The term “customer service” brings to mind smiling hotel clerks welcoming guests, or a helpful sales associate offering to “grab you a different size” to try on. It’s not a term often used when discussing a healthy psychological practice. Instead, we hear recommendations on how to “grow your practice” or how to “cultivate referral resources.”
While most advice for mental health professionals centers on how to reach more patients, there is an argument that true “customer service,” as simple as returning phone calls or keeping billing records in order, is the ethical focus that should be at the forefront in any discussion on building a therapeutic practice.
“It sounds like we are just talking about running a business,” said Jeffrey Zimmerman, Ph.D., ABPP, a licensed psychologist in Connecticut and New York and founding partner of The Practice Institute, a consulting service that works with psychologists to build ethically responsible practices. “But it really has some wide-reaching implications. I would define customer service as showing respect and care for the quality of the interactions and relationships between the mental health provider, the client, the family, and the community.”
Customer service is about being on time, being reasonable about cancellation policies, and having a welcoming practice, online, on the phone, and in the waiting room.
It is about basic courtesy, replying to phone or email contacts, even when your practice is full, or maybe adding that information to the website or the answering machine message. It is about showing up on time yourself, alert and ready to listen.
“It is about integrity,” said Brett Steinberg, PhD, ABPP-CN, director and forensic neuropsychologist at Comprehensive Neuropsychological Services, in Chesire, Conn., “not as a moral judgment but as a matter of completeness. It is about being my word. If I say I am going to do something, that creates a shared expectation.”
Admitting that there was a “breakdown” in the process is important, whether it is not sending out referral notes or being late for an appointment or needing a schedule change. Also important is following up with an apology and a plan for reparations.
“We all get what it is like to be on the other side of sub-quality service,” Steinberg said, “Patients don’t typically contact an office like ours because they have nothing better to do. Their life is not going the way they want it to. It is messy and they are looking for assistance. That awareness is a powerful place to operate from.”
It is about seeing the experience from the client’s point of view, which, in turn, of course, helps to grow your own practice. Remember, a patient’s experience begins before taking a seat on the couch or logging onto Zoom.
It begins with the first contact, whether that is in doing an online search, sending out an email, or placing a phone call. Does the website tell them this is a therapist they will enjoy working with, who will guide them in their journey, who will respond and pay attention and provide the feedback they need?
Does the phone machine message or answering service put out a welcoming vibe? Are directions clear for how to contact the office, book an appointment, or pay bills?
Especially during this time of a severe shortage of availability for therapists, people in need are struggling, making sometimes dozens of calls to find someone who is available. It can be dehumanizing not to get a response.
“We frequently receive comments from customers specifically saying, ‘I called your office and you were the only guys who answered the phone,'” said Steinberg.
Treating clients as customers may sound cold but, on the other hand, not treating them as customers can affect every part of their experience with you.
You may not even realize if their experience outside of the therapy room is doing you a disservice. It may be a new billing agency who is rude to customers when following up on payment or it could be that your waiting room is dark, too hot or cold, too busy, or difficult to access. The result can impact the therapy you provide, or even the opportunity to provide that therapy.
“In the treatment, you are creating an authentic relationship. We know the effectiveness of the therapy is often based to a great degree on the relationship you have with the patient and the strength of that relationship,” said Zimmerman.
“But, if you don’t have good customer service, you may not see the impact it may have and how the patient can harbor resentment which can subtly impact treatment. This is a grave disservice to a person who needs treatment but doesn’t get it because of micro aggressions or bad service received. The therapist may not even know it because some patients just quietly go away.”
If clients do not return to therapy, and especially if this is a recurring issue, it could point to a customer service problem.
“An easy thing would be to do brief patient satisfaction surveys,” said Zimmerman. “You can have a method for patients to anonymously voice their feedback. It is also helpful to know what is going well.”
Listening to the feedback, both good and bad, and making adjustments, will lead to a better experience and more effective therapy because the client feels more secure.
“From the moment they find us, we are already developing safety and security for the client,” said Julie Quimby, Ph.D., founder and director of Psychology Specialists of Maine, in Brunswick.
“I think of it from a trauma sensitive lens. By providing information and a warm welcome, we are helping the client gain confidence in the way we work, in our skills and specializations. They are showing up for the session already feeling some level of attachment and a lot of hope. It can be extremely impactful.”
Think of every step of a patient’s experience and then work on simplifying that path. In some cases, this process can be done by hiring staff to handle customer relations.
For smaller practices, there are options for outsourcing things like billing or for using technology to make processes work more smoothly.
Quimby’s suggestions include adding videos to a website to introduce each therapist and offer a taste of what a client can expect, simplifying the payment process by storing credit card information, and hosting intake and other forms online to make these easy to fill out at home.
“The better the systems you have in place, the more that minimizes stress on their end,” said Quimby, “We have the technology to automate so much and it makes it so much easier for the practice. Plus, if you have good systems, you are less at risk for burnout from all the administrative things you are trying to manage.”
In the end, good customer service is not just for the client. There is something to be said about the benefits to oneself when you know you are helping others, in the way that what you do outside the therapy room helps them take advantage of what you do inside. There is a sense of trust you develop in yourself, knowing you are doing your best that helps you to be a better therapist and human being.
“One thing I realized is that my capacity to say what I am going to do and then either do it or deal with not having done it, my word, is what gives me the ability to create a life I want to have,” said Steinberg. “Saying we going to do something and practicing how we make that happen is a fundamental skill of being a human being.”