Building Strong Therapeutic Alliances in Telehealth

Retaining Clients for Lasting Change

Telehealth has revolutionized mental health care, making therapy more accessible than ever. However, virtual sessions come with unique challenges, especially in retaining clients long enough to achieve meaningful progress. At WellQor, our goal is for at least 60% of assigned patients to complete at least 10 sessions over their initial 12-week treatment cycle. The key to achieving this? A strong therapeutic alliance and a focus on lasting change.

Here’s how therapists can foster deeper connections and improve client retention in a virtual setting:

Build Trust from Day One

First impressions matter, especially in telehealth. Establish rapport early by:

• Creating a warm and inviting virtual presence.
• Actively listening and validating your client’s concerns.
• Clearly explaining the structure of therapy, so clients know what to expect.

Set Clear and Motivating Goals

Clients are more likely to stay engaged when they see progress. Work collaboratively to:

• Define achievable short-term and long-term goals.
• Connect each session to these goals, reinforcing progress along the way.
• Celebrate small wins to keep motivation high.

Keep Sessions Interactive and Engaging

Virtual sessions can feel passive if not structured well. Encourage active participation by:

• Using digital tools like worksheets or interactive exercises.
• Assigning between-session tasks that reinforce insights.
• Encouraging journaling or mindfulness practices that tie back to therapy goals.

Address “Zoom Fatigue” and Virtual Barriers

Some clients may struggle with the virtual format. To counter this:

• Keep sessions dynamic with a mix of discussion and exercises.
• Acknowledge and validate frustrations with telehealth.
• Ensure clients have a comfortable, private space for therapy.

Reinforce the Value of Consistency

Clients who see therapy as optional may drop off before achieving meaningful change. Help them commit by:

• Framing therapy as a structured process, not just a series of conversations.
• Scheduling sessions in advance to establish routine.
• Reminding clients that change takes time and consistency.

Strengthen the Connection Between Sessions

Maintaining engagement between appointments can increase retention. Consider:

• Sending brief, supportive messages through secure platforms.
• Offering supplemental reading, videos, or exercises.
• Encouraging reflection on key takeaways from each session.

Handle Cancellations and Drop-Offs Proactively

When clients miss a session, follow up with care and curiosity, not just scheduling reminders. A simple message like, “I noticed we missed our session today. I want to check in and see how you’re doing,” can go a long way in re-engaging them.

Focus on Lasting Change, Not Just Symptom Relief.

Clients who see lasting benefits are more likely to stay engaged. Ensure that therapy is about more than symptom reduction by:

• Helping clients develop long-term coping strategies.
• Encouraging self-awareness and autonomy in managing challenges.
• Reinforcing skills that will continue to serve them beyond therapy.

Final Thoughts

Retention in telehealth therapy is about more than just keeping clients engaged—it’s about ensuring they reach their goals and experience real, lasting change. By focusing on trust, structure, and active participation, WellQor therapists can help more clients complete their treatment cycles and achieve meaningful progress.