How to Set Client Session Expectations for Better Retention & Clinical Outcomes
This episode of The Therapist Mom Podcast is all about a question I hear from so many fellow therapist moms: “How do I set up my schedule so I can actually fill my caseload and support clients in a way that’s truly therapeutic?” If you’ve noticed new clients asking for biweekly or monthly appointments—and you’re left wondering how to build momentum or retain them long-term—this episode is especially for you.
As someone who’s built a private practice while raising three kids (which means I’m no stranger to chaos, time crunches, and redefining what “success” looks like), I know these early struggles in private practice are often less about your skills and more about structure and expectations. In this episode, I’ll break down my approach to setting clear and compassionate expectations around session frequency, why weekly sessions matter (especially at the start), and practical ways to set boundaries that serve both you and your clients.
If you want more consistency in your schedule, stronger clinical outcomes, and less stress around rescheduling and retention, keep reading—or hit play on this week’s episode!
What You’ll Learn in This Episode
Why session structure matters (and isn’t a lack of compassion):
How setting expectations for session frequency actually supports your clients and protects your energy.
The script I use with every new client:
Step-by-step guidance on what to say in the consult or intake so clients understand the value and purpose behind weekly appointments.
Building a practice that’s sustainable for you:
Why it’s okay (and important!) to structure your practice for predictability and work-life harmony—while still empowering client choice.
Episode Timestamps
00:02: Introduction—addressing the struggle of filling your caseload when clients want less frequent sessions and why strategic structure matters for new private practices.
03:02: The clinician’s role—why it’s not selfish to recommend weekly appointments and how it mirrors medical recommendations.
06:26: The impact of frequency—building rapport, creating safety, and why biweekly or monthly starts can mean slower progress and lower retention.
12:35: Step-by-step: How I introduce and structure standing appointments, handle requests for biweekly/monthly sessions, and set boundaries for predictability in my schedule.
Top Takeaways on Setting Client Session Expectations
1. Don’t Leave Structure Up to the Client
Let’s break this down: While therapy is client-centered, the structure is your responsibility as a clinician. If you ask, “How often do you want to come?” most clients—understandably!—will pick the least frequent option (because therapy is hard work). Instead, come from a place of gentle authority and recommend what you know will support the client’s goals and good outcomes.
Relatable story: I used to think it was more caring to let clients decide, but quickly realized everyone starts off “nervous” about therapy, and low frequency sessions meant less rapport, more cancellations, and slower progress. Once I got clear with my recommendations, everyone felt better—myself included.
2. Set the Expectation Early (Script Included!)
Here’s how to start implementing this TODAY:
Step 1: During your first contact (consult call or intake), say:
"In my practice, we start with weekly appointments to build trust and create momentum. Once things are feeling stable for you, we’ll step down to biweekly or monthly if it makes sense."
Step 2: When someone pushes for biweekly or monthly right away, gently explain:
"That’s absolutely something we can revisit, but I find that weekly sessions at the start really help you get the most out of therapy and see progress."
Pro tip: Always schedule standing appointment times, so you and your client have predictability each week.
3. Common Pitfalls to Avoid
We all make mistakes starting out. Save yourself some headaches:
Mistake 1: Leaving frequency open-ended and letting the client decide without clinical rationale—leads to low retention and “therapy just isn’t working” vibes.
Mistake 2: Sliding your fee or bending your boundaries just to fill your schedule—usually breeds resentment and isn’t truly sustainable.
Mistake 3: Treating monthly clients like weekly clients with standing appointments—this disrupts your flow and doesn’t actually help with rapport or outcomes.
💻 This episode is sponsored by Jane, the all-in-one practice management software I use and love. Book your FREE Live Demo HERE and when you're ready to sign up use code ASHLEY1MO for a 1 month grace period
⭐️ Grab your FREE networking guide for therapists HERE
⭐️ Learn more about how I can help support you and your practice, and ways we can work together at www.raisedtoempower.com
You don’t have to figure this out alone. Ashley Comegys specializes in helping therapist moms build private practices that allow them the time freedom, flexibility and autonomy they need in their careers. Looking for support in either starting your practice, or looking to revamp your marketing and systems? Let’s chat— book your consultation here!
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Disclaimer: This podcast is for educational purposes only and is not a substitute for therapy, supervision, or legal advice.
