Engagement was not the problem. Relevance was.

The brief was to improve engagement. The real problem was relevance. By redesigning assessments, messages, and the moments between sessions around what clients needed next, I helped more people reach a third session and continue into longer-term care.

01 THE SYSTEM

I was handed an engagement problem. Getting to the root of it changed the diagnosis, and everything that followed.

The goal was specific and well-founded: get more clients to a third therapy session. We knew that clients who reached a third session were roughly 55% more likely to stay in care for the long term, so that third session was the threshold that mattered most. I was asked to raise it, on the assumption that clients simply weren't engaged enough.

So I went to the people. Talking with patients and providers, a different picture emerged. Patients arrived ready to do the work, but whether the platform met them there depended almost entirely on which provider they were paired with. A motivated patient would take an assessment, show up, and want something to hold onto between sessions; but between-session tools only existed if their provider assigned them, and many didn't. The person most ready to make progress was left with nothing at exactly the moments care needed to feel present.

The friction ran both ways. A patient couldn't book their own next session at all, so they had to message their provider and wait, a small task that quietly became a barrier for both. And patients would gladly complete assessments, but not every provider used them: with no fast, scannable way to read results before a session, the concerning signals called out, assessments felt like busywork, so patients stopped.

It was never an engagement problem. It was a relevance problem. We weren't meeting patients or providers in the moment, and in-the-moment care was exactly what we were trying to move toward. Naming that correctly is what made the next decisions obvious.