All Case Studies
01

45% of therapy clients drop out before their treatment plan is complete.

We analysed client retention patterns across Australian psychology practices. The finding is consistent: clients disengage before reaching therapeutic outcomes, and almost none receive structured follow-up. Here's the opportunity.

Routiq — Australian Psychology Report 2026
02 — The Market

Psychology is Australia's largest mental health profession and one of the most funded.

50,409
Registered psychologists in Australia (4.5% annual growth)
$715M
Medicare benefits paid for psychology services
2.7M
Australians accessing Medicare-subsidised mental health services
6.0M
Medicare psychology sessions delivered annually
$145.25 Medicare rebate (clinical psychologist)
10 Better Access sessions per year
$588.5M federal investment in mental health
AHPRA, Psychology Board of Australia, Medicare Benefits Schedule, AIHW
03 — The Problem

Mental health treatment is designed to be ongoing.
Client behaviour says otherwise.

45%
of clients drop out before completing their treatment plan
70%
of clients never complete their full care plan
5-20%
chance a new patient schedules their second visit

CBT typically requires 10–20 sessions. EMDR requires 6–12. Schema therapy runs even longer. These are evidence-based treatment durations — and the vast majority of clients disengage well before reaching them.

PMC, WebPT, SPRY PT
04 — The Cost

Client attrition is the single biggest drag on practice revenue.

Most practices invest heavily in acquiring new clients while existing clients silently disengage — taking their therapeutic progress and future sessions with them.

$300–$1K
Cost to acquire a new client
5-25x
Cheaper to retain an existing client than acquire a new one
$15,600+
Lost per clinician per year from just 2 weekly no-shows at $150
25-95%
Profit increase from 5% improvement in client retention
Bain & Company, Harvard Business Review
05 — What We See

A consistent pattern across every psychology practice we analyse.

Different sizes. Different modalities. Different locations. The same retention gap shows up every time.

What follows is representative of what we typically see in psychology practice databases.

06 — The Pattern
~65%
of clients are lapsed beyond 90 days

In a typical psychology practice database, nearly two-thirds of all clients have not been seen in the past 90 days. Many haven't returned in years — despite having incomplete treatment plans.

Typical client recency distribution

0–30 days
18%
31–90 days
17%
91–180 days
15%
6–12 months
15%
1–2 years
14%
2–3 years
10%
3+ years
11%
Routiq Practice Analysis 2026
07 — The Gap
No system.

Most psychology practices have no automated system for sending sensitive, clinically-appropriate reengagement messages to lapsed clients at scale.

The clients are reachable. The clinical need is there. The system isn't.

08 — The Segments

Four reengagement segments hiding in every psychology database.

~35%
Treatment Plan Dropouts
Clients with an average of 5–6 sessions remaining on their treatment plan at $318/session. The highest-value reengagement segment.
$318/session — highest-value segment
~15%
Maintenance / Check-in Lapsed
Clients who completed treatment but would benefit from quarterly check-in sessions at $318/session to maintain progress.
$318/session quarterly check-in
~20%
Initial Contact Only
Clients who attended 1–2 sessions and never returned. Full treatment plan value of $3,180+ still unrealised.
$3,180+ full plan value
~8%
No-Show Recovery
Clients who missed a session and never rebooked. 70% disengagement risk after a single missed appointment. Intent was there — life got in the way.
70% disengagement risk after missed session
Routiq Practice Analysis 2026
09 — The Opportunity

What reengagement looks like for a typical psychology practice.

Based on a practice with 1,500 clients, ~65% lapsed beyond 90 days, at standard Australian psychology session rates.

SegmentEstimated PoolReengagement RateRecoveredRevenue
Treatment Plan Dropouts~3408%27$42,930
Maintenance / Check-in~14610%15$14,310
Initial Contact Only~1955%10$31,800
No-Show Recovery~7820%16$5,088
Total — First Pass68$94,128
$318 average session value
10–20 sessions in a typical CBT treatment plan
Modelled on Australian psychology session rates. Conservative reengagement assumptions.
10 — Industry Validation

These numbers aren't optimistic. They're conservative.

15-25%
of lapsed clients are successfully reengaged by targeted recall campaigns
42%
click-through rate on healthcare SMS messages (vs 2-3% for email)
38%
reduction in no-shows from SMS appointment reminders alone
97-99%
of SMS messages are read (vs 80-90% contact rate for phone calls)
67%
increase in client attendance when SMS reminders are used
~99%
of clients in practice databases have a mobile number on file
Dialog Health, PMC, Etactics
11

“Isn't reengagement in psychology… different?”

It is. That's exactly why generic recall messages don't work. Clinically-sensitive, behaviourally-informed outreach does.

12 — The Science

Behavioral science applied to client retention.

Routiq's messaging engine is built on behavioral science frameworks from 20 seminal works in psychology and economics — calibrated specifically for the sensitivity required in mental health outreach.

Fresh Start EffectCommitment & ConsistencySocial ProofPratfall EffectEndowment EffectShrink the ChangeLoss AversionAutonomy FramingDefault EffectsPeak-End RuleImplementation IntentionsIdentity-Based Habits
82 behavioral principles
20 seminal research works
Psychology-specific engagement protocols
13 — In Practice: Treatment Dropouts

Commitment & Consistency + Fresh Start Effect

Generic Recall
“Hi! It's been a while since your last session. Call us to book your next appointment.”
Behaviourally Optimised
“Hi Sarah, we understand that sometimes life pulls us away from the things that matter. You made real progress through your first 4 sessions — and that progress doesn't disappear. Whenever you're ready, we're here. Reply BOOK to pick up where you left off, or CALL and we'll reach out.”
Pratfall Effect — validates the gapEndowment Effect — affirms progressAutonomy — removes pressureShrink the Change — easy restart

Tone is warm and non-judgmental — critical in mental health outreach. The message validates the gap rather than guilting the client, affirms their existing progress, and puts them firmly in control of next steps.

14 — In Practice: Check-in & No-Shows
Maintenance / Check-in
“Hi James, it's been 6 months since we wrapped up your sessions. Many of our clients find a periodic check-in helpful for maintaining their progress — like a tune-up. Dr Chen has some availability next week if you'd like a 30-minute session. No obligation — reply YES if you're interested.”
No-Show Recovery
“Hi Alex, we noticed you couldn't make your session last week — no worries at all! Would you like to rebook? Reply 1 for Monday, 2 for Thursday, or CALL and we'll ring you.”

Social proof (many of our clients), shrink the change (30-minute session, not a full commitment), autonomy framing (no obligation), pratfall effect (zero guilt for no-shows), and planning prompts (specific options, not open-ended). Every message is designed to feel like a gentle invitation, never a demand.

15 — Campaign Architecture

The 3-touch clinically-sensitive sequence.

Every campaign follows the same evidence-based structure. Three messages. Three psychological mechanisms. Clinically sensitive throughout.

Touch 1 — Day 1

Validation + Endowment

“We understand life gets busy. The progress you made in your sessions is still yours. Whenever you're ready, we're here to help you continue.”

Touch 2 — Day 5

Fresh Start Effect

“A new week can be a good time to pick things back up. Dr Chen has availability on Thursday — would you like us to hold a spot for you?”

Touch 3 — Day 10

Social Proof (gentle)

“Many of our clients find that checking in after a break helps them maintain the progress they've made. No pressure — just letting you know we're here.”

Clinically sensitive throughout. Every touchpoint prioritises warmth, autonomy, and zero guilt.

16 — Why Routiq

Three layers no one else has.

Layer 1
Clinical Intelligence

Routiq doesn't just know a client is “lapsed.” It knows they completed session 4 of a 10-session CBT plan, their presenting concern is anxiety, and their psychologist is Dr Chen. Treatment-plan-aware reengagement at scale.

Layer 2
Behavioral Science

82 principles from 20 seminal works — with sensitivity calibration for mental health contexts. Every message is warm, non-judgmental, and designed to feel like a gentle invitation rather than a clinical recall. Psychology-specific engagement protocols.

Layer 3
Automation at Scale

Daily monitoring against each client's treatment plan and session schedule. Messages sent from your own practice number at the right moment. Replies handled instantly with AI-powered clinical context. Works nights, weekends, holidays.

17 — Comparison

Where Routiq sits.

CapabilityFront Desk / PMSPractice SoftwareRoutiq
Treatment plan trackingManual chart reviewStores data, doesn't act on itYes — plan-aware
Same-day follow-upIf receptionist remembersNoAutomated, instant
Clinically-sensitive messagingDepends on individualGeneric templatesSensitivity-calibrated
Behavioral scienceNoNo82 principles, systematic
White-label sendingPractice numberThird-party numberYour practice number
AI reply handlingDuring office hoursNoInstant, 24/7
Predictive disengagement flaggingNoNoYes — before they lapse

Your practice software holds the data. Routiq turns that data into recovered clients.

18 — The Compound Effect

Reengagement isn't a campaign. It's a system that compounds.

10 clients per month at a blended $636/client (2 sessions average). Each reactivated client often continues beyond their initial return.

Month 1
$6,360
Month 2
$12,720
Month 3
$19,080
Month 4
$25,440
Month 5
$31,800
Month 6
$38,160

By month 6: 60 reactivated clients generating $38,160+ cumulative revenue — and many of those clients continue with their treatment plans beyond the initial return session.

19 — Your Practice

What this means for your practice.

The pattern is universal. The opportunity scales with your database size.

Your Database SizeConservative RecoveryModerate Recovery
500 clients$15,438$30,875
1,000 clients$30,875$61,750
1,500 clients$46,313$92,625
2,000 clients$61,750$123,500
5,000 clients$154,375$308,750

Based on $950 per recovered client (blended across segments). Conservative assumes lower reengagement rates. Excludes ongoing session revenue from clients who continue treatment.

20 — The Bottom Line

Without Routiq

Lapsed clients sitting in a static database
No follow-up after treatment plan dropoff
Revenue dependent on new client acquisition
No visibility into incomplete treatment plans
Generic recall messages that feel clinical
Therapeutic progress left unrealised

With Routiq

Every client monitored against their treatment plan
Warm, non-judgmental outreach at the right moment
Revenue from clients you've already built trust with
Automated behavioral campaigns for every segment
Sensitivity-calibrated messaging for mental health
Fraction of the cost, measurable ROI
21

You already did the hard part — creating a safe space, earning their trust, helping them start to heal.

Those clients didn't leave because therapy wasn't working. They left because life got in the way and nobody followed up.

Their mental health hasn't stopped needing support. They just need the right nudge — delivered with the right sensitivity.

How many clients are you losing to silence?

22 — Sources

routiq.

Clinical Intelligence Meets Behavioral Science

routiq.ai

Industry statistics sourced from:
AHPRA & Psychology Board of Australia
Australian Institute of Health and Welfare (AIHW)
Medicare Benefits Schedule Data
Services Australia
Department of Health and Aged Care
Bain & Company / Harvard Business Review
WebPT / SPRY PT
Dialog Health
PMC Systematic Reviews
Etactics

Practice analysis data from Routiq platform analysis. All data anonymised and presented as industry patterns. February 2026.