In September 2021, approximately 4,200 users per week canceled their Cerebral accounts, with only 175 of them expressing intent to reactivate at some point.

This resulted in negative publicity for the company, with approximately 25% of negative reviews on TrustPilot referencing the cancellation process. In September 2021, around 4,200 users cancelled their accounts each week, with only around 175 (4%) of them reactivating at some point. This was a critical issue that needed to be addressed urgently to save the company's reputation and improve customer satisfaction.

How might we improve Cerebral's cancellation flow to reduce the number of cancellations and negative reviews, and increase the likelihood of account reactivation?

1. Increased friction: The manual cancellation process was time-consuming and frustrating for patients, resulting in longer wait times and increased costs for the company as each cancellation had to be handled by an employee.
2. Low reactivation rate: Difficulty reconnecting with users only allowed Cerebral to save 3.2% of cancellation requests in January 2022
3. Negative publicity: 25% of negative reviews on TrustPilot, Apple App Store and Google Play Store reference the cancellation process

To address these pain points, the following solutions were proposed and implemented:

1. Accessible Cancellation: Make it easier for clients to cancel their subscriptions by adding a cancel button on the dashboard for quick and convenient access.
2. Implement Save Strategies: Implement save strategies based on client survey responses to reduce the number of cancellations.
3. Leverage Reactivation Success: Utilize the successful reactivation flow to improve the cancellation flow, increasing the rate of those who express interest in reactivating by 47%.

The success of these solutions would be measured through the following metrics:

1. Reactivation rate: Increase from 5% to 10% by EOY 2022, resulting in ~1,300 more reactivated patients per month
2. Save rate: Improve from 3.2% to 7% by EOY 2022, resulting in an additional 1,000 saved patients per month
3. Paused client reactivation: 25% of paused patients automatically reactivate once pause is complete by Q4 2022, with an average pause length of <2 months
4. Cancellation request rate: Keep the daily rate below 12%
5. Negative reviews: Reduce by 50% by EOY 2022

Existing state

‍Onboarding: users were presented with instructions for cancelling their subscription at the time of checkout, which are included in the legal text next to the purchase button:

"Cancel by emailing cancel@getcerebral.com before your next billing date to avoid future charges. No refunds for partial periods unless required by law.

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In-Dashboard: users had the options of viewing plan details or changing plans, but no clear indication for cancelling their subscription:

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Users needed to reach out to their Care Coordinators to request a cancellation, or follow the instructions received during onboarding and send an email to Cerebral's cancellation account.

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The cancellation process involved a survey conducted via Typeform, which served as the final step for users requesting to cancel their subscription. While the survey aimed to gather insights into the reasons for cancellation and offer potential solutions, its length created a significant barrier to cancellation. As a result, the process became unnecessarily complex and cumbersome for users.

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The results of the cancellation survey revealed the following as the main reasons for cancelling:

1. Cannot afford at this time
2. I prefer a different care experience
3. Lack of appointment availability

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Legal Considerations

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In California, the cancellation process for companies providing online subscription-based goods and services was directly affected by clauses included in US state laws known as ARL (Automatic Renewal Laws) implemented at the beginning of 2022, which raised legal considerations for such companies. Other states have followed this example since then, including Idaho, Columbia, and Tennessee.

Among the clauses that aimed to protect U.S. citizens using online subscriptions, the ones that directly affected the cancellation process included:

1. A consumer that signed up for a subscription online, should be able to cancel online
2. Consumers should be able to cancel at will, and without engaging any further steps that obstruct or delay the consumer’s ability to terminate
3. The business must offer one or both of (a) a prominently located direct link or button in the customer’s account, profile, or settings; or (b) an immediately accessible pre-written cancellation email that the consumer can send without any additional information.

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Competitive analysis

A brief competitive analysis was performed on several online mental health services, as well as other subscription-based businesses, to better understand the following:

1. Law constraints: Identify the measures that business implement to comply with ARL requirements. The business community continues to discuss the best alternatives that offer a balance between a good UX and achieving business goals since the implementation of the new law.
2. "Step down" alternatives: Identify the alternatives to cancellation that they offer, and at which stage of the user cancellation journey did they offer these selections.
3. Email communications: Identify the volume, tone, and format of cancellation-related communications sent to the users.

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"Step down" Alternatives

Based on survey information, the first phase of this project aimed to focus on the main reason for cancellation: "Cannot afford the service". It was also taken in consideration the scenario where the user organically finished their treatment and were cancelling the subscription because they were feeling better.

With this in mind, a system of "step down" alternatives or "saves" was created that included:

1. Selecting a cheaper plan: If a cheaper plan was available for the user, they were presented with it as an alternative to cancelling.
2. Offering a discount: If it was the user's first time cancelling a subscription, a 30% off discount for 3 months was offered.
3. Pausing the subscription: As a last resort, a "pause subscription" system would be implemented. - This was very similar to cancellation, but it allowed an automatic reactivation at the end of the period chosen by the user.

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Workflows

The design solution needed to consider not only legal requirements, user motivations for cancelling, and the "save system," but also technical limitations stemming from Stripe integration, backend architecture, and insurance usage by users. In particular, insurance had a significant impact on the types of step-down alternatives that could be provided.

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Wireframes

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Mockups

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Prototype

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In summary, by the end of the project, I was able to deliver

1. Wireframes: Low-fidelity wireframes illustrating the proposed user interface for the improved sign-up and assessment journey, incorporating conversational and supportive elements.
2. Competitive Analysis: With references to cancellation flows in and outside the industry, and recommendations aligned with the Automatic Renewals Law.
3. Interactive Prototypes: Interactive prototypes showcasing the redesigned sign-up and assessment experience, allowing stakeholders to experience the proposed changes firsthand.
4. Design System: Additions to the design system with guidelines for visual elements, typography, color palette, and UI components to ensure consistency across the platform.
5. Content Guidelines: Guidelines for creating engaging, conversational, and empathetic language throughout the user journey, addressing the issue of impersonal language.
6. Final Design Mockups: High-fidelity design mockups of the sign-up and assessment journey, showcasing the visual and interaction design elements, incorporating the revised language and supportive features.
7. Implementation Guidelines: Detailed guidelines and recommendations for the development team to implement the proposed design changes effectively.

Cerebral's case study highlights how a cumbersome, manual process can lead to negative publicity and high churn rates. To address this problem, the company adopted a multi-step approach and successfully improved its cancellation flow, resulting in increased retention rates and a decrease in negative reviews. Here are the key takeaways:

• The manual cancellation process led to high churn rates, negative publicity, and a low retention rate.
• Leveraging the success of the launch of the activation flow that resulted in a 47% increase in the rate of those expressing interest in reactivating was a key area of focus to include in the cancellation flow.
• The solution involved adding a cancel button to the dashboard, making the cancellation flow native, implementing a system of saves based on client data and survey responses, and improving save tactics by offering options such as downgrading, changing clinicians/therapists, pausing for different time periods, canceling but telling the customer when to come back to reactivate, and more.
• The company was able to improve the reactivation rate from 5% to 7.5% and the save rate from 3.2% to 6.7% by the end of 2022, and reduce negative reviews associated with the cancellation flow.
• Technical limitations stemming from Stripe integration, backend architecture, and insurance usage by users were acknowledged and integrated, along with legal requirements that impacted this project.

The scope of this project was focused on the main reason for cancellation, which indicated that a majority of the users found the services too expensive for their wallets. The next iterations of the project would include a more personalized cancellation journey that offer alternatives to users based on other reasons for cancellations, such as therapist availability and technical difficulties.