Full Caseload Therapist

The September wave is here and most practices are not ready for it

By Steve Meitler · 2026-09-04 · 4 min read

Inquiries jump when school starts and routines return. Here is what to fix this week so the second-biggest intake surge of the year does not go to voicemail.

The phone starts moving again in the first full week of September. Summer travel ends, school schedules lock in, and the people who spent June through August telling themselves they would deal with it later start dealing with it. In most practices this is the second-strongest inquiry stretch of the year after January, and it runs about six weeks.

The problem is that it arrives at the exact moment a clinician is busiest re-establishing a caseload, which is why so much of it goes to voicemail and stays there.

Here is a short list of things that can be fixed this week, in order of what they return.

Fix the hours on your Google profile today

If you shortened your hours in July, or set special hours for a vacation, check whether they are still there. A profile showing summer hours in September tells a caller you are closed when you are not.

Then check whether you have hours at all. Across the 171,610 listings in our dataset, 22.7% publish none. Google treats an hours-free listing as less reliable and a caller treats it as a reason to try the next practice. This is a two-minute fix with a real return in the one month of the year when the most people are looking.

While you are in there, add any evening or weekend slot you are holding for the fall. 28.4% of practices publish Saturday hours. If you have two Saturday morning openings, saying so puts you in a small group in your city.

Email your waitlist before you advertise

Every practice has a list of people who called in June when there were no openings. Most of them were told "I will let you know" and never heard back. Some found someone else. Many did not.

Send them one short email this week naming actual availability. Not "we are accepting new clients". Specific: "I have Tuesday at 11 and Thursday at 4 open starting September 15." Specific availability books. General availability does not.

This is the cheapest new client you will get all quarter, and it costs one email.

Say the availability out loud to your referral partners

The same rule applies to physicians, psychiatrists, school counselors and attorneys who send you people. A referral partner does not refer to a practice they assume is full, and they assume you are full unless you tell them otherwise.

One message, one line: "I have two openings for adults with anxiety on Thursdays, starting next week." Send it to five partners. In September that message converts at a rate no ad can match.

Test what happens when you cannot answer

Call your own office line from a number your phone does not recognize, in the middle of a workday. Listen to what a person in their car on a lunch break actually experiences.

Does it ring more than five times. Does the greeting name a callback window or just say "leave a message". Does anything happen after the beep, or does silence sit there until you notice the missed call at 6 p.m.

A missed-call text that goes out within a minute, naming a person and a specific callback time, costs $20 to $60 a month. In a six-week surge it is usually the highest-return spend in the practice. The wording that works for a therapy practice, including the crisis-line line that belongs in every one of these messages, is in the follow-up guide. What the leak costs you is in the calculator.

Update the fee and the insurance page

Fall is when people finally look at their benefits, and it is also the run-up to open enrollment, which means a lot of the September and October calls include a question about coverage.

Make sure your site lists every panel you are currently on, spelled the way the payer spells it, and states plainly what you do if you are out of network. If you raised your fee this year and the site still shows last year's number, fix that before the surge, not during it. Practices that publish the fee get fewer calls and more bookings, which is the trade you want in a busy month. The reasoning is in the website guide.

Then use October to prepare for January

The September wave lasts about six weeks and then tapers into the holidays. January is bigger. Everything you want working on January 2 has to be built in November, and October is when a practice has both the caseload income and the calendar space to do it.

That means the website rebuild, the Google Ads campaign built and paused, the profile finished, and the waitlist process written down so next year's June callers actually get a September email. Where each of those sits against the rest of the field is on the benchmark report, and the shape of the whole practice year is in the seasonality guide.

The wave is going to happen whether or not you are ready. The only variable is whether the calls reach you.

If you would rather have the profile, the follow-up and the January campaign handled, any single service can be run for 14 days at no cost through the free trial page. Text or call (385) 832-6175.

SM
Steve Meitler, Editor
Steve has spent the last several years running growth campaigns for local service businesses, therapists among them, and builds the benchmark datasets on this site from public Google listings. About this site

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