Between-session therapy support is the structured work that helps a client prepare, follow through, or reflect between appointments. It can include homework, reminders, check-ins, assessments, and preparation prompts. It should not be positioned as a substitute for therapy, autonomous clinical judgment, or crisis response.
For a practice, the question is not whether more client activity is always better. The question is whether a tool supports a purposeful care workflow that clinicians can review without creating noise or unrealistic expectations.
Choose one purpose for each activity
Every between-session activity should have a clear reason. Common purposes include preparing for the next appointment, completing a clinician-assigned task, monitoring a scheduled assessment, or helping a client remember practical next steps.
Avoid sending prompts simply because the software can send them. Too many disconnected notifications can become background noise for clients and more review work for clinicians.
| Activity | Useful when | Question to ask before enabling it |
|---|---|---|
| Homework task | A clinician has assigned a specific exercise or reflection | How will completion be reviewed in the next session? |
| Reminder | A client needs help remembering an appointment, form, or task | Can timing and content be adjusted for the care plan? |
| Check-in | The practice has a defined purpose and a review process | Who sees it, when, and what happens next? |
| Assessment | A clinician uses a standardized measure in the workflow | Is it assigned, completed, and reviewed in the right context? |
| Preparation prompt | A client benefits from reflecting before a session | Does the prompt set appropriate expectations about response time? |
Build the review loop before launching
A client-facing feature is only useful if the practice knows what happens after the client uses it. For every task, define the reviewer, the expected timing, the information shown, and the appropriate next step.
This helps protect both the therapeutic relationship and the practice. Clients should understand whether a prompt is self-guided preparation, something to discuss at the next session, or part of a configured workflow. The product should not imply immediate clinical monitoring or emergency response unless the practice has implemented and communicated such a service.
Make homework easier to complete
Therapy homework often fails for ordinary reasons: instructions are lost, tasks are vague, clients forget, or the work feels disconnected from the next session. A digital tool can help by making the task specific, accessible on mobile, and easy to revisit.
The tool still needs clinical intent. Therapists should be able to tailor the task, explain why it matters, and discuss barriers when the client returns. Completion data can be a useful conversation starter, not a scorecard.
Evaluate the client experience
Ask a colleague to complete a task as if they were a client. Check the language, the number of steps, the notification experience, and the clarity of what happens after submission. If the experience is confusing for a colleague, it will likely be confusing for a client.
Also inspect the clinician view. Relevant context should be easy to find before a session, and the product should make clear that the clinician remains responsible for interpretation and care decisions.
Sources used for this framework
- Canadian Counselling and Psychotherapy Association: Guidelines for the Uses of Technology in Counselling and Psychotherapy
- Office of the Privacy Commissioner of Canada: PIPEDA Fair Information Principle 7 - Safeguards
A practical launch checklist
- Select one use case, such as pre-session reflection or a single homework workflow.
- Define who assigns it, who reviews it, and what response-time expectations clients receive.
- Test the full client and clinician flow with a small internal group.
- Gather feedback after several real workflow cycles.
- Expand only when the practice can operate the review process consistently.
enodoHealth is designed around this connected approach: enodoAlly supports structured engagement between visits, while enodoCare brings that context closer to practice operations and clinician preparation. For a product-oriented overview, see between-session therapy tracking.
The best between-session support feels intentional to the client and workable for the clinician. It adds continuity without making promises the practice cannot keep.