PhD, Counselor Education & Supervision, Belmont University | LPC-MHSP · C-DBT | Founder & Clinical Director, Delilah Counseling, Nashville

dr. andrea santa maria

understand how clients choose you

Most therapists were trained to treat clients, not to understand how clients find them. Andrea’s doctoral research looked closely at that moment: a young woman deciding, for the first time, whether to reach out and to whom. From in-depth interviews and a focus group, seven core categories emerged. They were then built into a grounded theory visual model entitled The First-Time Client Pathway.

This model informs the systems we utilize at Delilah everyday. In sharing it with you, we hope that this research can be helpful in improving your client outreach and intake processes.

the research at a glance

  • Most women reached out after about three distressing life events, when they could no longer self-manage.

  • An intrinsic drive toward wellness kept them searching on their own.

  • Once they decided, they moved quickly and decisively.

  • Easy-to-find information and a beautiful, distinct design shaped who made the shortlist.

  • They chose a relatable counselor who works in a hands-on, directive way.

  • Clients connected the right choice to early trust, quick progress and reaching their goals.

consulting with us is different

There is no shortage of business advice for therapists. Most of it comes from one person's experience of building a practice. Our work starts from the client's side, with what first-time clients told us about how they chose.

research, not anecdote

The approach comes from a grounded theory study built on in-depth interviews and a focus group, not from a single success story.

a systemic approach

This work focuses on the moments where a client decides to call you: your directory profile, website, office photos and consult call.

ethical by design

Every recommendation follows the ACA Code of Ethics on honest self-advertising, because the goal is the right fit, not more clicks.

from a working practice

We implement these findings every day at Delilah Counseling, a group practice with clinicians and graduate interns.

Research-to-Practice Guide (PDF): the seven categories in plain language, with a self-audit for each

First-Time Client Pathway visual model: a high-resolution model, licensed for use in your practice, supervision or teaching

Recorded training (90 min): the model walked through stage by stage, with examples from a group practice

Reduce process variance

Accelerate cycle times

Enhance resource utilization

Strengthen stakeholder alignment

Mitigate transition risk

Sustain performance momentum

our consultation offerings

the research & model

The findings, made practical. Get the First-Time Client Pathway model and a guide that turns grounded theory into decisions about your website, directory profile, office, consult calls and first sessions.

Research-to-Practice Guide (PDF): the seven categories in plain language, with a self-audit for each

First-Time Client Pathway visual model: a high-resolution model, licensed for use in your practice, supervision or teaching

Recorded training (90 min): the model walked through stage by stage, with examples from a group practice

Full dissertation: a link to the open-access copy (free)

Consultation

Apply the research to your own practice with me. Choose the format that fits:

First-Contact Audit: I walk your Google results, directory profile, website, photos and inquiry response the way a first-time client would, then deliver a written report and a 60-minute debrief.

Consult Call Coaching (90 min): the phone consultation is where clients make their final choice. We refine yours so it conveys understanding and relatability, ethically.

Office Space Consult: a review of your in-person space, and how it photographs, through what young women told me makes an office feel safe.

Consultation Cohort (6 sessions, 6 to 8 clinicians): a small group working through the pathway, applied to your own marketing and first sessions.

Team & Program Training: half-day or full-day trainings for group practices, agencies and counselor education programs.

Practice Resources

Toolkits built and tested at Delilah Counseling: some for running your practice, some to use with your clients.

The First-Contact Checklist (free): a quick self-check against all seven findings

Website & Directory Profile Toolkit: what first-time clients look for on your website and Psychology Today profile, and how to stand out from sites that all look the sam

The Consult Call Toolkit: scripts, a relatability guide and follow-up templates for the call where clients make their final choice

Designing a Safe, Welcoming Office: how to set up your space, and photograph it, so clients feel at ease before they arrive

Ethical Self-Advertising for Counselors: specialty claims, self-disclosure and the ACA Code, applied to your website and profiles

Teaching Help-Seeking: a slide deck and discussion guide for counselor educators and supervisors

First-Time Client Pathway Bundle: the first five paid toolkits at a bundle price