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March/April 2007

The PR-Savvy Social Worker — 7 Smart Tips for Marketing Your Practice
By Matthew Robb, MSW, LCSW-C
Social Work Today
Vol. 7 No. 2 P. 14

Build a robust practice with proven strategies from the most successful therapists in the field.

For every social worker who has ever cursed managed care for all its bureaucratic excesses, clinical shortfalls, and intermittent Kafkaesque psychodrama, the fruits of an out-of-pocket practice have never seemed sweeter—nor more inaccessible.

A successful out-of-pocket practice has long been the clinician’s golden ring, but those in the know are quick to caution that all that glitters isn’t gold. Look a bit closer, they advise, and you’ll notice that just 20% of therapists seem to corner 80% of the out-of-pocket market.

Intrigued, Social Work Today turned to a national panel of experts for answers to two questions: What does it take to succeed as an out-of-pocket therapist? And, what separates the flourishing few from the middling many? Their answers, we learned, were nearly unanimous. Even in this austere, hypercompetitive era of managed care, competent clinicians can increase their share of cash-paying clients by following time-tested principles of marketing.

Cognizant that our panel’s collective insight could fill volumes, we asked them for the essentials.

1. Define yourself. Social workers who choose in-demand specialties typically get their practices up and running much faster—and more profitably—than their generalist peers, says Laurie Kolt, PhD. Author of more than 100 articles on practice building, Kolt wrote the 1999 book, How to Build a Thriving Fee-For-Service Practice: Integrating the Healing Side with the Business Side of Psychotherapy. When the San Diego County psychologist isn’t counseling clients, she is helping a national clientele of therapists fine-tune their practices.

According to Kolt, “anything in the medical realm” tends to be an in-demand specialty, including infertility counseling, gastric bypass assessments, eating disorders, and drug and alcohol issues. Physicians who can’t find time to give couples emotional support need social workers who can. PsychJourney Vice President John Riolo, PhD, sees the underlying principle as one of solving problems. To the problem solver go the clients.

International loss and grief expert Mila Tecala, LICSW, learned a corollary business principle some 30 years ago: “Offer a service such that when someone needs it,” she says, “they can only think of me.” Tecala suggests going beyond clinical specialties to choose “several niches not under the purview of managed care.” Among hers: providing group therapy for physicians with life-threatening illnesses and forensic evaluations in wrongful death cases. Even the license plate on Tecala’s car advertises her specialty. It reads: grf3apy.

Jerilyn Ross, LICSW, a Washington, DC, therapist and president of The Anxiety Disorders Association of America, shares her perspective: “Generalists entering private practice will have a much wider net, but it may be harder to get referrals. Specialists, by contrast, will cast a narrower net but will probably become more quickly known.” Ross is a nationally recognized specialist, popular author, and go-to media expert.

At the age of 63, Los Angeles social worker David Kuroda, LCSW, has been in private practice for only six years but has parlayed his stint with the Superior Court into a fast-track career. Taking a cue from Los Angeles’ attorneys, he bills divorce mediation clients at a premium $300 per hour. “It’s amazing,” he says, “but people pay without even asking my rates first. I think we social workers need to charge more to reflect our value. The services we provide are at least as important as what lawyers and financial professionals charge.” Kuroda has a second niche: child custody.

Casey Truffo, MFT, a Los Angeles practice-building coach and therapist, suggests choosing a specialty based on circumstances, such as: “I’m afraid of going to the dentist,” “I’m worried that my child is making bad choices,” “I wish my wife and I talked the way we did when we first got together,” or “I don’t feel loved or appreciated by my mate.”

2. Plan for success. A clinical practice is a business, and all new businesses need a plan for success. Kolt suggests writing a one-year business plan that: (a) is tailored to one’s clinical specialties and community demographics; (b) includes quarterly benchmarks and timetables; and (c) addresses the key operational issues in “clear, specific, measurable, and realistic terms.” Don’t worry about writing the definitive, blue-ribbon plan, she says. Start small, hit the major themes, and update as needed. When consulted, practice-building coaches can show social workers the what, when, where, why, and how.

3. Aim high, but be realistic. Riolo says beginning practitioners will almost certainly need to join one or more managed care panels to get a respectable income stream. The key, he says, is to “choose wisely, diversify sensibly, and work toward getting more out-of-pocket clients.”

Kolt says forward-thinking therapists start networking and developing a strong referral base well before they enter private practice. “I see a lot of people just getting out of graduate school or [who] are still in graduate school already thinking about how they are going to build their practice,” she says. She likens practice building to getting a stalled car moving. “To get it in motion is very hard. But once you get some momentum, it starts rolling faster and faster.”

But remember: first things first. Would-be out-of-pocket therapists must be clinically competent in all areas of practice. This proposition, our panelists say, entails years, not months, of preparation. Falsely holding oneself out as an expert is among our profession’s highest ethical breaches and will likely harm the client, torpedo a clinical practice, and cast the therapist out as a pariah in the professional community.

4. Locate for success. A robust economy creates fertile ground for new practices. During the early “build out” phase of new suburbs, population pressures often create spot shortages of mental health professionals, giving rise to practice-building opportunities.

But don’t ignore the nation’s major job markets either. “Here in Washington, DC,” Tecala comments, “the economy is strong and privacy is all-important. People are worried about someone getting hold of a paper trail. They have a lot of disposable income to pay out-of-pocket.” Tecala emphasizes another key point: When people are unable to afford (or even to find) essential human services, the obligation to give sliding-scale or pro bono assistance is clear.

5. Get referrals. Referrals fuel private practices, but you can’t gain traction from behind a desk. Truffo says the phrase prospecting for clients may be unpalatable, but it’s essential to any business’ success. Finding referral sources and clients means getting out of our comfort zones, establishing a high community profile, and demonstrating our value to others. Ross simply sees this activity as raising awareness. “If you are doing good work, you should let people know about it,” she says. Every person we encounter is a potential referral source or client. Some may be professionals, others the public at large. Kolt says the hard sell never works. The key is to be open, caring, authentic, and to convey a sense of hope.

“This isn’t the kind of field,” Ross observes, “where you can build it and they will come. You have to go to them. The absolute best thing a new therapist can do is to network, network, network.”

Savvy marketing can quickly bulk up a referral base, but implementing the wrong strategy can devour a marketing budget without yielding a single client. How best to market your services? There is no one best way, Kolt and Truffo say, but begin by targeting your message and tailoring your marketing initiatives to fit your personality style—whether extroverted or introverted. Go with your strengths, as a poor fit will project incompetence. The introvert capable of flourishing as a mental health columnist in a weekly newspaper may experience embarrassing brain freeze when stepping in front of a church assembly to discuss panic attacks. By the same token, the extrovert with the gift of gab could probably find a dozen better ways of reaching out to clients than by cranking out an amateurish “depression fact sheet” that few people will read.

6. Extroverted strategies. Extroverts belong in front of the public. That could mean many things: appearing on a Sunday morning TV or radio health segment or speaking at the local Rotary Club, women’s business circle, stay-at-home mother’s support group, investment club, senior center, or even at a seminar in the café of a Borders bookstore. Just remember to target those venues “where your ideal client is likely to hang out” and analyze what works and what doesn’t, Truffo says. Landing a speaking gig is usually no more difficult than demonstrating your message’s relevance to the “powers that be” and asking for the opportunity.

Therapists can network at PTA events, church or religious bookstores, town hall meetings, singles’ dances, dating services, fitness centers, health food co-ops, and farmers’ markets. Social workers, Truffo says, may need to work a bit harder than other mental health professionals, as laypeople don’t always see the psychotherapy connection.

Prior to the debut of his private practice, Kuroda began developing a referral base by contacting “the most experienced people” in the Los Angeles divorce mediation community. Treating them over lunch, he recalls, “I was OK saying, ‘I need your help,’ but I also let them know how I could help them. As it turns out, they were only too gracious to help.” Next, Kuroda joined the Los Angeles County Bar Association, which put him in regular circulation with dozens of judges and attorneys. Today, he also belongs to two Los Angeles practice groups whose members include attorneys, financial experts, and mental health professionals.

When a new therapist joins the 12-person Ross Center for Anxiety Disorders, Ross gives this advice: “Have lunch with people, meet folks after work for a cup of tea, go to meetings, join a club, take any and every chance to give a talk—whether it’s at the local library or at your kids’ school.” Networking can be harder for younger therapists, she says, “so I tell them this: ‘If you ask three people and they all say no, then ask a fourth person.’” Persistence, she says, moves mountains.

Truffo and Kolt suggest building “strategic alliances” with people in noncompeting services. Mental health professionals with different specialties may be good sources of referrals as clinical societies might be, particularly those with a marketing subcommittee.

Chiropractors, Kolt says, “tend to have high-volume practices and understand how emotional stresses can affect structural stresses of the body. This can make chiropractors incredibly good referral sources.”

Other strategic alliances may include working with personal trainers, sports medicine experts, dentists, physical and occupational therapists, dietitians and nutritionists, even tattoo artists and body-piercing technicians. Upscale hair salons and day spas may also offer referral possibilities, as the client is more apt to share private details with his or her stylist.

Says Truffo, “If you want to work with women business owners who have a lot of discretionary income—or with women business owners juggling motherhood and business—hook up with an acupuncturist or massage therapist or aesthetician.” For social workers hoping to work in the divorce or divorce mediation arena, Kolt suggests speaking at a meeting of attorneys on “ways to deal with the kind of anger or stress their clientele may be experiencing.”

Healthcare professionals may be the ultimate referral base, but getting face time with a busy internist, physician’s assistant, or nurse practitioner can be next to impossible. Sometimes, the de facto referral person is the office manager or front-desk person.

Make yourself known whenever and wherever possible, Ross says. “If you have just opened a new practice in an office building,” she says, “it’s really nice to drop by the other offices and introduce yourself.” Build a good working relationship, but don’t be “obnoxious or tacky,” she says. Going floor to floor to floor in a towering office building—or knocking on doors in other buildings—is apt to turn people off. Chuckling at the thought, Ross adds, “But if you can really pull that off, I say go for it.”

Ross hosted a popular radio program for five years. “Ultimately,” she says, “that radio show allowed me to network with a lot of people. When I did a show on bipolar disorders or depression, I had access to interview the nation’s top experts.” The broadcast industry opened doors for Ross and burnished her clinical reputation far and wide. “As a result,” she says, “when an out-of-town expert guest knew somebody in the DC area with an anxiety disorder, they might later give me a referral.” All that said, Ross’ personal comfort level was such that she wouldn’t see her radio listeners as patients.

Today, notes PsychJourney’s Riolo, AM radio “tends to be very conservative and blue-collar.” If that’s your market, he says, “be ready to speak their language.” Even though FM radio and satellite radio offer precious few opportunities for mental health professionals today, Riolo says start your own Internet-based radio show. The entry costs are rock-bottom low, and Internet radio remains a virtual frontier.

7. Introverted strategies. Being introverted isn’t necessarily a stumbling block to the successful marketing of mental health services, but to succeed, the introvert must work twice as hard. Traditionally, an enterprising social worker could tap print journalism to reach his or her audience, by way of local newspapers and city/regional/state magazines, the state or national NASW (National Association of Social Workers) journal, or brochure or letter of introduction. For years, Kolt penned a column in the San Diego Business Journal, which drove a steady stream of clients to her door.

Private practitioners often consider investing in Yellow Pages ads. Tecala speaks for the entire group when she says, “Yellow Pages ads are expensive, and nobody seems to really see them.”

Electronic communication is where it’s at, our panelists says. The morphing of the Internet has given rise to thousands of social work Web sites nationwide. Some are well-executed, but many are textbook examples of bad design. Kolt says the private practitioner who doesn’t have an Internet presence is “handicapping him or herself,” but recommends paying an expert for a professional design. A Web site, she says, is an expression of you as a professional. Don’t worry about bells and whistles. The objective, she says, is to create a place where visitors can view your practice in the privacy of their homes and get a sense of whether you feel “right for them” as a therapist.

To gain visibility for their clients, Riolo and PsychJourney President Deborah Harper have created a mental health Web “portal” that links therapists with the public at large. From there, visitors can access dozens of therapists’ Web sites, as well as links to key articles and mental health organizations. Riolo emphasizes that getting traffic depends on gaining a high ranking by the major search engines. This, he says, again raises the need for an expert Web consultant.

San Francisco author and psychologist Lara Honos-Webb, PhD, maintains both mental health-related Web sites and blogs (essentially, Internet-based journals). Yet another blog—this one located at www.amazon.com—allows her to communicate with buyers of her books. Honos-Webb is among the profession’s leading “early adopters” of Web technology, especially in the area of mental health-related “podcasts” (see sidebar).

Riolo—also a podcast enthusiast—is convinced that the Web is the wave of the future. “Young people today rarely, if ever, use the [phone book],” he says. “When they want a therapist, they search for one by Googling them.” Google, of course, is the world’s largest Internet search engine.

Is print advertising effective? Ross isn’t convinced. “We run one small ad in a Washington, DC, parenting magazine, but it’s very targeted,” she says. “I don’t spend a lot of money on advertising. To me, referrals [are] all about the personal touch.”

Kolt comments that once a social worker has established visibility as a community mental health expert, he or she should “look for timely opportunities to give psychology away.” Volunteering offers a splendid opportunity to get known locally, she says, and is a win-win situation.

Social workers should maintain good media relations, Kolt says. “If you are on the news as an expert,” she says, “you are instantly linked with authority and respectability. You can’t pay for that kind of exposure in your community.” Her advice is to be proactive. Cultivate a working relationship with the media, suggest compelling stories to them, and make yourself available at the drop of a hat.

Ross agrees: “I owe a lot of my business success to my involvement with the media, to writing stories, and to raising awareness of mental health problems. When a reporter calls, it is a top priority. I don’t mind reporters calling me at home—night or on weekends.”

Regardless of the marketing vehicle, repeating your message is essential. Administrative support staff are usually too busy, radio listeners too distracted, and Web surfers too jaded to focus on one brief message. “A single marketing push,” Kolt says, “usually only opens the door to the possibility for referrals. Forging a working relationship might take three, four, maybe six messages or viewings.” And once established, that delicate relationship must be cultivated over the long term. It’s a lot of work, but Kolt says getting your own out-of-pocket practice to thrive is a very doable proposition.

Ultimately, says Truffo, a social worker’s marketing tools “should give people an introductory experience of you such that they can decide if they know you, like you, trust you, and believe you have the solution to their problem.” When a social worker approaches a possible referral source or client, Truffo says the question that should be on your lips is simple: “How may I serve you?”

— Matthew Robb, MSW, LCSW-C, is a social worker and freelance writer residing in suburban Washington, DC.

Podcasting: Savvy Therapists Adopt Cutting-Edge Technology
If you’re looking for savvy tips on cyber marketing, you can’t do better than Lara Honos-Webb, PhD.

Last year, at the age of 36, the San Francisco psychologist struck publishing gold when Newsweek, The Wall Street Journal, and Publisher’s Weekly gave a thumbs-up endorsement of her latest book, The Gift Of ADHD: How To Transform Your Child’s Problems Into Strengths. Sales soared. But Honos-Webb deserves full credit for a second, even bigger, sales spike. Her secret? Podcasting.

In 2003, the term podcasting didn’t exist. In 2005, The New Oxford American Dictionary declared it “word of the year.” Now in 2007, Googling the word podcast yields more than 130 million hits—and experts say it is taking the nation by storm.

Podcasts are digital radio broadcasts you can download from the Internet. Podcasting lets mental health professionals like Honos-Webb get her upbeat, “let’s build on strengths” message to the Web’s worldwide audience.

Presently, Web surfers can download more than 30 of her digital discussions on issues ranging from attention-deficit/hyperactivity disorder (ADHD) and depression to “How to Find Your Life Path” and “Heart-to-Heart Inspirations.” This summer, Honos-Webb will begin offering video content, effectively creating her own publishing firm, radio show, and television program. Her reach? Unlimited. Her costs? Practically nil.

“People are Googling ADHD and depression, and they’re finding my blogs, my podcasts, my books, and Web site,” she says. “People all over the place send me e-mails saying they listen to my podcasts while commuting, working, cooking dinner, even grocery shopping.” Always mindful of cross-marketing, Honos-Webb makes frequent reference to her books, which helps drive sales.

Deborah Harper, president of PsychJourney, provides Honos-Webb’s podcasting platform. In the comfort of her home, Honos-Webb can dictate a topic into her telephone and, soon after, give birth to another podcast. “PsychJourney brings traffic to me,” she says, “so that I’m not just another person out in cyberspace or in the ‘blogosphere’ that no one sees.”

Agreed, says PsychJourney’s John Riolo, PhD. “Clients who can hear a therapist’s voice and get to understand her through podcasts are more likely to say: ‘Hey! I can really relate to what she’s saying. I’m going to contact her.’” Ultimately, observers say, podcasting and telecounseling are destined to work hand in hand, giving therapists a national—even international—clientele.

“If you want out-of-pocket clients,” Honos-Webb says, “you need to do both conventional marketing and cybermarketing. But podcasting is also a great way to interview and forge partnerships with leading professionals, to expand your network, and to broaden awareness of you as a professional.”

— MR