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📱 SMS Automation

A complete post-session SMS sequence. Triggered automatically. Runs itself.

Patient attends a session. Spokk takes over. Private feedback at 2 hours. Gentle reminder at 24 hours. Review nudge at 3 days. Referral message at 20 days. Every step checks what the patient already did and skips what's no longer relevant. Nobody on your team does anything.

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No credit card required · 150 SMS included in trial · Activates in minutes

98%
SMS open rate -- vs 20% for email. Texts get read. Emails get ignored.
source ↗
7.01%
no-show rate after SMS reminders at a mental health clinic -- down from 18.55%
source ↗
38%
average reduction in non-attendance across behavioral health settings with SMS reminders
source ↗
85%
of patients want to receive text messages from their healthcare providers
source ↗

The default mental health automation sequence

This is what runs out of the box. Every timing and message is editable. Every step can be toggled on or off.

Feedback Request2 hours after session

Sends a private feedback link. The form opens in the patient's mobile browser -- no app needed. Emoji rating, session type, optional dimensional ratings, free-text note. Takes under 60 seconds.

Default SMS template:

"Hi {{name}}, how are you feeling after today's session? We'd love your quick feedback: {{link}}"

Feedback Reminder24 hours after session

A gentle follow-up for patients who received the first SMS but haven't submitted feedback. Uses the same personalized link.

Default SMS template:

"Hi {{name}}, just checking in -- your feedback means a lot to us. Takes 15 seconds: {{link}}"

↳

Automatically skipped if the patient already submitted feedback.

Google Review Nudge3 days after session

Sends the Google review link to patients who gave positive feedback but haven't posted a review yet. The AI draft is ready and waiting -- one tap to see it.

Default SMS template:

"Hi {{name}}, glad your session went well! Would you mind leaving us a quick Google review? {{link}}"

↳

Skipped if patient never submitted feedback OR already clicked the review link.

Referral Request20 days after session

Sends each patient's unique referral code. The framing is stigma-neutral -- 'someone who could use support' rather than 'another patient'. 20 days post-session is long enough for goodwill to have settled, short enough to still be relevant.

Default SMS template:

"Hi {{name}}, know someone who could use a bit of support? Share your referral code and you both get a reward: {{code}}"

↳

Automatically skipped for opted-out contacts.

The part that makes it not annoying: smart skip logic.

Sending every patient every scheduled message regardless of what they've done is how you get opt-outs and brand damage. Spokk tracks what each patient has actually done and skips anything that's no longer relevant -- or inappropriate given their feedback.

✅

Patient submits feedback within 2 hours

24-hour reminder is automatically skipped. They responded -- no need to remind them.

✅

Patient submits feedback AND clicks the Google review link

3-day review nudge is automatically skipped. They already engaged. No need to ask again.

⏭️

Patient doesn't submit feedback at all

Review nudge is skipped. Referral still runs at 20 days.

🛑

Patient replies STOP to any message

Contact is marked opted out. All remaining steps for this contact are permanently skipped.

⏱️

Patient attends twice-weekly sessions

Cooldown protection prevents re-triggering too soon. You set the cooldown period -- no patient gets over-messaged.

💙

Patient gave a low rating (1-2 stars)

Review nudge is skipped. Patient sees a private service recovery message instead. Never exposed to the Google prompt.

Why this matters especially in mental health

Mental health patients are more sensitive to feeling harassed or surveilled than most other patient populations. A badly timed or redundant message from a therapy practice doesn't just get ignored -- it can feel like a breach of the careful, considered relationship you've built. Smart skip logic means every message that does arrive feels intentional and well-timed.

Why SMS specifically -- and why it works so well for mental health.

A randomized trial at Kaiser Permanente Washington analyzed over 33,000 mental health visits and found that an additional text message reminder reduced no-show probability by 11% across the entire patient sample. And a dedicated study at a community adult mental health service found SMS reminders reduced the no-show rate from 18.55% to 7.01% -- that's not an incremental improvement, that's a transformation.

Why does SMS work so well for behavioral health specifically? Because forgetfulness is an outsized problem in this population. Research shows forgetfulness is cited twice as often as a reason for missed appointments in psychiatry compared to other specialties. Text messages hit the patient where they are, when they can act on it, with zero friction.

There's also a between-session dimension that's unique to mental health. The 2-hour post-session check-in isn't just a review funnel -- it signals to the patient that the practice is thinking about them after they leave. That kind of continuity of care messaging is associated with improved between-session engagement and treatment adherence in behavioral health settings.

Metric
SMS
Email
Open rate
~98%
~20%
Read within 3 minutes
90%+
Hours to days
Response rate
~45%
~6%
Ends up in spam
Rare
Common
Works without internet
✓
✗ Requires app
Best for mobile feedback
✓ One tap
More friction

The defaults work. Everything is yours to change.

The out-of-the-box sequence runs immediately for most mental health practices. But if you want to tune it -- different timing, a warmer tone, an extra step for specific situations -- the flow builder gives you full control.

⏰

Adjust timing

Move the feedback request to 4 hours if 2h is too soon for your patient population. Extend the referral to 30 days. Every delay is configurable.

✍️

Rewrite any template

Adjust wording to match your practice voice. Use {{name}}, {{company}}, and {{link}} as dynamic variables.

🔧

Toggle individual steps

Only want feedback and review steps? Toggle the rest off. Each step is independently enabled or disabled.

➕

Add custom steps

Add a between-session check-in at 7 days. Add a re-engagement message at 90 days for patients who haven't rebooked. Any message, any timing.

📍

Per-location config

Multi-location practices can give each location its own sequence, templates, and timing. Or share one flow across all locations.

⏱️

Feedback cooldown

Set a minimum interval between automation triggers for the same patient -- critical for clients attending twice-weekly sessions.

Frequently asked questions

What SMS messages does Spokk send automatically for mental health practices?+
The default post-session sequence sends: (1) a private feedback request 2 hours after check-in; (2) a gentle feedback reminder 24 hours later if they haven't responded; (3) a Google review nudge 3 days after the session if the patient gave positive feedback; and (4) a referral request 20 days post-session. Every step is fully customizable -- timing, message, and which steps are active.
Is it HIPAA-compliant to send automated SMS messages to mental health patients?+
SMS appointment reminders and feedback requests are widely used in behavioral health. Spokk's automated messages do not transmit protected health information -- they reference sessions generically without diagnoses, treatment details, or clinical notes. For HIPAA-covered entities, we recommend obtaining patient consent for SMS communication as part of your intake process, and consulting your compliance advisor for your specific obligations. The general consensus in behavioral health technology is that non-PHI SMS communication (reminders, check-ins) does not constitute a HIPAA violation.
How does Spokk know when to skip a message?+
Every step has smart skip logic. The 24-hour reminder skips if the patient already submitted feedback. The review nudge skips if the patient hasn't submitted feedback (can't send them to Google without a feedback foundation) or if they already clicked the review link. The referral skips for opted-out contacts. No patient gets a message they've already acted on.
Why does Spokk send the feedback SMS 2 hours after the session rather than immediately?+
Timing matters, especially in mental health. Sessions can be emotionally intense, and a feedback request that arrives while a patient is still processing something difficult can feel intrusive. Waiting 2 hours gives them space to decompress, reflect, and respond from a more grounded place. The result is more honest, considered feedback -- and a meaningfully higher response rate than same-minute requests.
Can I customize the SMS messages for my practice voice?+
Yes, fully. Every message template is editable. You can adjust the wording, timing (e.g. send feedback at 4 hours instead of 2), and enable or disable individual steps. Templates support dynamic variables: {{name}} inserts the patient's name, {{company}} inserts your practice name, and {{link}} inserts the relevant URL. Many practices adjust the tone to match how they communicate with patients.
What if a patient does not want to receive automated texts?+
Patients can opt out by replying STOP to any message. Opted-out contacts are never messaged again -- all future automation steps are automatically skipped for them permanently. For patients who prefer phone calls or email, you can exclude them from SMS automation at the contact level.
How is the automation triggered for mental health patients?+
The most common trigger is a QR code check-in at reception -- the patient scans when they arrive, which starts the automation sequence. You can also trigger it manually from the Spokk dashboard for a specific patient, or via the API if you want to connect it to your EHR or practice management software.
Can I add extra steps -- like a between-session check-in?+
Yes. The Spokk flow builder lets you add custom SMS steps with any timing. A between-session check-in at 7 days ('How are you doing this week, [Name]?') is a common addition for mental health practices. Research shows between-session contact improves treatment adherence, and the step can include a link to a brief mood check-in form.
Does the automation work for telehealth sessions?+
Yes. The trigger is based on a session being logged in Spokk -- not a physical QR check-in. For telehealth sessions, you can trigger the automation manually from the dashboard or via API when the session is completed in your practice management software. The post-session sequence runs identically regardless of session modality.
How does SMS automation connect to the loyalty and referral programs?+
They share the same automation backbone. The QR check-in that triggers the post-session sequence also increments the patient's loyalty visit count and checks for milestone rewards. The referral step in the sequence uses each patient's unique referral code. All activity is tracked in the same contact record.
What is the feedback cooldown and how does it work?+
The cooldown prevents the automation from re-triggering too soon for patients who attend sessions frequently. You set the number of days -- for example, 14 days -- and any patient who checked in within that window won't re-enter the sequence. This prevents over-messaging patients who have twice-weekly appointments.

More for mental health practices

Spokk for Mental Health Clinics

The full platform overview.

Patient Feedback Collection

What the feedback form looks like and what it tells you.

Google Reviews for Therapists

Turn private feedback into public reviews.

Patient Loyalty Program

Reward consistent attendance automatically.

Patient Referral Program

Privacy-first referrals via SMS.

Therapist Performance Tracking

Per-therapist satisfaction scores.

Starter

For solo operators & small teams

$49/month

Billed $588/year

250 customers / month

Unlimited SMS included

  • 250 customers / month
  • 1 manager + 1 staff member
  • Unlimited locations
  • Dedicated toll-free SMS number (US & Canada)
  • Full automation sequence
  • AI review response drafts
  • Loyalty & referral programs
  • Feedback forms & QR codes
  • HubSpot integration & API access
  • Buy additional customer top-ups

Growth

For growing businesses & teams

$82/month

Billed $984/year

500 customers / month

Unlimited SMS included

  • 500 customers / month
  • 2 managers + 2 staff members
  • Unlimited locations
  • Dedicated toll-free SMS number (US & Canada)
  • Full automation sequence
  • AI review response drafts
  • Loyalty & referral programs
  • Feedback forms & QR codes
  • HubSpot integration & API access
  • Buy additional customer top-ups

Pro

For high-volume businesses

$166/month

Billed $1992/year

1,500 customers / month

Unlimited SMS included

  • 1,500 customers / month
  • 3 managers + 5 staff members
  • Unlimited locations
  • Dedicated toll-free SMS number (US & Canada)
  • Full automation sequence
  • AI review response drafts
  • Loyalty & referral programs
  • Feedback forms & QR codes
  • HubSpot integration & API access
  • Buy additional customer top-ups

All plans include a 14-day free trial. No charge until your trial ends. Questions?