By
Adam Simmons
· Last checked
September 2026
The best phone system for a small therapy practice depends on how many people answer the phone.
One practitioner: a second number that isn't your own. Either a second line from your carrier, if you're happy returning calls at the end of the day, or a practice phone such as Rivet, if you want callers answered while you're with a client. Rivet is ours, so read this page with that in mind.
A front desk, or several people sharing calls: a business phone system with extensions, ring groups and an auto-attendant. Routing calls between people is the real problem at that size, and that is what those systems are for.
The question after that is what happens to a missed call. Most calls to a solo practice arrive while the practitioner is in session. A number that only rings leaves those callers with voicemail; a practice phone sends them a reply and keeps the thread.
What does my practice software already cover?
Records software handles notes, scheduling, billing, forms and often video. It doesn't give you a phone number. Jane's Practice and Thrive plans include SMS appointment reminders, noting that SMS availability varies by region (Jane pricing), and Owl Practice lists email and SMS reminders on its solo plans (Owl Practice pricing). Those are reminders going out. For a client to call or text you back, you need a number.
What are the options?
A carrier second line. A second number from your mobile carrier, on your phone or a cheap spare. Simple, separate, and a missed call goes to voicemail.
A virtual number app. A second number over the internet on the phone you already have. Check how it handles texting and calling back on a Canadian number, since many of these apps are built for the US.
A business phone system. Extensions, ring groups, an auto-attendant, hold music. It earns its cost once more than one person answers. Priced per user, so a one-person practice pays for a switchboard with one user on it.
A practice phone. Rivet gives you a local Canadian number on the phone you already carry. When you're in session, the caller gets a text reply you wrote in advance, the voicemail is transcribed, and calls, texts and voicemail stay together for each client. It is $29 CAD a month, with video sessions and clinical tools available on the $65 plan.
What does getting it wrong cost?
Buying too much. A per-user business system for a one-person practice, mostly unopened, usually on an annual contract.
Buying too little. A number with nothing behind it. Calls land in a voicemail box nobody hears until evening, and a prospective client who reaches silence often calls the next therapist on the list. That cost never shows up on a bill.
Before you commit to any of them
Ask whether you can take the number with you. Under the CRTC's rules a Canadian number can move between providers (CRTC). Your number is the one part of your practice your clients have written down.
Ask what happens to your messages if you stop paying, before you sign up rather than when you leave.
The short version
One practitioner, and you return calls yourself: a carrier second line. One practitioner, and calls come while you're with clients: a practice phone like Rivet. Several people answering: a business phone system with extensions.
About Rivet
Rivet is a Canadian practice line built for therapists — a separate number for calls, texts and voicemail, with video sessions and clinical tools in the same place. Your data stays in Canada, and transcription runs on Rivet's own hardware rather than a third-party AI service.
$29 CAD a month per practitioner for the practice line, or $65 with video sessions and clinical tools. Fourteen-day trial, no card.