Effective Couples Therapy: Stand Up and Stand Out

By Vagdevi Meunier Psy.D.
April 28, 2015

Generally speaking, a private psychotherapy practice is an isolated activity.  I remember dreaming of the day when I would open my own practice, hang out my shingle, and the clients would pour in, wanting my services.  Right?  Well, not exactly.  The first couple of months in my newly formed private practice, which was a sublease of two evenings a week from a colleague, I spent most of the time sitting on the couch meant for my clients and watching the birds outside the window.  I worried about how I was going to stand out in the saturated Austin, Texas market.  I worried about whether I was competent enough to handle anyone that walked through the door.  It did not matter that I had over 20 years of experience working in different agencies by then.  I still worried that I was taking a huge risk, and I was.

What I did not know then was that the risk I took was not in my clinical competence, it was in my ability to be a successful entrepreneur.  Therapists are typically not trained in business management.  If your graduate program had a class on running a successful small business, that is unique and laudable.  When I opened a practice I thought the most important things I needed for my small business were the right business cards, the right website, and the right forms.  Turns out that is not the most important thing if you want to run a successful therapy practice.  How you market yourself, how you “sell” your skills, and who knows what you are doing is way more important than making sure you look good on paper or online.

Maybe you live in an area where you are the only counselor within twenty miles.  That might mean job security although I would bet you live in a town where people think therapy is for the weird.  So you have market share but you may not have much of a market to share.  You have a similar dilemma to a therapist opening a practice  in a large progressive city, for example, Austin, Texas which is where I live.  How you market your “brand” and whether you stand out as a professional to seek out for help will be your key to success.

Another challenge I encountered as a new business owner was the discrepancy between what I believed from my graduate training versus what really matters in the trenches.  In my graduate program, the phrase that we bandied about was “generalist scientist practitioner” training.  What this meant was that my graduate training emphasized that having a broad generalist training with skills in many areas of clinical practice was going to be valuable to my professional identity and maybe even its success.  When I joined the ranks of many private practitioners, I realized the opposite was true.  I had to stand out and speak out about my particular talents.  Generalist was a word that implied your practice was struggling and you were happy for any clients at all.  My generalist training prepared me for a little bit of everything but for nothing special.  I had to prove that I was special, that I had something to offer my clients that the other hundred therapists, just like me, that had their profiles on the most popular therapist directory sites, did not have.  I had to come out of the generalist closet and claim my identity.  It also meant that I had to take more specialized training in particular models in order to become known in my market for something.  I had to develop a “brand” that people would begin to associate with my name and my practice.  My particular brand was couples therapy but that was because I was personally and professionally drawn to this work.  Choosing from the inside out meant that I built a practice that spoke to my strengths.  When therapists can sell something they really believe in, the authenticity of the message is appreciated by the customer. 

But selling ourselves hits a sour note.  As a mental health professional, I wanted to be ethical and “professional”.  In the beginning I thought this meant I could not do anything crass as selling myself.  My colleagues told me to get approved on insurance panels so I did that.  The harsh reality of getting on insurance panels is that 1) it is hard to get approved, not as automatic or easy as it used to be 20 years ago; 2) some markets are closed to certain license holders (the only way to find this out is to apply and get rejected) and 3) insurance companies are not your friend.  While being on an insurance panel may ensure a steady flow of clients, the challenges of meeting all the demands and processes of filing insurance claims can intimidate the most courageous of therapists.  

I am not a pessimist by nature but a year into my private practice I was practicing pessimistic thoughts like a pro.  If you are already in this place as an emerging professional, or if you are worried you will find yourself in this pessimistic doldrum, here are some suggestions for holding on to your confidence and advocating for your own success — 

  • Choose a specialization wisely.Don’t be swayed by what is the latest trend or the hot new model other people are drawn to.  The two ways of knowing what to pursue are – first, paying attention to the types of clients that are seeking you out.  You have to be patient in the beginning and see what you attract in the types of clients or issues.  Once you have a critical mass of clients, notice what themes are common in your practice.  Get additional training in whatever will make you most successful with your “bread and butter” clients, the ones who are already seeking you out.  Second, get trained in something that has personal and professional relevance for you.  In our profession, when the personal and the professional coincide, we speak more eloquently about our passion and we are able to move our customers by our integrity as well as our message.
  • Don’t be afraid to stand out.  You cannot be all things to all people.  You don’t need to be.  Pick two or three areas of your practice that you want to be known for and develop an expertise as well as a clear message that you communicate in all your materials.  Be direct and be precise.  Flowery, emotional, and meandering calls to action on your website can make you appear insubstantial and detract from your core expertise.  
  • Practice your airplane pitch.  Forget the elevator pitch, I don’t encounter too many people on elevators who want to know what I do.  More often, I meet people on airplane flights who want to have a brief but interesting conversation with me about my professional identity.  If I can communicate my interest, my dedication, and my excitement about being a couple therapist, my fellow passenger not only enjoys the flight with me, they might even ask for my card and tell their friends about me.  Don’t dismiss the power of random encounters to generate new leads for your business.
  • Survey your market.  Don’t be afraid to ask every single client that calls you the following questions.  How did you hear about me?  What kind of therapist are you hoping to work with?  Have you been in therapy before?  Why are you not returning to see your previous therapist?  Can you describe a “good moment” in therapy that made you feel like the time and money was worth the value for you?
  • Don’t fall for gimmicks.  I don’t believe in asking my clients to submit reviews on Yelp or other business review sites.  Besides being a touch unethical to invite a client to reveal their professional relationship with me, I think it cheapens the sophistication of the work I do with them to invite them to rate me the same way they do their hairdresser.  I also don’t believe in letting marketing drive my business.  I want to be known in my market and I want to be seen as a local expert, but I don’t want to solicit clients by appearing on milk cartons or value coupons.  
  • Get professional help.  I don’t mean get therapy for yourself.  That is the first thing most therapists think about.  I mean get professional help in setting up your business, building a marketing plan, doing a market survey or figuring out who your customer is and how to reach them.  Therapists are not taught to be entrepreneurs in most graduate programs.   Courses on setting up your private practice are often about developing a niche practice, creating your forms, learning how other therapists have developed success and so on. Learn how someone with a business background will look at your enterprise.  Guy Kawasaki’s book, The Art of the Start was one of my favorites.

Ultimately, successful practice building is a mixture of imagination, perseverance, patience, and pitching the right idea at the right time.  So don’t be shy, stand up and stand out about what you believe in and know how to do.

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