The initial phone screen with a therapy client is an important first step towards building a relationship with a potential client.
A long time ago, when I first started my YouTube channel I made a video all about things to consider when you do your initial phone screen with a therapy client.
But, one item that I feel isn’t really talked about enough is the therapeutic aspect of the initial phone screen. For most potential clients this is the very first time they are interacting with us. This phone conversation is going to set the tone for the therapeutic frame of the relationship.
Prefer to watch the video? You can watch the episode here:
It’s so important, in that first call, for potential clients to feel a sense of trust and safety.
Something I want to make clear is how important it is for us to hold that therapeutic frame regardless of whether somebody chooses to book with us or not. If someone wants to book with me and I see that I’m equipped to support them…great! And, if it makes sense to refer out, I still want them to feel cared for and well-supported.
Another thing I want to name is that the initial phone call is, of course, not therapy. This is a potential client who hasn’t become a therapy client yet. However, I still think it’s important that we hold a therapeutic frame.
Goals of initial phone screen
In this article, I’m going to share the tools that I try to utilize to help a potential client feel cared for and supported.
I have four main goals for the initial phone screen with a therapy client:
- Express empathy
- Screen for fit
- Answer questions
- Instill hope
For today’s purposes, I am going to focus specifically on my first goal: expressing empathy.
Express empathy
As a grad student, I found that the initial phone screen at the agencies I interned at felt extremely administrative. It’s like I took off my therapist hat and put on my office admin hat.
The initial phone screen sounded something like this: “…How many hours of sleep do you get at night? Ok. Are you drinking or using substances? Right. And are you having thoughts of harming yourself or others?”
Sometimes it felt like we were expected to breeze through a quick checklist, as though we were simply asking folks to talk about their grocery shopping list.
But, usually the initial phone screen is incredibly uncomfortable for potential clients.
For some, this may be the first time they’ve ever spoken about some of the questions we’re asking them. For others, they may have been burned by negative past experiences in therapy and are feeling closed off to therapists in general.
I believe we need to approach our clients as a therapist, rather than as a telemarketer.
But I can hear you asking: How do we do that in just 15 minutes and not a full 50-minute therapy session? I’m so glad you asked! 🙂
Avoid open-ended questions
As a rule of thumb, I tend to avoid open-ended questions to tell me more about a situation. Rather, I frame closed-ended screening questions with empathy.
Open-ended questions are a naturally curious approach. Often, even without expressing any other empathy, asking something like: “How did that make you feel?” can convey a certain amount of empathy.
But, when we have a close-ended question it can sometimes feel a little bit less empathic. For example: “Did you try to hurt yourself? Did you try to hurt someone else?”
It could feel like I’m just after the answer and I don’t care about my potential client’s experience.
But, when we offer those open-ended therapeutic questions in that initial phone screen, the conversation can start to get away from us like a runaway train.
Since the phone screen really only allows time for close-ended questions, I like to couch those questions within empathic statements.
Close-Ended questions
When we keep our questions close-ended it helps us stay within our time frame and then we can follow up with empathic validation. We can acknowledge that there is so much more to the story that we don’t have time for today.
It might sound like: “Wow, that sounds terrible. I realize there’s so much more to that story that we won’t get to touch on during our call. If we do meet in the future I’d really like to ask you more about that. Thank you for sharing with me, would it be alright if we switched topics and I asked you a few more questions?”
A statement like the one above can offer empathy and validation while also gently closing on a topic for now.
Examples of how to insert empathy
There are all kinds of empathic micro behaviors we can include in our initial phone call without taking us down an extensive rabbit trail.
Here are a few more examples:
Acknowledging potential discomfort
- When we first start the call, it can be helpful to name how hard it is to even reach out to a therapist, and how common it is to feel uncomfortable during the first call.
- For example: “I know it’s a strange and often uncomfortable process to reach out to a therapist, let alone schedule an appointment. I appreciate you hanging with me for this call as I’m going to ask you a few questions to see if I’m able to offer the support you’re looking for.”
Previewing phone call format
- If a potential client seems particularly uncomfortable, give them a little overview of the structure of the phone screen, and let them know they’re welcome to ask questions at any time.
- For example, if the client says something like: “Uh, yeah…I’m actually kind of freaking out and I don’t know how this is going to go.”
- You might say: “I understand, that’s very normal. How about I give you a little overview of what this call typically looks like and you can let me know if you have questions or want to make any changes?”
Prefacing screening questions
- Rather than diving straight into your screening questions, insert a quick preface before personal or potentially uncomfortable questions. Invite potential clients to flag anything they don’t feel ready to answer:
- For example: “I’m going to ask you a few personal questions that I ask everyone on the first call. I understand it can be uncomfortable sharing this information with a complete stranger. Let me know if anything I ask is too uncomfortable to discuss.”
And a bonus tip: If you have an FAQ page on your site, you can include a question about “what to expect during the first call?”. There you can offer information about the general structure and types of questions potential clients might get asked during the call. Folks who are particularly nervous about the call may find this helpful to mentally prepare for it.
Of course, as always, this isn’t an exhaustive list of all the ways to insert empathy into your initial phone screen with a therapy client. But, hopefully these examples offer a framework to operate from so you can still wear your therapist hat while you run through a bunch of questions.
Tools to support relationship building
A large part of why empathy is so important is to create a sense of safety for your potential client. Read my article about 13 tips to make clients feel safe in therapy to discover more ways to foster this sense of security.
If the potential client you do the phone screening with ends up booking with you, how do you make that first initial therapy assessment more conversational? I have a video that deep dives that very thing!
And, if you haven’t created a website where potential clients can learn more about you and start building a connection, check out my course all about how to DIY a therapist website that can help fill your practice.
And until next time, from one therapist to another: I wish you well!
-Marie
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Photo by Annie Spratt on Unsplash
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