Cultivating Commitment to Regular Attendance and Engagement
The Challenge of Client Commitment
Have you ever struggled to have clients commit to regular attendance? I see this as a common struggle with therapists. Often, in our nurturing, client centered way, we accidentally dissuade clients from making an ongoing commitment to their treatment.
Perhaps we mistake the goal to share decision making and treatment planning through collaboration by leaving the client to make all the decisions.
When clients seek out our services, they are looking for an expert, a professional opinion. They are looking for a guide to take them from problem to solution. To help them achieve transformation.
The Therapist as a Guide and Expert
Imagine you’re a travel guide planning a trip for a client. They may know where they want to go but aren’t sure how to get there. That’s where you come in! As a therapist, you can create a roadmap to reach their goals and motivate them to stick to it. Without regular sessions, the “travel” is slower, and they might not reach the “destination” they’re hoping for.
They may know where they want to go but aren’t sure how to get there. That’s where you come in! As a therapist, you can create a roadmap to reach their goals and motivate them to stick to it. Without regular sessions, the “travel” is slower, and they might not reach the “destination” they’re hoping for. If they knew how to get to their destination, they would plot their own course and travel there immediately.
So, are you showing up in your sessions as their expert travel planner, their guide?
Make sure you name the destination (s) and show the route to get there. Explain why this route is an effective, efficient one. Show them how wonderful the destination will be if they commit to the trip.
Reflecting on Language: Scripts that Either Encourage or Dissuade Commitment
Consider the common statements, “Do you want to schedule another appointment? or “Just follow up when you’re ready.” While this open approach may feel respectful, it can unintentionally convey to clients that therapy is optional, diminishing the likelihood of consistent attendance.
Instead, as therapists, we can use language that guides clients toward viewing therapy as an essential and regular part of their lives, similar to other health-focused routines. Try this, for example.
“I recommend weekly sessions for at least 8 weeks. I have Tuesday at 5 or Friday at 1. Which time is best for a weekly appointment?”
Key Steps and Strategies to Enhance Client Buy-In
1. Name the Destination and Describe the Route
Strategy: During the initial sessions, collaboratively set clear, achievable goals. Outline the steps or milestones necessary to reach these goals and emphasize how regular attendance plays a critical role.
Script: “Our goal is to help you manage your anxiety so it doesn’t interfere with your daily life. To get there, we’ll work on specific techniques and coping strategies each week. When you’re consistently attending, we can address each part of this goal in a manageable way.”
2. Explain the Importance of Commitment to the Process
Strategy: Compare therapy to a medical treatment plan, where adherence to prescribed actions leads to better health outcomes. Explain that while therapy is a flexible, individualized process, consistency is essential for sustainable progress.
Script: “Just like in a medical treatment, if we skip steps, we might not see the full benefit. Regular sessions help us build on each skill and insight, making each week’s work more effective.”
Reinforcing the Benefits of Therapy: The Power of Positive Outcomes
Remind clients of the positive outcomes they can achieve with regular engagement. Similar to a physician explaining the benefits of medication or lifestyle changes, we can highlight the potential improvements they’ll experience by consistently participating in therapy.
Script: “When you’re coming in regularly, we can make steady progress toward your goals. It’s like physical therapy: each session builds on the last. I’d love to see how far you can go if we keep building momentum.”
Reducing Stigma and Building Trust
Stigma and a sense of vulnerability can make clients hesitant to engage fully. Building trust and addressing these concerns openly can foster a stronger commitment.
Script: “I know it can be hard to commit to something that requires opening up about personal challenges. Let’s make this space as comfortable as possible for you so that each session feels like a step toward the life you want.”
Implementing Commitment Scripts
Use language that normalizes commitment to therapy as an expected part of treatment, emphasizing the client’s choice while guiding them toward a structured plan.
Script: “Our work together will be most effective if we meet consistently, so how about we plan for weekly sessions over the next three months? After that, we can reassess your goals and decide if we need to adjust the frequency. How does that sound to you?”
Motivational Strategy: When clients hesitate, empathize with their concerns, and gently reframe the commitment as an investment in their well-being.
Script: “I hear you’re busy and that time is valuable. Think of these sessions as a time you’re setting aside to work toward feeling better, managing stress, and building a life that feels right to you. Your time here is important, and I want it to be as beneficial as possible for you.”
Conclusion: Cultivating a Culture of Commitment
Engagement in therapy is a collaborative process, but as therapists, we can help clients find the direction and motivation they need to commit fully. By setting clear goals, reinforcing the importance of consistency, and using MI strategies to work through ambivalence, we can empower clients to view therapy as a valuable journey toward growth and resilience.
When clients see you as their guide and feel your commitment to their progress, they are more likely to make the same commitment to themselves.