Don’t Be a Client Hoarder

Today we’re going to travel into the future! We’re focusing on when your practice is full to bursting. Now before you say I’m putting the cart before the horse, consider that this situation will actually do some early-practice mindset shifting.

Let’s talk a bit about waiting lists, shall we? It’s a pretty exciting thing to be full. If you’re like me when I first got full, at first you may try to cram new clients into spaces without realizing it displaces current clients.

Maybe you loosen your boundaries and work an hour late to make up for that mistake or schedule someone in during your lunch hour. At some point, you realize that you can’t keep taking more clients on.

Waiting Lists

It’s a very tempting thing to have a waiting list. It soothes those scarcity fears. It feels like a promise of on-going success. But let’s take a minute to really look at that scenario.

I’m going to use an extreme but real example.

I once worked for an agency that often had a three to six month waiting list. We were told to “manage our caseloads” (it pisses me off just to type that because I heard it ALL the time).

It felt like there was this line of people banging on the door and it was my job to get the current clients out the door before they were really done with therapy.

I would wake up in the middle of the night feeling anxious about the waiting list, as if I was personally responsible. That’s probably because I tend to work with folks with longer term issues for whom solution-focused therapy isn’t appropriate.

It’s probably because I really loved doing intense, life-changing work with people and I never figured out how to do that quickly. And, it’s probably because I felt pressured every single day to manage my caseload.

Guess what happened when people were finally called for their turn? Sometimes, they muddled through the misery on their own enough to make life just good enough that they didn’t feel like they needed therapy.

Sometimes they had decompensated so much that they needed a higher level of care than we provided.

I still remember the look on this man’s face when he said, “You made me wait five months to tell me that I need rehab? What the *&^%# is wrong with this place?”

Here’s my point: waiting lists aren’t good for clients.

Referral Matchmaking

If there is another clinician who has availability and is capable of helping your client, I think it’s more ethical to refer them. Sure, if you’re the only therapist within a 60 mile radius who knows how to treat eating disorders then maybe we can consider a waiting list, but that’s probably not the case for most of us. Why should a client wait weeks or months because you’re stuck in scarcity?

Here’s a valid concern: if word gets out that you’re full, people may stop referring to you. I have a workaround for that. If people are referring to you because you have expertise in a particular niche, tell them that though you’re full, you are so happy to talk to the client and refer them to some of the other great people you know in your niche.

If you have an inner matchmaker, this option really satisfies and you can leave your friends’ love lives alone.

Yes, it means you are going to be devoting time every week talking to not-your-clients and referring to not-your-practice. This part is where you feel good about helping people. You’re spreading good will, helping multiple people in need and it will only be beneficial to both your reputation and your karma.

You’re also living in abundance and trusting that all the good work you do will keep you full. I’ve found this to be true. Each time someone graduated from therapy or moved away, I got a call within a week to fill in that slot. As you’ll find (and I’ll keep shoving down your throat) there are plenty of clients. Keep it flowing!

This article was adapted from blog post published on the Abundance Practice-Building Blog.

Waiting in line photo available from Shutterstock

Don’t Be a Client Hoarder

Allison Puryear, LCSW, CEDS

Allison Puryear is an LCSW with a nearly diagnosable obsession with business development. She has started practices in three different cities and wants you to know that building a private practice is shockingly doable when you have a plan and support. You can download a free checklist to make sure you have your ducks in a row here. Get in on the conversation in the Abundance Practice-Builders Facebook Group.


APA Reference
Puryear, A. (2015). Don’t Be a Client Hoarder. Psych Central. Retrieved on October 27, 2020, from


Scientifically Reviewed
Last updated: 17 Jul 2015
Last reviewed: By John M. Grohol, Psy.D. on 17 Jul 2015
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