With the demand for mental health services rising steadily—and ongoing workforce shortages putting providers in a seemingly perpetual squeeze—the pressure to optimize all available treatment time has never been more real.

The problem is, the push for higher appointment volumes doesn’t always support the mission to deliver effective mental healthcare. In fact, strict numbers-based “productivity standards” can end up not only watering down the care people receive, but also wearing out the very professionals providing it.

While it’s true that more appointments mean more revenue in the short term, a laser-focus on care volume misses the real goal of therapy: helping people. True productivity in behavioral health should also factor in the impact of care on client well-being—because if clients aren’t achieving positive outcomes, can we really call the care productive?

Of course, you can’t manage what you don’t measure, which means industry leaders must look toward new approaches to managing provider performance—specifically, ones that emphasize value over volume. 

Here’s how.

1. Focus on the outcomes from care, not the amount of care.

When we shift measurement away from the number of clients seen or the number of sessions completed—and instead consider the effect of therapy on client health and wellbeing—we give behavioral health the depth and dimension it deserves.

Through this lens, interventions aren’t just delivered—they genuinely and objectively contribute to client progress. Below are some suggested outcomes and measurement methods.

Which Outcomes to Track

• Reduction in Symptom Severity: Track how the intensity of symptoms changes over time.
• Improvement in Coping Strategies: Assess how clients better manage stress and emotions.
• Increased Life Satisfaction: Gauge improvements in overall well-being.

How to Measure These Outcomes

• Use Standardized Tools: Apply validated measures regularly to get a clear picture of progress.
• Collect Client Feedback: Implement qualitative feedback mechanisms like surveys to hear directly from clients (and/or their caregivers) about their therapy journey.

When providers and organizations focus on quality over quantity, they also contribute to the greater movement toward value-based care—and that’s good for the overall healthcare and client community.

2. Account for provider wellbeing.

Provider burnout is counterproductive to productivity. (Say that five times fast!) When providers get so burned out that they leave their jobs, it disrupts care progression for existing clients and reduces the remaining workforce’s capacity to take on new cases.

In other words, the satisfaction and wellbeing of your provider staff are solid indicators of not only their performance today, but also how long they can sustain that effort over the long haul. When providers feel like their own mental health is a priority, they’re more likely to stick around—and to deliver the kind of care that drives higher engagement and better outcomes.

“When therapists are given unrealistic workloads or caseload expectations, not only do they suffer significant burnout and potentially secondary trauma, but clients suffer as well,” said Ohio-based counselor Meggen Horwatt, LPCC. “It has become a numbers game or a quantity-over-quality mindset. What therapists need in order to truly help their clients is reduced caseloads and support for their own mental wellbeing. Quality of care is much more important than the number of clients being seen.”

Indicators of Provider Wellbeing

• Work-life Balance: When providers are able to build healthy, well-rounded lives outside of work, they are better able to bring their best selves to work.
• Job Satisfaction: Contentment in the workplace is directly linked to lower turnover rates and greater care continuity.
• Stress Levels: Monitoring stress and burnout levels is crucial to offering preemptive support and intervention.

Ways to Collect this Data

• Surveys: Anonymous and evidence-based measures give clinicians an outlet for sharing their honest thoughts and feelings about their work environment.
• Personal Check-ins: One-on-one conversations draw out deeper insights into individual experiences, creating a more nuanced understanding of clinician well-being.
• Percentage of PTO Used: This objective measure helps assess whether clinicians feel comfortable taking needed breaks to maintain their mental health.
• Retention Statistics: Reviewing the average length of employee tenure and common reasons for ending employment can guide strategies to improve retention.

By focusing on the satisfaction and retention of current staff members, organizations can cultivate a work culture that values and supports providers, ensuring they are equipped and motivated to provide the best care possible in both the short- and long-term.

Oklahoma-based GRAND Mental Health, which boasts nearly a 90% staff retention rate and was recently named a Newsweek Most Loved Workplace®, keeps provider well-being at the heart of organizational strategies, priorities, and decision-making. As Matthew Spencer, Chief Clinical Officer, explains in the video below, that means investing in tools and resources that truly benefit staff—whether that’s by making their jobs easier and less stressful, or supporting their professional growth. “Invest in your clinicians, and you will see better outcomes for your clients,” Spencer said.

3. Balance caseload intensity.

Provider workloads (and productivity) aren’t only influenced by how many clients they see, but also how intense each case is. For instance, a therapist working closely with a few clients who have severe mental health issues or diagnoses often does more heavy lifting than someone handling a larger number of less complex cases. To optimize productivity, then, it’s critical to ensure caseloads are:

• manageable,
• matched to individual strengths, and
• weighed according to the depth of care each client requires.

How to Measure and Manage Caseloads Effectively

• Assess Case Complexity: It’s important to regularly review the demands of each case, recognizing that some require a greater investment of time and expertise.
• Tailor Caseload Sizes: Balancing the number and complexity of cases assigned to each provider helps ensure they can continue providing quality care without risking burnout.
• Match Provider Skills to Client Needs: Assigning cases based on provider strengths and areas of expertise maximizes the effectiveness of care and promotes job satisfaction.

This approach to caseload management not only prevents clinician burnout, but also ensures that clients facing serious mental health challenges receive the focused care they need.

4. Set team-based goals.

One way to relieve some of the pressure that comes from traditional productivity standards is switching to a team approach. That way, it’s not about how many clients each individual provider can cram onto their calendar—it’s about how many clients the team or organization as a whole can serve. This introduces a collaborative dimension to volume-driven goals and aligns with the push to improve wellness at the community level.

Tips for Tackling Productivity as a Team

• Set Collective Outcomes Goals: Go beyond raw appointment numbers and incorporate measures that reflect your team’s impact on community mental health—like reducing hospital readmissions or broadening access to services in underserved communities.
• Celebrate Team Milestones: Highlight and reward team accomplishments to reinforce the importance of working and succeeding together.
• Encourage Team Unity: Promote open dialogue and create clear pathways for team members to lean on one another for support. This ensures every team member feels valued as a member of a cohesive unit.

At GRAND Mental Health, collective outcomes-driven goals are key to performance management. As CEO Josh Cantwell explains in the video below, their approach to defining and measuring success is starting with the overall end outcome in mind—and then working backwards to define each individual’s role in achieving it.

When organizations adopt team-based care goals, not only do therapists get to appreciate how they’re contributing to something bigger than themselves, but they’re also less likely to feel isolated—something that often leads to burnout and attrition.

5. Recognize and encourage professional development.

Growth in professional knowledge and skills directly affects a provider’s ability to deliver high-quality care. So, it makes sense to integrate measures of professional development into your organization’s performance management efforts.

Strategies to Encourage and Monitor Growth

• Customized Development Plans: Offer personalized learning trajectories that align with each clinician’s interests and the evolving needs of the community.
• Leadership Skill Building: Provide avenues for providers to hone their leadership abilities, equipping them for more strategic roles.
• Innovative Upskilling Opportunities: Facilitate access to the latest in mental healthcare best practices through workshops and training, ensuring the team remains agile and informed.

“We want an environment where we’re focusing on the experience for the clinician,” Spencer said of his team’s approach at GRAND Mental Health. “If there’s an outcome we want for a client and they’re not getting there, we’re doing something wrong. So we have to make a shift there. And what we’ve learned is the best way to help ease that burden on clinicians is to focus on the training piece.”

When organizations look at professional development as a measure of productivity, they recognize an important connection: providers get better as they learn and grow. In addition to improving client outcomes, professional growth creates an environment where continuous learning and improvement are deeply valued, empowering the entire organization to deliver the best possible care.

6. Leverage provider feedback and support systems.

There’s more to organizational productivity than numbers and metrics; frontline clinician experiences and insights play a big role, too. Feedback and support systems are crucial to an organization’s ability to understand and improve productivity levels.

“My supervisor genuinely listens to understand and isn’t just placating our ideas or concerns,” said Florida-based therapist Nicole Pizza, LMFT. “The difference comes with action, and I really appreciate that. It makes me want to do more for whatever company I’m with.”

Ways to Use Feedback for Performance Management

• Provider Insights as Key Performance Indicators: A clinician’s unique insight into organizational processes, client interactions, and support systems can help an organization assess its strengths, weaknesses, and overall productivity. 
• Continuous Improvement through Feedback: Organized feedback sessions allow providers to share experiences, voice concerns, and suggest improvements. Iterative improvements result in better workflows, better support systems, and ultimately, better productivity.
• Support System Utilization as a Measure: Whether for professional growth or well-being, clinicians need support systems. It’s important to monitor provider engagement with the support resources available to them—and how that engagement impacts productivity and other performance measures. That way, you can identify gaps or opportunities to adjust existing resources.

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The reasons behind workforce shortages and provider turnover aren’t so mysterious when we look more closely at the unsustainable productivity standards running rampant in behavioral health. By shifting focus away from traditional productivity measures in favor of a more multidimensional approach to performance management, behavioral health organizations enable themselves to manage what really matters: their impact on the health of their community. 

Our new ebook, “Rising Above the Workforce Shortage,” provides actionable insights for those ready to lead the way toward better care experiences for clients and providers alike. Grab your copy here.