Community Notes

Communication is Part of the Therapist's Job

July 30, 2021

Article written by
Kealy Spring

Many clients have shared stories with me about therapists who did not respond to them or times there were communication breakdowns that occurred during the course of treatment. Having coached and mentored other therapists, I have also heard from them about the communication they are avoiding or not navigating well. Sometimes that is because they are afraid to express a boundary with a client or they are uncomfortable addressing questions related to payment or fees. Or it might be that they simply do not have any availability at this time. While I understand that these situations can be uncomfortable to deal with, it is a therapist’s job to manage these moments for several reasons.

First and foremost, part of our job as therapists is to model healthy communication. A previous professor once told me, “you can’t not communicate. Even your silences communicate something.” By not saying something you are sending a message to clients and potential clients whether it is intended or not. Take a moment to reflect on the last time you did not respond to a client from the lens of “what was I communicating to that person?” Or, “how might they have interpreted my lack of response?”

Additionally, therapists are frequently tasked with helping our clients more effectively communicate with their partners, friends and colleagues. Whether that is about boundaries, their needs/desires or role playing a difficult conversation, the ultimate goal is to help them build their communication skillsets while speaking their truths in a respectful and appropriate way. This work has the added benefit of helping them build their confidence levels when handling difficult situations in the future. Most therapists would not encourage clients to avoid challenging discussions with others so why would we model that behavior for them?

Secondly, when clients reach out to us for support they are already in a vulnerable state. They are not sure if we can help them or even if we are willing to help them. Will we like them? Empathize with their situation? Have tools to help them navigate challenges? They have no way of knowing the answers to any of this, especially when we do not engage well with, or at all, in the conversation.

Finally, let’s look at this from a different angle. Say you had a toothache. You reached out to your dentist’s office via phone, but no one answered, so you left a message. Twenty-four hours later and no return call. So, you try again. This time emailing and calling. Still, no response. What would you think? How would you feel? Would you give them a bad yelp review? Call and leave an angry message? Whether we like it or not, in many ways we are in customer service. And our customers, like the person with a toothache, need our help. Even if the answer is “no,” a response is warranted.

Steps to Improve Communication Skills

1. Engage in difficult conversations. Yes, it may be a challenging situation to deal with, but see it as a part of your job rather than something separate. Remember that even your silence communicates something. Aim to be in control of the narrative rather than letting someone decide what that is for you and your business.

2. Consult with colleagues. Consulting with colleagues when a client requests something that is difficult or something you haven’t dealt with before is part of the job for therapists. There is no shame in not knowing how to handle a situation as we will never be able to know the best way to handle every one presented to us.

3. Admit when you mess up. Model for clients when you say or do something that feels off for you. Simply acknowledging it can help those you work with to know mistakes are a part of life and not something that should stop them from trying again.

4. Respond to requests in a timely manner. Have a strategy for managing requests from new and current clients. A general rule is to respond within 24 hours, even if it is to say “I am unable to work with you at this time” or “I will have to get back to you on that.” Clients will appreciate it and if not one already, they could become a client further down the road when you do have availability. Unable to deal with a response in the time you have between sessions? No worries. Mark the message as unread or make a list to keep track of things to follow up on.

5. Set expectations. In your first session, tell clients what they can expect from you regarding communication. For example, “I try to get back to emails and texts within 24 hours.” If you don’t work on the weekends, let them know that too. “If you reach out on a weekend, I will respond on the next business day.” Also discuss steps for how they should communicate with you if they are in the middle of a crisis. Setting these expectations will be helpful when communicating practice policies and boundaries in the future.

6. Address your feelings proactively on challenging topics. For many of us, talking about payment and fees is not much fun. We are caught between wanting to help and wanting to provide for our own selves and family. Our time is limited, valuable and the emotional labor it takes to hold others well is a lot to manage, so please empower yourself to charge accordingly. To address feelings related to difficult topics like fees, consult with your own therapist or have open conversations with colleagues to help gain clarity before you talk with clients about it.

Challenge yourself to have those difficult conversations. The more you do, the more they will become easier to navigate moving forward. See communicating with your clients as a part of your job…because it is.

Kealy Spring is a Licensed Marriage and Family Therapist (#93512) as well as a Leadership, Communication and Career Coach with offices in San Francisco. She works with driven professionals who seem to have it all together but feel lousy on the inside. Kealy can be found at or at

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