Let me say the quiet part out loud: consults are a waste of everyone’s time. And worse, they’re hurting access to mental health care.
As a clinical psychologist, a clinic owner, and someone who gives a damn about getting people the help they need when they need it—I’m begging fellow therapists to stop offering free 15-minute consultations. Not just because they’re annoying (which they are), but because they’re actively working against our mission as mental health care providers.
Let’s break it down.
1. Consults delay care. Full stop.
In private practice, one of our greatest strengths is flexibility. No long waitlists. No red tape. We can move fast when people are struggling—which is exactly what they need. But the consult model throws a massive wrench into that process.
You know how this goes. A client reaches out. You offer a consult. They don’t respond for a few days. You send a Calendly link. They’re busy for two weeks. You finally meet. You talk for 15 minutes. Then they might book an intake three weeks later.
That’s a month of waiting. For someone who might be in crisis.
Research is clear: delayed treatment leads to worse outcomes. Symptoms get more entrenched. Motivation drops. Risk increases. Every day someone sits in limbo is a day we’re not doing our job.
Research consistently shows that delays in initiating mental health treatment can exacerbate symptoms and lead to poorer outcomes. A meta-analysis indicated that longer durations of untreated illness are associated with brain changes in individuals with various mental health disorders, emphasizing the importance of early treatment .
📌 Wang, P. S., Berglund, P. A., Olfson, M., & Kessler, R. C. (2004). Delays in initial treatment contact after first onset of a mental disorder. Health services research, 39(2), 393-416.
2. Consults don’t predict fit. They predict performance.
We like to tell ourselves that consults are for “ensuring a good therapeutic fit.” But let’s be honest—what are they really measuring?
Who’s got the best phone voice.
Who seems the friendliest in 15 minutes.
Who can sell themselves as the “right” therapist.
Even worse: consults open the door to unconscious bias. Clients are more likely to choose someone who looks like them, talks like them, or presents in a familiar way—rather than the person who’s actually best equipped to help. This creates a ripple effect that disproportionately impacts therapists from marginalized backgrounds and narrows access to diverse, skilled care.
This isn’t a job interview. It’s therapy. And research doesn’t back up the idea that short consults lead to better outcomes. In fact, most predictors of therapeutic success come after therapy starts—things like early alliance, feeling understood, and session consistency.
If clients want to try out a therapist, they can do that the real way: by booking a first session.
The strength of the therapeutic alliance is a robust predictor of positive treatment outcomes. However, this alliance typically develops over the course of therapy, not during brief initial consultations. A comprehensive review suggests that the quality of the client–therapist alliance is a reliable predictor of positive clinical outcomes, independent of the variety of psychotherapy approaches📌 Manubens, R. T., Babl, A., Doran, J., Roussos, A., Alalu, N., & Gómez Penedo, J. M. (2023). Alliance negotiation as a predictor of early treatment outcome. Journal of clinical psychology, 79(8), 1740-1751
3. Consults create unrealistic expectations for clients.
We’ve unintentionally trained the public to believe they should shop around with consults. And it’s not their fault—we built this monster.
But here’s the thing: no other healthcare provider does this.
Dentists don’t offer to peak into your mouth for free.
Doctors don’t block off time to pitch themselves.
Optometrists don’t take unpaid phone calls to explain how great they are.
So why are we doing free labour under the guise of client empowerment?
We need to shift the narrative. Educating the public is part of our job. That means being clear that the first therapy session is the consult—a full, billable hour (or two) designed to build connection, explore goals, and decide if we’re a good match. And if we’re not? We refer. We adjust. We support the next step.
But doing unpaid emotional labour as a marketing tool? That’s not it.
Brief consultations can inadvertently allow unconscious biases to influence client choices, potentially leading to preferences based on perceived similarity rather than clinical effectiveness. An experimental study found that racial match influenced perceptions of therapist credibility and working alliance, mediated by perceived similarity📌Meyer, O., Zane, N., & Cho, Y. I. (2011). Understanding the psychological processes of the racial match effect in Asian Americans. Journal of counseling psychology, 58(3), 335.
4. Intake IS Treatment
Here’s something I tell clients and supervises all the time: an assessment is interventional. It’s not just a formality or a box to check before the “real work” starts. The very act of telling your story—of putting words to your pain, your patterns, your history—is therapeutic.
Why? Because the more we tell our story, the less power it has over us. That’s why the first session can feel so heavy. It’s supposed to. And because it’s hard, it’s also incredibly important.
So yes, there’s a cost to booking a full intake. But it’s a cost that comes with value. You’re not just sampling a vibe—you’re getting real clinical attention, real insight, and real momentum. Even if it turns out the fit isn’t quite right, that session still moves the work forward. And if you have to do more than one intake to find the right person? That’s not a failure. That’s a commitment to getting the care you actually deserve.
Intake isn’t what you do before therapy. Intake is therapy.
5. Consults are bad for business (and burnout).
Let’s talk brass tacks for a second.
Free consultations are unpaid time, often offered by therapists who are already overbooked, under-boundaried, and under-maybe even compensated. For those of us running group practices, free 15-minute consultations also create a cascade of issues—confusion around scheduling, inconsistent onboarding, and unnecessary admin strain.
You know what’s better for everyone? Clear systems. Direct scheduling. Compassionate onboarding policies that trust therapists to assess fit once therapy starts, and trust clients to advocate for themselves if something’s not working.
When you respect your own time, your clients benefit too. Because you’re not resentful, rushed, or stretched too thin to offer the care they came for in the first place.
Here’s the alternative to free consultations
Let’s stop centering consults and start centering access.
What if instead of offering 15-minute calls, we:
- Made it easy to book online.
- Had Intake Coordinators to help guide clients to the best-fitting therapists for their unique needs.
- Had transparent bios and fee info on our websites (why does no one list their fees, already?!).
- Offered first sessions with the explicit framing that they’re about mutual fit.
- Trusted clients to choose again if the match isn’t right.
What if we moved faster? Trusted our clinical skill? Cut out the delay?
The TL;DR
Consults are:
- Unnecessary
- Unsupported by evidence (!!!)
- A scheduling mess
- Bad for business
- Not in service of the client
- Not supportive of therapists
Let’s stop doing them. Let’s build something better.
Want help figuring out a better intake process for your solo or group practice? I consult with clinicians and clinic owners across Ontario. Reach out—I’d love to support your vision.