One of the biggest challenges early intervention therapists face is building a caseload. Especially for those who are new to early intervention, adding clients is usually a top priority. It is frustrating when you want to be “full-time,” but barely have enough clients to fill one day’s schedule. New clients seem to trickle in very, very slowly. MANY therapists quit early intervention because they can’t get enough clients fast enough. Over the past 15 years, I have learned several strategies to help build a caseload and keep it full.
1. Create a detailed bio for yourself on your state’s website.
In early intervention, parents have “freedom of choice” when deciding who the ongoing provider will be. Most states have a “matrix” of providers for parents to choose from. It always surprises me when providers don’t offer a bio about themselves when one is allowed. After attending hundreds of eligibility meetings, I have learned what is important to the parent/caregiver. Parents want to know how much experience you have, what type of experience, any special training or certifications, and how you will help them. Parents also like to find someone who is “relatable.” For this, you can include something personal about yourself such as how many children you have or if your child required early intervention. Writing a concise, informative, and easy-to-read bio about yourself is crucial to being selected as an ongoing provider. Just a few extra minutes for detail goes a long way.
2. Update your availability and respond to texts/emails.
Usually, you can enter your caseload availability on your state’s website. Keep your availability up-to-date. If you let too much time lapse, your name will disappear from the list altogether! So, make sure to update regularly (i.e. at least once per month). Once you've been chosen by the parent, the coordinator will contact you to ensure that you are willing to accept the client. A timely response to this request is crucial! If it takes you 2 days or longer to respond to a request, then the coordinator is required to move on to the parent's next choice. Combine a lack of response to texts/emails with an out-of-date availability on the state's website, coordinators will likely assume you are not accepting any new clients.
3. Expand your territory.
Be willing to drive a little farther, especially when you are first starting to build your early intervention caseload. If you live in an area where there is an over-abundance of providers, be willing to venture into more rural areas. When rural areas don’t have any providers, and you can quickly add clients. Many states even offer extra monetary incentives for working in rural areas. The bigger your territory, the greater the probability for you to add clients. Once you have a full caseload, you can start to limit your territory for new clients. It may take a bit longer, but you will eventually get to a full caseload in smaller territory.
4. Keep an open mind.
I’ve heard many therapists talk about how they only go to “certain” neighborhoods. If you choose, you can be selective in what socio-economic areas you work, but I suggest you keep an open mind in regards to where you will work. Working with families who couldn’t get therapy otherwise can be the most rewarding of all! Expand your territory and be willing to go to lower income neighborhoods. If necessary, agree to meet at the library, a neighborhood park, the grocery store, or other location in the natural environment.
5. Work after hours.
If you are able, make yourself available to see clients later in the evenings or on the weekends, even if it is just one day per week or one weekend per month. With this strategy, you can quickly add new clients, especially for working parents who want to be present for some sessions.
6. Show up and be the best you can be.
Word travels fast when a provider goes above and beyond for their clients, but word travels even faster when a provider doesn’t show up or misses sessions frequently. We all know that early intervention is crucial, and missing sessions cheats clients out of valuable therapy time. Plus, extra paperwork is required of the service coordinators when parents request a new provider. Be sure to attend all of your sessions, and do your best to not cancel/reschedule sessions.
7. Keep your therapy sessions professional.
Send appointment reminders, show up for sessions on time, wear scrubs or professional attire, and stay focused on the client. Don’t let your personal life into your sessions. Caregivers report good and bad information to other providers, service coordinators, and other caregivers. Staying professional will increase word-of-mouth referrals.
8. Attend all IFSP, quarterly, and annual meetings.
When possible, go to all team meetings. Attending meetings not only allows you to provide your input for the client’s plan, but also allows you to network with team members. Yes, parents ultimately choose who the provider will be, but service coordinators and other providers will be more willing to recommend you to other families once they meet you.
9. Attend regional and state meetings.
If you intend on making a career in early intervention, building relationships and learning as much about the resources available in your area is crucial. Not only can you meet service coordinators in your area, but these regional and state meetings often provide insight to what is going on in your area and your state’s early intervention program. You may even find that you can volunteer for projects or committees. Networking is always beneficial. The more you know, the better. The more people you know, the better.
10. Be willing to learn new skills… be a jack of all trades.
Attend as many continuing education courses (online and in-person) as possible. Be willing to step out of your comfort zone and accept clients with various diagnoses, ages, and medical backgrounds. Make sure to indicate your training and experience in your bio.
11. Become the “go to” therapist.
In my area, I know a therapist who we all call “The Feeding Guru.” She has many years of experience and is known by everyone in our area for her expertise in feeding. Almost all of her clients have feeding issues and she typically has a waiting list of clients who want to be on her caseload. Similarly, another colleague in my area achieved a certification in a specific sensory technique. She only accepts children with underlying sensory problems, and also has a waiting list for clients. Both of these therapists spent years working with all types of clients as they honed their skills to specialize in one area. Over time, they became “go-to” therapists for their specialty.
12. Be patient.
If you do all of the above, you will soon be on your way to a bigger caseload. As with any practice setting, early intervention can be cyclical. Sometimes, there seems to be a drought of new clients entering the EI program, and other times a mad rush. For example, holidays may be slow for adding new clients, but after New Year’s and after local schools start, there may be an influx of new clients. Be aware of the “season.”
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