Ghosted by Therapy Clients? This Test Explains Why.
- Jordanthecounselor
- May 9
- 5 min read
Updated: May 21
If you get ghosted by therapy clients, here's a simple assessment to find out why.
First, watch this video.(Transcript provided below for your convenience.)
Dr Phil : So how much do you weigh?
Client: 103
Dr Phil: And how much do you want to weigh (You can tell from the context that these aren’t merely assessment questions. These are leading questions which imply “logically you have to see this is a problem").
Client: 70-80? like that.
Dr Phil: And do you think you're overweight now?
Client: I do. I see myself that way.
Dr Phil: So at 103 you think you're 20 to 30 pounds overweight
Client: I still - even when I was 120 I still felt, I still feel so overweight.
Second, write down your response to the client's last statement.
____________________________________________________________________________________________________________________________________________________________________
Based on this response I can tell how good of a therapist you are.
I'm joking.
But not really.
Of course, responding to one prompt on the internet can't determine how effective you are as a counselor. However, researchers do use this method for evaluating therapists' clinical skills. And understanding this is the key to retention, or keeping clients in therapy longer.
How researchers test therapists clinical skill.
In 2024, I got 1-1 coaching from Alyssa Di Bartolomeo, she’s a researcher in Canada at York University. She assesses therapist skill with two tools: the TERM and the RVT.
The TERM is an assessment where you watch a clip of therapy and identify whether the therapist made an error or not.
The RVT is an assessment where clinicians watch video clips and write down their responses (as in the example above). Then a trained administrator can score a counselor's responses and rate how well counselors do at responding to clients.
How? I mean doesn't your response depend on your model?
You would think. But no.
Turns out that regardless of model, there are a set of mistakes that therapists make. These mistakes, logically, lead to clients dropping out of therapy. These assessments test for those mistakes.
Why is this important?
One of the biggest problems many therapists face is client drop out.
Drop out is tricky. We rarely know the full reason a certain client drops out of therapy.
Maybe the client dropped out because they couldn't pay the deductible. Maybe the client dropped out because they got sick, but they'll be back when they feel better. Maybe it's summertime and instead of going to therapy, your client is going on vacation. Maybe they finally got on medication, didn't tell you, but feel better.
For any given client, it could be anything, and if it happens occasionally it's not a big problem.
But for many therapists, drop out is a big problem. Their clients are sending a message, "Hey, I don't like doing therapy with you, but I can't tell you that, so I just won't come back."
In these cases, these therapists are likely making mistakes that, regardless of model, are accidentally pushing clients out of therapy.
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Many therapists don't know they are getting ghosted my therapy clients.
Strangely, many therapists don't know they have a drop out problem. They believe they have a marketing problem.
Paul and I run a Private Practice Incubator (PPI), a small consulting firm where we help counselors build their practices. We often get people reaching out to us asking for help with marketing. They say things like "I want to get into a better niche," or "I'd like to work with more motivated clients."
Sometimes the problem really is marketing, and we have skills and processes we teach counselors for that. But, oftentimes, it's not a marketing problem. Oftentimes, it's a drop out problem. They can't build a practice because they're leaking clients.
I think many therapists don't know they have a drop out problem for two reasons. First, many therapists don't track their metrics. So they simply don't have the data to make the decision. In PPI, we use 12-15 sessions as a rule of thumb. To be able to build a practice, you must be able to keep a client for about 12-15 sessions.
Of course, the actual math of that changes based on a few different factors. We use this calculator to get a specific counselor's individual number of minimal sessions. You can get it here, FREE.
Second, many therapists don't know they have a drop out problem because we avoid uncomfortable thoughts. It's uncomfortable to think that people don't like working with us.
So we avoid the issue; focusing on marketing instead.
Honestly, I have a lot of compassion for therapists who avoid this question. I mean it can bring up a TON of shame to acknowledge that maybe clients don't like working with us. Especially when we're trying very, very hard to connect with clients.
So let's acknowledge that it's really hard.
Before You Take the Assessment...
I've recently uploaded the TERM and the RVT to Google Forms to make them easy to administer. The full TERM is 12 questions. Below is a part 1 of the TERM, containing only 4 questions. Feel free to take it and see how well you do.
A word before you do. For many people, getting assessed is full of baggage. We become self-critical. We shame spiral. We feel overwhelming anxiety.
If that's you, that's totally normal. Take a breath. Rest. If you take this test, it is totally your choice. This test may not be for you right now. That's okay.
Just acknowledge that assessments and tests bring up a lot of complex emotions for you. Honor where you are.
This assessment is a gift to help you run a better practice, not an assessment of you as a person.
Take your time. Be gentle with yourself. And when you are ready, the test will be here.
Best,
Jordan (the counselor).
Paul Peterson and Jordan Harris are co-founders of Private Practice Incubator, a consulting firm dedicated to:
Helping clinicians earn more money.
Helping clinicians help more clients.
If you'd like to learn more about launching your practice, visit us here.
Jordan Harris, Ph.D., LMFT-S, LPC-S, received his Doctor of Philosophy in Marriage and Family Therapy from the University of Louisiana Monroe. He is a licensed professional counselor and a licensed marriage and family therapist in the state of Arkansas, USA. In his clinical work, he enjoys working with couples. He also runs a blog on deliberate practice for therapists and counselors at Jordanthecounselor.com
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