple hours listening to the person and then you go for break? Do you notice that people never move their chairs? They stay at the same spot the entire time. They always go back. You don’t have to put anything there because your seat is now yours. You live there.

And so people have this propensity to have consistency and have some stake of territory. So when we activate that in the human mind, that becomes even more enticing to them because this is my slot. I live here. I’m not going anywhere.

Because if somebody comes back from that conference and they sit in your chair, you’d be appalled. Excuse me, I was there. How can you be sitting in my seat? I was here. You need to move. Now, ask me if that happens a lot. Surprisingly, no. People go back to their seats that they chose from the beginning. It’s not assigned. They assigned it themselves.

So when we assign quote unquote, that time slot. They stay there. That is their place, that’s their land, that’s their home. That’s how they see it, and that’s how the brain interprets it. And so they love it. It’s like a little house that they build inside their head. This is 11 o’clock slot. I’m going to my little house at 11 o’clock.

That’s such a great analogy, and I’m just trying to think of everywhere I’ve ever been. And you’re a hundred percent right, like once you sit in that seat nobody is taking that spot. They’re not even going to try. Because they have their own and this is your own little house. So it’s an amazing analogy and I agree with you a hundred percent.

So what are practical strategies to help clients feel progress early in therapy so that they remain engaged in the process?

I touched on it earlier, it’s called Easter Egg. So you’re going into find all the different things that people are seeing and then write them down as they go. This helps with finding those centered problems and they feel more attached to, oh good, we’re going to be taking care of a lot of other things. And also, yes, I would like to heal that. Thank you.

So again, it’s about having them feel hope that there’s going to be changed, having them feel heard, that their problems are not being ignored or dismissed. Because if you don’t go into these sessions, you actually are dismissing their issues without recognizing it. Their consciousness may not recognize it, and your consciousness might recognize it. But guess what does subconscious, the subconscious picks up dismissiveness. Now what does that do for the person?

Consciously, it’ll show up as I don’t connect with this person. I don’t really know if they know what they’re doing. For some reason, I don’t feel like I’m getting anything out of it. They’re consciously not aware that the therapist inadvertently dismissed their thoughts and feelings because they didn’t probe longer, harder, or more intensely.

And so when we get to that validation piece of, I feel seen and heard, all of a sudden the brain lights up in different modalities in their minds, that is starting to create neuron activity for connection. Because that’s how it starts. You have to start creating neuron activity for the brain to capture that this is a connection that we’re going to create. And so that starts creating a sense of safety, groundedness, and again, feeling like, this is my home. I’m going to stay here.

I love that. So how can therapists set expectations and treatment goals in the beginning to improve retention?

So one of the things to do is having expectations of, Hey, typically 12 sessions at minimum is a way to start making changes.

So you already got them understanding that this is going to take a little while, and a lot of people are okay with that. If you give them a timeframe of how long, because a lot of people are like how long am I going to be here? Let’s start with 12 sessions and see where we go. By the time you hit 12 sessions, you’ve already amassed a ton of issues, and now we’re at session 12. They’re just going to keep going. They don’t even know we’re at session 12. They’re just going to keep going and going because they enjoy it.

Goals are ongoing. We tackle the first three, then the second three or stay on one for a month. Because that’s just what we have to do. But that is part of the process is like, we’re going to be on this for a minute and let them know. And they’re like, okay, that sounds good. Telling them what we’re doing, the behind the scenes look of how we’re handling things. They love it. They love it. They’re like, oh, I didn’t realize that’s what’s going on. And then they’re like, this is cool. Let’s do it again. It’s like you’re revealing the magic trick.

Agree a hundred percent. Like I think that’s such a great way to look at it.

Jennifer, you have a community of therapists. Can you tell us what the community looks like and how it can help listeners?

So my community is, two of them is therapist growth network for private practice and growth. That community has probably a mass for hitting 12,000 in six months. Asked me how I did that. I found Easter eggs in the community. I have started watching people’s posts. I started asking questions. I got answers, and so I created a community based on that and that’s how it exploded.

And guess what I’m doing? Retention. It’s a mass scale retention, but it also is education. It also is not just marketing. I’m teaching people, I’m creating content. I’m giving you educational tools. It’s more valuable, which is also what clients need value. What am I getting if I join this group? Is it just another Facebook group? Nope, it’s not. It’s quite different.

So the second one is find a therapist directory. That one’s actually public and can be indexed at Google. So therapists, if they go online, if they file the template that I gave them that I made for SEO search engine optimization, Google will index that. People will be able to find you just by Googling your name. It’ll show up on that Facebook group because it’s public.

And it also allows clients and therapists to connect immediately instead of waiting. Therapists and clients are able to connect and actually get the care they need pretty immediately. So it’s a game changer in how I utilize Facebook and when they join, it’s really supportive. It has a lot of connection and it allows for people to feel seen and heard. which is the whole concept of retention.

I love that. So to check out Jennifer’s link Tree, head to linktr.ee/gratitudeandgrowthcounseling,

or you can simply scroll down to the show notes and click on the link.

Jennifer, thank you so much for joining us on the podcast today to share strategies for how to build client engagement in the first five sessions.

Thank you so much for having me. I hope it helps the community.

And thank you everyone for tuning into today’s episode, and I hope you join me again soon on The Designer Practice Podcast.

Until next time, bye for now.

Credits & Disclaimers

Music by Denis Pavlov Music from Pixabay

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