Reducing No-Shows and Cancellations in Mental Health Practices 

By Owl Team

When someone no-shows for a session, it can impact the productivity and financial health of your practice. You spent time preparing and setting aside time for a session, and when your client doesn’t show up or give you notice that they’re not coming, you may feel that your time has been wasted, and you miss out on the revenue that the session would have generated. Additionally, when your client habitually misses sessions, it can disrupt the therapeutic process, affecting their outcome. If this sounds like something you’re experiencing with your practice, you may want to begin implementing some strategies to reduce these occurrences and keep your practice successful. Below, we’ll dive into some strategies that can help reduce now-shows and how Owl Practice can help you save time and money. 

Understanding the why clients cancel or don’t show up 

What are the underlying causes of no-shows and cancellations? Some common reasons include: 

  1. Client Forgetfulness: It’s not uncommon for clients to forget their appointments, especially if they scheduled them weeks in advance. Without reminders, clients might overlook their sessions amid their busy schedules. 
  2. Scheduling Conflicts: Life is unpredictable, and sometimes other commitments clash with therapy appointments. Whether it’s work, family obligations, or other personal matters, clients might find it challenging to keep their scheduled appointments. 
  3. Anxiety or Reluctance: Therapy can be a daunting process for some clients. Anxiety about discussing personal issues or reluctance to confront challenging emotions can lead to cancellations. Additionally, clients may cancel if they feel they are not making progress. 

The impact of poor attendance on practices 

No-shows and cancellations disrupt your schedules, resulting in lost revenue and reduced productivity. When a client misses an appointment, it creates a gap that could have been used to help another client in need or that you could have used for practice housekeeping. Moreover, inconsistent attendance can hinder the progress of your clients, delaying their recovery and potentially leading to poorer outcomes. For therapists such as yourself, this can also mean increased stress and frustration, as you strive to manage their time and resources effectively. 

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Effective strategies to improve client attendance 

Implement Reminder Systems 

Automated reminder systems are highly effective in reducing no-shows. You can send reminders a few days before the appointment and again on the day of the appointment. Personalized follow-up messages can also reinforce the importance of attendance and make your clients feel more committed to their therapy sessions. 

Offer Flexible Scheduling Options 

Providing your clients with flexible scheduling options can reduce cancellations. Online booking systems can allow clients to schedule and reschedule appointments at their convenience. This flexibility can be especially helpful for clients with unpredictable schedules. Offering evening and weekend slots can accommodate your clients who may have varying schedules, making it easier for them to attend sessions. You may also want to consider offering a teletherapy option for a few times a week or for certain clients who have exceptionally difficult schedules. 

Encourage Commitment Through Pre-Appointment Communications 

Clear and proactive communication can encourage clients to commit to their appointments. You might want to provide preparation materials and session agendas to help your clients understand the value of each session and what they can expect. This can alleviate anxiety and make your clients feel more prepared and engaged. Additionally, communicating appointment policies clearly, including cancellation fees or rescheduling procedures, can reinforce the importance of attendance and discourage last-minute cancellations. 

Build Strong Therapeutic Relationships 

Building strong therapeutic relationships with your clients can also help reduce no-shows and cancellations. When clients feel connected to their therapist and see the value in their sessions, they are more likely to prioritize their appointments. You can foster these relationships by showing empathy, actively listening, and tailoring your approach to meet each client’s unique needs. Regularly checking in with clients about their progress and addressing any concerns can also reinforce the importance of consistent attendance. 

How Owl Practice Can Help 

Late Cancel and Preset Charges 

In Owl Practice, you can easily set up late cancel charges and policies. When you set your services, you can also set a late cancel and no-show fee as a percentage of the session rate. As soon as you mark attendance for late cancel or no-show, the amount your client will be charged will automatically change to the correct fee.  

You can also set your cancellation time preferences in the client portal. For example, if you set your cancellation time to be 48 hours before the session, a client who cancels their appointment after that window will get a notification before confirming the cancellation saying, “Charges may apply”. 

Features Like Automated Reminders 

Owl Practice’s free automated reminder system is easy to set up and manage. These reminders can be customized to suit your specific needs, ensuring your clients receive timely and relevant information. For instance, you can personalize messages to include the client’s name, and the date and time of the appointment. 

Online Booking and Flexible Scheduling 

Owl Practice’s online booking system is user-friendly and integrates seamlessly with practice management workflows. Your clients can book and cancel appointments online, providing convenience and reducing your administrative burdens. If a client needs to reschedule, they can cancel their appointment and then rebook for a session time that works better for them. This feature allows clients to take control of their scheduling, making it easier for them to find appointment slots that fit their schedule.  

Success Stories 

Once my client base grew, I found it increasingly difficult to manage everything efficiently. Keeping track of appointments, sending reminders, and distributing PDF intake forms became quite a challenge. Thankfully, I discovered OWL Practice, and it has been a game-changer.— Stephanie Jeret, CCC-SLP 

Owl Practice has revolutionized our operations by significantly reducing no-shows, providing an efficient electronic database for our services, streamlining practice documentation and handwritten notes, and offering ready-to-fill forms. Their robust appointment scheduling system has been a game-changer for our practice.— Véronique Thibeault 

Owl has streamlined my practice and I love being paper free. Scheduling is a breeze and I love that I can program my clients to get reminders.— Johanna Simmons, MA, RCC-ACS, BCRPT-S 

Additional Tips for Reducing No-Shows and Cancellations 

  1. Establish Clear Policies: Clearly communicate your policies regarding cancellations and no-shows during the initial client intake process. Include these policies in written form and ask clients to acknowledge and sign them. This can help set expectations and reduce misunderstandings later. 
  2. Implement a Cancellation Fee: While it’s important to be compassionate and understanding of clients’ circumstances, implementing a cancellation fee for last-minute cancellations can deter clients from missing appointments without a valid reason. Make sure to communicate this policy clearly and consistently enforce it. Here are some things to think of when setting your policy: 
  • The cancellation window: For example, you may only accept cancellations up to 48 hours prior to the session appointment. 
  • The cancellation fee: Will you charge a specific cancellation fee or charge them the full session fee?  
  • How a client should communicate a cancellation: Should they text, email, call or send a carrier pigeon? Or should they cancel the appointment themselves through the EHR client portal? 
  • Exceptions: You can decide how strict you want to be of course, but if your client experiences a true emergency 24 hours before your appointment, you may want to call this an exception. 
  1. Regularly Review and Update Your Approach: Continuously evaluate the effectiveness of your strategies and be open to making adjustments.  

Conclusion 

Reducing no-shows and cancellations is achievable with the right strategies and tools. By implementing effective reminder systems, offering flexible scheduling and developing clear policies, you can maintain a more predictable and productive practice. Building strong therapeutic relationships with your clients and continuously evaluating your approach can help support the policies and automations you’ve put in place. With Owl Practice’s support, you can focus more on providing quality care to their clients and less on managing administrative challenges. Embrace these strategies and tools to enhance your practice’s efficiency and client outcomes. 


Reduce clinical administrative tasks and transform more lives with Owl Practice. Owl Practice provides all the tools you need to make your practice successful. Join the thousands of care professionals using Owl to run their practice every day.

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