The goal of every business is happy customers. However, in the mental health business, we usually deal with three customers rather than one. They are:

  • The client
  • The payor (if other than the client)
  • The referent (agency, private practitioner, etc, who sent the client to us)

Customer expectations are largely influenced by three factors.

Price. The more you pay for something, the higher your expectations. But we don’t all have the same resources, so what’s prohibitively expensive for some is just plain cheap to others.

Desirability of the product. If you’re selling a ‘hot’ commodity – something much in demand – then customers are more eager to have it and more willing to overlook its flaws. When the market cools down, you’ll need to make adjustments in price and quality of service.

Service. Some customers expect more in terms of individualized service. Translation: they want what they want, when they want it – and are willing to pay for it.

Exceeding – not just meeting – a particular customer’s expectations is the key to happy customers. You don’t have to be perfect. You just have to be better than the customer expects, at that moment in time.

For instance, from McDonald’s, customers expect convenience and low price – and in return, are willing to bus their own tables. From Nordstrom’s, customers expect employees to ‘go the extra mile’, and expect to pay more for it. From Apple, we expect products on the cutting edge, and happily pay exorbitant prices for the newest rage.

In the mental health biz —

Clients tend to value attention above all other things. They want to ‘feel attended to’, and that is highly subjective. They are perhaps oversensitive to any suggestion of impatience or lack of caring from staff. And because of their psychological state, they can become quite upset with relatively little provocation.

Payors, on the other hand, are invariably looking for a ‘deal’ – something extra for their money. Even managed care companies, famous for frugality, are sometimes willing to pay more for a service they perceive as unique, so long as on some level they believe they are getting superior value for their dollar.

Referents also tend to value individual attention, but their needs are different from those of the client. Referents want to feel involved in the process. In some cases, this tips over into an unhealthy need to control that process – a situation that must be handled carefully if relationships are to be preserved.

Practical tips for exceeding customer expectations


Spend time with them. Never rush, never hurry. Calm yourself between clients to make sure the client doesn’t pick up an impatient ‘vibe’ from you. Strive to avoid becoming defensive when clients are unreasonable – it only feeds their anxiety. Recognize you are communicating with your body (your posture, your expression, your tone) as well as with your words. Early on, look for opportunities to perform a favor for your client – preferably, something small that is nonetheless more than they expect. You’re building a reservoir of good will that can help you establish trust.


Put yourself in the place of the person paying the bill – what would be important to you? Learn how to communicate what’s valuable or unique about your services, in concrete, practical terms. Where you offer advantages over other choices, learn to articulate those advantages. Don’t become defensive when payors challenge the value of your services – you might do the same in their place. Learn instead to reassure them of the wisdom of their decision.


Perhaps the most difficult relationships to manage, because you will find yourself having to negotiate your way out of inevitable conflicts. Look always for a ‘win-win’ outcome – something that makes both sides winners. Strategic concessions are your best weapons. If you sometimes say ‘yes’, it’s a lot easier for others to accept when you eventually have to say no.