MHM#32 Waitlist - Should you have one?

Considering what to do about a waitlist is a good problem to have. It means you've achieved something significant and worth celebrating — a full caseload.

The therapists I work with are often surprised (in a good way) when they realise they've hit capacity. When you're starting out, the focus is so heavily on bringing in new clients and building momentum that there's not much time to think ahead to what happens after you reach your appointment goals. So when you do get there, it's exciting — but it can also come with a bit of uncertainty. You've reached a goal you've been working towards, but now you're in new territory, and it's not always clear how to navigate what comes next.

Here are some thoughts on whether or not to have a waitlist — and how you might go about it if you choose to.

The ethics of a waitlist

For some therapists, the idea of making someone wait when they've finally reached out for help just doesn't sit right. And obviously, there will be times when the issues a client is presenting with require urgent attention. It's also obviously important to follow your governing body's Code of Ethics and relevant guidelines.

A normal part of running a private practice

Other therapists see a waitlist as a standard feature of running a busy, full practice. It can help with business stability — if a few clients finish up unexpectedly, you have people ready to start. A waitlist can act like a bit of a safety net for your schedule and your income.

Using a balanced approach

The idea of someone waiting for therapy while struggling doesn't feel great, but having no waitlist can make your client numbers and revenue quite volatile, which can add a lot of pressure.

Having a network of therapists you know and trust and being open and transparent can help you feel comfortable with your waitlist approach and empower prospective clients to make decisions best for themselves.

Let prospective clients know it might be a few months before a spot opens up and that if they'd prefer not to wait, you've got some excellent therapists you can refer them to. If they do choose to wait, keep them in the loop — check in every so often and update them on how things are looking. And if you happen to have the occasional one-off appointment available, and it suits the kind of work you do, you can offer it as a short-term option. Just let them know that once a regular spot becomes available, you'll be in touch to offer it to them first. You can also invite them to join your newsletter and offer to send them resources. Depending on what therapy you provide, this could include video or audio recordings you've created. A mini hypnotherapy session, somatic exercise, mindfulness meditation etc. Or a tool or guideline relating to what you help clients with. 

Calculating capacity can actually be quite tricky

Managing a waitlist — or even knowing if you need one — can be really tricky. I've worked with a therapist who thought they were at capacity and then a month later realised that wasn't the case and they actually needed 8 more clients. There are so many moving parts, and things can change from month to month. If every client stayed for six months and came every two weeks, it'd be easy to work out your capacity. But that's rarely how it goes. In reality, it usually takes time and experience to get a feel for what full actually looks like for you.

If you start a waitlist, keep it simple

You don't need fancy systems. Many practice management tools have waitlist functions built in, but even a spreadsheet can do the job. Note down their name, when they contacted you, whether they're happy to wait, what resources you sent them, and when you last touched base with them.

Is it time to stop marketing?

Definitely not. I talk more about this in last week's article, but especially if your waitlist is new and you're still getting a feel for what "full" actually looks like — now isn't the time to hit pause on marketing.

There's always a bit of a lag between your marketing, new enquiries, and clients actually starting sessions. So, you want to avoid suddenly finding yourself with gaps and a dip in revenue. I usually recommend holding off on scaling back your marketing until you've had at least three solid months of filling 90% of your available appointments.

And even then, ease off gradually. If you're running something like Google Ads, you could slowly reduce your budget rather than stopping altogether. That way you stay visible but reduce the number of enquiries. 

Be kind to yourself

Most importantly — be kind to yourself in all of this. Managing a full caseload while also responding to new enquiries or juggling a waitlist can feel like a lot. It's okay not to have the perfect system. The goal isn't perfection — it's to do your best with the time, energy, and space you have and to support people as honestly and clearly as you can.