The most common number of sessions that patients attend in their life is one.  There are many other factors throughout the care process that influence and predict success, but it is clear that the first session is foundational to the building blocks of therapy.  The first session is a unique opportunity and an important opportunity to set the stage for treatment, especially if this represents the first time the patient is seeking care.  Some patients may approach that first session with hopefulness, curiosity, optimism, and relief, while many others experience cautiousness, skepticism, confusion, vulnerability, and fear.  There may be a range of all of these feelings that have built up over years prior to the courage to take this very first step.  The first session is where a provider focuses on building rapport and trust, discussing expectations,  providing psychoeducation, and identifying/agreeing on a treatment plan.

While the first session is also where a major task is completing a clinical assessment, if we get too fixated on asking these questions, we may miss the moment to instill a sense of hopefulness that there is a pathway to reduce suffering.  We need to give the patient a “nugget” – something they find meaningful to continue this process.  Essentially, providers are best served to focus on connection, understanding, and an initial demonstration that treatment can help with a patient’s concerns.  Success in this first interaction is engaging the patient to come back for another visit (if it’s clinically indicated) and there is a good match between provider and patient.  We often don’t have a chance to have “successful overall treatment” when a patient does not return.  I see treatment success as being set up by two components that ladder upon each other – (1) good match between patient and provider, and (2) first visit validates that match, and a connection is formed.

Imagine how we feel in every interaction with a new person.  Now, couple that with that person being someone who is supposed to help you through a vulnerable, delicate, and sometimes terrifying time in your life.  Before even stepping into that first session, many patients look for some degree of assurance that this provider will understand them and be able to help them.  This is different for each patient.  They may want to see someone who looks like them, shares similar identities, speaks the same language, specializes in certain conditions, practices in certain ways, etc.  The more areas in which a patient can find alignment, there is more likelihood of fit, comfort, connection, and hopefully engagement.  This gives the patient a sense of agency in their care, and may reduce some of the initial apprehension.  We do know that matching to providers based on patient preferences is more likely to succeed than random, first available matching¹.

Most provider profiles consist of a headshot and text descriptions of the provider’s background, their approach, and their practice information.  It’s difficult to get a true sense of a provider.  Patients, depending on their level of experience with psychotherapy, may not actually know what any of those words on the profile mean, nor do they always know what they’re looking for in a provider.  Profiles tend to blur together, and are hard to differentiate.  Of course, patients may want to be matched according to identity, language, etc., but each provider also has a unique blend of personality, insight, and approach that informs the whole picture.  However, we all have a sense, fairly quickly in interactions, which person we feel most comfortable being around.  We want to find a provider that resonates with us in a meaningful way that goes beyond a list of skills and walls of text.  Again, it’s different for everyone, but could be warmth, body language, tone of voice, etc.  A video not only lets us get to know the provider, but also is more personal and human.  It gives a profile much more life, and we can make a decision to select a provider based not solely for intellectual reasons, but also emotional and interpersonal.  You get to hear directly from a provider, almost like they’re speaking to you.  It’s both professional and personal.  As a patient coming for my first session, I have some exposure to the person that I am going to meet.

To be clear, “matching” is not just fitting a provider’s practice; it’s also the patient making an initial decision that the provider is a fit for them.  It’s really a mutual agreement, and usually the patient takes the first step.  Having profile videos gives a provider an important moment to communicate directly to potential patients, and give them the information that they need to make an informed decision about a match.  Therapists are rarely “good or bad.”  Rather, certain therapists are effective with specific types of patients and less effective with others.  Patients initiate the relationship in most cases, and while they’re not making a clinical decision about a match, their perception of fit is central to the effectiveness of treatment.  A clear, informative, and engaging provider profile strengthens that match by helping patients envision sitting with you, and hearing you speak.  A patient may read through a text profile and find some alignment, but that’s not necessarily indicative of a good match.  There’s so much left to discover during the first real interaction, and video uncovers some of that mystery to provide more depth and dimension.

Profile videos are a double-edged sword.  There’s a clear advantage to professional profile videos to provide a personalized, human touch for prospective patients that gives them a sense of who you are in the room.  However, a poorly created video may have the opposite effect. Understandably, therapists may not have experience in front of the camera, and may appear uncomfortable, and unnatural.  Instead of showcasing who you are, a different message may be sent to potential patients.  Poor quality production may also overshadow the provider and their content.  Even a movie with great writing can suffer from poor production and acting that detracts from the experience.  The fear of this happening is likely why so many of us avoid profile videos.

Most providers would definitely want to create deeper engagement with potential patients in a meaningful way, but retreat to safety.  Photos and text help us feel less threatened, but in some ways, it also creates a distance from potential patients.  We’re prioritizing our own safety and comfort, and sacrificing an opportunity for meaningful engagement. I know many providers agonize over creating the “perfect” profile text, and choosing the best headshot because, on some level, we know how hard it is to demonstrate our unique approaches, insights, and personalities through text.  Profile videos add another dimension to provider profiles that make them jump off of the page, showcase a provider in a real way, and align better with our goal to engage and connect.  We can actually use the time to say less, and instead demonstrate who we are.  Imagine being a patient and sifting through an endless amount of text-based profiles.  How do you feel most confident in your eventual choice?

Across healthcare, the no-show rate is approximately 23%² of patients no-show appointments during the source of treatment, and that number can be much higher in mental health depending on the setting.  Missing the first session is especially painful because it means that a patient’s care will either be delayed, or never occur at all.  Patients may miss that first appointment for a variety of reasons.  Sometimes there is an emergency, scheduling conflict, transportation issues, financial concerns, technical challenge, or simply forgetting the appointment.  Other times, patients may no-show to avoid dealing with the difficult issues that motivated them to make the appointment.  It can feel truly terrifying to address our challenges, and our readiness may waver from moment to moment.  When a patient misses an appointment during ongoing treatment, it’s an opportunity to understand the psychological, physical, and environmental barriers to strengthen engagement, and perhaps tap into an important area for their care.  When it occurs in the first appointment, we may never get that chance.

In my opinion, I believe that personalized profile videos could reduce first-visit no-shows (and perhaps overall no-shows) due to improved engagement and fit.  Patients no-show their first visits for a variety of reasons.  If we can convey a sense of hope, competence, warmth, and acceptance, there may be just enough motivation and comfort to take that courageous step to attend the session.  While that seems like a tall task for the provider to communicate all of these things in a concise way, I think that’s true for text descriptions, but not for video.  Many of these can be communicated in just how we show up as providers, which video can capture with ease.  We don’t have to hide behind walls of text.

One of the most difficult parts of independent practice is filling your caseload with patients quickly that are appropriate for your clinical practice.  Even if you’re getting referrals, it doesn’t mean that those patients fit your practice.  Given the financial implications, providers often need their caseload filled relatively quickly with the most appropriate patients, and not over months.  Then, you have to manage an EHR, continuous marketing (to ensure that your practice remains full), billing, submitting claims if working with payers, case coordination (mostly unbilled time), administrative patient support, finding networking opportunities, and much more.  Providers who sign up for telehealth platforms are usually looking for an organization that will fully enable their clinical practice (i.e. finding them appropriate patients), while reducing the burden of that “other stuff.”  Essentially, providers can focus on helping their patients with less distraction of the business and administration side that isn’t taught in school.

The best platforms have a steady stream of patients, and have matching algorithms that align patient preferences to the “right” provider.  The more degrees of “match,” the better the fit.  The difference here is that you’re not just receiving referrals; you’re being matched with patients.  This reduces fit issues between the patient and therapist.  We know that if a patient has to switch providers, 50% may not continue treatment.  It takes so much energy to meet a new person, and tell your story again.  That’s why that initial match is so important.  We may not get a second chance.  Platforms must provide the best possible patient matches in a timeframe that fits the provider’s needs.  The platform has to do much more than that too.  The best organizations provide a central EHR (and technical support), patient scheduling, patient support (fielding phone calls), billing (submitting insurance claims), predictable payout, no-show compensation, care coordination support, crisis protocols, and quality (clinical best practice) oversight.  The provider can focus on seeing patients and completing clinical documentation, and all other areas of practice management are off of their plate.

Simply, a bad match between patient and provider could disrupt the patient’s engagement and hopefulness that things can change for them.  They may be more reluctant in continuing with therapy now or later.  They may lose a chance to receive support with something that they may feel alone and ashamed with already.  Disappointment and frustration in the experience could make things worse (“no one can help me”).  This is why the initial match process should not be overlooked.  It’s the patient’s first full step into treatment.  We lose up to 60% of patients during the switch or transition to another provider.  This is why health systems invest so deeply in care coordinators to reduce this drop-off, although results are still mixed.  For telehealth platforms, this is a call to action to ensure that matching algorithms are continually refined (“never good enough”), and for provider profiles to be as robust as possible to help patients select the “right” provider for them.All is not lost with a bad match if a provider can read the signals and turn this into opportunity.  A provider can help the patient understand that there is poor fit without blame.  They can help the patient find the right therapist now they better know the patient’s needs, and can provide a warm handoff.

Meeting a new person, especially a helping professional, can be such an uncomfortable experience, and it’s normal to be anxious for that first meeting.  The more information that we can have about the experience, the more comfort that we can walk in with.  A professional profile video could certainly help a patient feel more acquainted with a therapist.  It breaks the ice at some level.  It can also break through preconceptions (previously held beliefs) of therapists.  Videos provide a better sense of the provider as a person, how they show up, and how they work.  Could I be comfortable with this person?  How would it be like to sit with this person?  Are they intimidating or warm?  Do they seem authentic?  Can I understand what they’re saying?  Does how they explain their approach make sense for what I need?

Although having a professional video has many advantages, many providers don’t take this step.  Having a video produced is often expensive.  Next, most therapists have very little experience in front of the camera, and that may create fear and avoidance.  We often have no idea what makes a great production.  What should I say?  How long should it be?  What about the background of the video?  How do I even take the video?  Where do I upload it?  What if I actually scare away potential patients?  There’s also the many self-conscious thoughts that come up for therapists!  With all of these questions and fears, it makes sense that we’d have very little confidence in ourselves or abilities to make a video.

Much like professional videos help patients and therapists bridge that initial gap, TakeOne takes something that used to be inaccessible for therapists and makes it a reality.  TakeOne’s app uses AI to act like an automated video production company. It gives you real-time guidance to record a professional video on your own.  Now, you have a tool that develops your scripts (based on your practice), tells you where to look, how to position yourself, and manages uploading and publishing automatically.  A therapist with absolutely no experience can create a professional video.  

As an industry, tools like TakeOne, give us an opportunity to give our patients more confidence in selecting their providers.  They can make more informed decisions, and that agency is important for treatment success.  Providers also share in this confidence, and get to express more about themselves and showcase their individual approach.  Boring and unengaging referral directories can become a lively, dynamic experience for a patient seeking care if they include video.  It adds a personal touch to work that relies upon it for success.