I was looking for a therapist for one of my kids recently and got four names recommended by colleagues. I called all four and was shocked at the poor response time. One never called back; two called after five days; and one called after two days.

This is an example of shabby business practices. The message to the potential client is that you don’t care and/or you’re not important. So before you say “But Joe, they were busy!”, realize what it’s like on the other end. It feels like you don’t care, like it’s not important, like you could take it or leave it. None of these may be true, but that’s what I found myself thinking.

More importantly, recognize what it’s like on the other end when you respond the same day: Wow! This person is efficient. This person cares. Surprise is the typical response, which is always a good thing. You have exceeded their expectations before you even make contact.

Also, when you respond promptly, you benefit from the well-documented social psychology ‘primacy effect’. You’re in the lead, way ahead. You only get one chance to make a good first impression. Don’t blow it. Create systems that allow you to respond very quickly, despite a busy schedule. You’ll never know how many clients you lose if you don’t do this consistently.

Well whether the economists agree on the semantics or not, the US is in some sort of serious economic funk. I live in Michigan where things are worse than most other places - highest unemployment in the country; most people moving out of the state of any state; most loss of manufacturing jobs. So how’s my practice doing? It has gone up every year. That’s because I have a clear area of specialization and a very solid, diversified marketing strategy that doesn’t depend on 1 or 2 referral sources.

But I realize that not everyone is in that situation, so I wanted to offer some suggestions for strategies to apply when your clients express concerns about fees, copays or therapy in general:

1 - you don’t have to see people every week! Consider less frequent sessions, since most people have a monthly amount in mind that they are comfortable with

2 - start a group - groups require lower fees and yet your fee as the therapist is usually greater per hour vs. therapy sessions

3 - help your clients get reimbursement when possible - go the extra mile and let them know you understand they are concerned about money right now. Call their insurance company for them and ask about in or out of network benefits, since they may not know the right questions to ask to get reimbursed

4 - expand your referral sources - this is the time to expand your reach, both in the local community as well as online. Recessions are often times when new relationships are forged - your new referral sources are experiencing the same thing you are and may be eager to expand their network of influence as well

5 - generate new therapy prospects by offering free or low-cost lectures - the most expensive, time-consuming thing is to get someone in your office the first time. Make it easy for that to happen by offering quality information at a low price, and overcome people’s initial resistance to working with you. Let them see how much you know and how approachable you are. Make an easy bridge to therapy from that lecture.

These strategies can help you maintain your numbers even when the mass psychology of the country has people tightening their belts.

Just about everybody does. Talk to anyone who promotes or sells any product or service to psychotherapists and within 2 minutes the conversation goes like this:

They are so cheap!
All they ever do is whine about how much things cost!
Yet they say they aren’t making enough money!!!
Blah blah blah blah blah!!!

We’ve heard this from magazine editors; newsletter writers; workshop trainers; people selling books; and therapist referral sites.

We don’t agree actually. Oh we’ve certainly seen the phenomenon first hand enough to know it’s real, but we happen to think that therapists are not cheap. We happen to think therapists spend a lot of money on things they value, such as graduate school, licensing exam prep courses, post-graduate clinical trainings and fancy furniture for their offices.

The bizarre thing?
Therapists only tend to tighten the purse strings when
it comes to things that could actually make them more money!

• Great clinical trainings don’t make you money if you don’t know how to market them.
• Degrees and licenses don’t make you money if you don’t know how to promote yourself effectively.
• Fancy furniture doesn’t bring people into your office the first time.

Studying business makes you more money. It really does. Understand those six words and you’ll do fine. Ignore them and your dream of private practice success may never materialize.

A friend of mine recently told a story of a potential client who called her to inquire about her counseling service. The caller asked quite a few questions: how she worked; where she went to school; how many years in practice; what books she had read recently; her marital status and how many kids she had. Clearly, some of the questions were inappropriate and a boundary violation and my friend did not answer them all. The person then said “I’ll think about it” and hung up. She called back 2 days later and asked six more questions (three of a personal nature) and again said, “Ok thanks, I’ll think about it.”

My friend called and asked, “How many times should I talk to this woman?” I responded, “No more unless she makes an appointment.” Why? This woman is a classic example of what car dealers call a ‘tire kicker’. 98% of the time, she’s not serious about treatment. She wants to call 4 or 5 therapists and ask each of them the same questions. Some people will spend time giving her a diagnosis (e.g. Axis II), but that’s really unnecessary. The likely outcome? She will waste a lot of time with a lot of people, and then make an appointment, show up two times and conclude the therapist isn’t right for her.

The point is this: if you are working this hard to convince someone to come in for an appointment, they aren’t worth convincing. Let them go. They will waste your time and drain your energy.

You don’t have to see everyone who calls or emails you. Checking someone out goes both ways. You have as much right to check out or qualify the person as they do you. Remember the 80/20 rule: 20% of your referrals will cause 80% of your problems. Keep as many of those off your caseload as possible.

I spent a delightful hour today at GoldfishTea in Royal Oak, Michigan. It’s quite possibly the most elegant, detailed tea house in the United States today. The tea is served at one of three different temperatures. There is seating for 70. There are three ‘tea bars’ where you can experiment with different types of tea. The owner is a tea fanatic, who first got turned onto tea on a two-year business assignment in Beijing while working in the auto industry. He talks about tea the way people in Napa talk about wine.

I hope they succeed because it’s a beautiful place, exquisitely done. I’m fairly certain this place would do very well in San Franciso or New York. Unfortunately, it’s in a small, moderately trendy suburb of Detroit, which to its credit has one of the few lively downtowns in the state. So there’s lots of foot traffic in the area. However, alcohol is clearly the beverage of choice (sports bars), with coffee close behind (four wi-fi fireplaced coffee shops).

So where does that leave tea? If this is merely an expensive hobby for someone’s well-funded retirement, great. But if it needs to be profitable, I’m concerned. Tea? Do people here really want tea? What’s the evidence that they do? (a similar venture, admittedly less well executed, folded in the next town last year). Do people here (or anywhere for that matter) really go nuts over tea the way they do over coffee or wine? Do people care about the temperature of their tea? Does tea alter your state or solve any problems the way coffee does? Is there a profit margin here? Starbucks is not successful because of $1.25 cups of coffee, but because of the many $5 + drink concoctions that cost next to nothing to prepare. There are no such recipes for tea.

So before you launch your great idea, test it out. Just because something excites you doesn’t mean there’s a market or a profit to be made from it. Just because you just took a workshop on the greatest healing technique of all time doesn’t mean people will flock to learn it. Don’t make the website yet. Don’t write the brochure. Don’t register the business name. Don’t send out an ezine to your whole mailing list. Instead, create a survey or do a focus group. Or launch a very small trial balloon and see what comes back.

The point is this: be as certain as you can of three things:

1) people clearly understand what the benefits of your service are in their life

2) they need your service and its benefits to deal with a particular life problem or challenge

3) they are willing to pay for your service

If any of these turn out not to be true, you’ve wasted a great deal of time and money proving something you could have gotten a good handle on much sooner and for almost no cost.

Most therapists I talk to are looking for “tips”. Gimme something right now. What can I do today? What will fill up my appointment book this month? What will be easy, and not take too much time, thought or money?

In the business world, tips are called tactics, and are contrasted with thinking strategically.

There are plenty of tips out there. That’s not the problem. And they often work to generate a few extra referrals, which is great.

The problem is that tips are common knowledge within the field and thus are usually only useful for a short period of time. Tips are horizontal. They skim the service but don’t fundamentally change the way you think about promoting your practice.

Thinking strategically, on the other hand, goes vertically deep. It requires the development of a new mindset, an uncommon way of looking at usual phenomenon. Like any creative process, it requires new associations between previously disparate ideas. Eventually, the ideas jell and integrate. A a new lens is formed from which to view your practice, which is now a business. This new business lens exists next to your clinical lens. It’s not better or worse; it’s just a different lens that exists for a different purpose. You can flip either one on when the circumstances require.

And when the two work together, it’s a beautiful, very successful thing.

Seth Godin had a great post recently on how Fear, Love and Hope are the three marketing levers you need to push when promoting a product or service.

Which one(s) you using? Why? What are the consequences of using the others?

Some people like to say there’s really no good time to have your first child, but there are clearly some bad times. There’s no good time to turn your entire life upside down. There’s no perfect amount of money. There’s no optimal time for your job or your relationship or your ability to deal with sleep deprivation. But there are bad times for each of these.

And so it goes with our practices. When’s the best time to start a new service, write that book or launch that new idea that you’ve been secretly fantasizing about? Is it brilliant or merely foolish? Will it blaze a new path in your field or humbly go the way of the Ford Edsel and the Apple Lisa? How can we know? What if…

When’s the best time to throw caution to the wind and risk time, money, reputation and self-esteem? When’s the best time to go out on a limb for what you truly believe in, for what speaks to and from your most inner authentic self?

The best time isn’t when you have $100,000 to blow or when you’re retired. It’s not when the GDP is growing at a 5.5% clip, nor when houses are appreciating at 15% a year. The best time isn’t when the unemployment rate and inflation are at historical lows. It’s also not when a war ends or another begins, nor when a new President takes office.

The absolute best time to launch your new baby is now.

What do these have in common? They all are examples of service professionals who set a clear expectations for their clients, right at the outset of the business relationship.

It used to be that the common knowledge was that you would change the oil in your car every 6000 or even 7000 miles. This was cut in half so that now the ‘common knowledge’ is that you should change it every 3000 miles. How did this shift occur in the minds of the public, despite remarkable advances in engine technology?How often should you have your teeth cleaned by your dentist? Some will say six months, some three, some a year. But the point is that the expectation is clearly stated and is repeated over and over again until it becomes a de facto standard. The dentistry industry has been so clever for decades that they even have the public school system marketing these concepts for them to very young children (could you imagine telling first graders and their parents that it would be good for their health to go to a chiropractor or psychologist?) They have institutionalized the concept of prevention at a deep cultural level (and are probably the only health care providers to really have accomplished that).

An acquaintance of mine went to a chiropractor for a back problem. Sometime during the initial session she was told that she would need 38 sessions. Her response was “Ok, let’s get started.” She assumed the expert knew best. I have no idea whether that number of sessions was necessary or not, but my point is that the chiropractor clearly expressed an expectation during the first session, and the client accepted that as a professional assessment.

Do you do this with your clients?

How clear is it?

How often is it repeated?

How consistent is your industry as a whole in setting clear expectations?

In any promotional piece, be it a website page; a flyer; a brochure; an ad or a direct mail piece, you have to decide what to lead with. In general you have 3 choices:

1. stuff about you: your wonderful credentials, training, skills, degrees
2. the issues/problems you work with
3. describe what the potential client is experiencing at the moment they see your piece

#1 is the most common thing healthcare providers do. It’s also gets the least response. LESSON: people in some form of pain or stuck place initially don’t care about you. They really don’t. Don’t take it personally, but they don’t.

What they DO want to know is this: can you help me deal with this situation I’m in? The answer comes down to the cliche that was often used to make fun of Bill Clinton when he was running for office: I feel your pain. Do you feel their pain? Do you get it? If so, let them know. That will elicit more connection than anything else you can offer.

Once they realize that you get it, THEN you can discuss your services and lastly your credentials. Of course they want to know that you have some training, but always remember that’s not the first thing they care about. Understand the correct sequence and your promotional pieces will perform much better for you.

Simple test: what’s the ratio of “my” plus “I”s to “you”s on your page or flyer or ad? If it’s greater than 1.0, you’re in trouble.