The Business of Therapy

The Business of Therapy

By Lynn Grodzki

Recession-Proofing Mantras
How to stay calm when your practice seems to be under siege

For therapists trying to keep their heads above water, struggling to fill their schedules with clients and show a profit every month, it's hard to see the current economic crisis as being positive in any way. But crises, by their very nature, whether personal or global, challenge us to fit old practices to new realities. As noted economist Paul Romer says, a crisis is a terrible thing to waste.

Coping with this recession means contemplating changes in how we do business. In fact, many small businesses improve only during bad times, when it's no longer possible to put off making necessary changes. This recession offers therapists the opportunity to reassess their position in today's mental health marketplace.

Since changing old ways of working is never easy, I encourage the therapists whom I coach to use "business mantras" to free them to think "outside the box" and develop new business strategies. Here are three such mantras that therapists who consult with me say are especially helpful for challenging tired assumptions about their practices.

"Focus on Profit, not Growth."

Bernie, a licensed counselor in central Florida, phoned me from a small beach town that he termed the recession's "ground zero." "We've had massive losses in population and jobs; it looks like a ghost town around here," he said. Desperate to boost his practice, he said, "I have a million ideas, and don't know what to do first. I'm thinking about new workshops, networking more with referral sources, redoing my brochure, producing some training videos, or writing a book. Sometimes, I think I'll bag it all and look for a part-time job. I just don't know where to start."

I understood the fear in Bernie's voice and the impulses that alternated between trying everything at once and giving up. The first thing I did was ask him to focus on his immediate situation; I wanted him to get grounded in the here and now. During a business crisis, it's important to keep your eye on short-term profit (your income minus your expenses) and put aside any ideas of expansion, which inevitably require time, money, or other resources and may be slow to show results. I told Bernie, "I want you to put all thoughts of new services aside for now. Conserve your energy and finances. Let's start by looking at what's going well in your practice—anything at all—and let's build on that."

When he started thinking this way, he found that he had a lot that was going well: solid referral sources, loyal and appreciative clients, and a reputation as the "go-to therapist" for acting-out teenagers. I suggested a slow-growth, three-tiered strategy. First, lower your input costs. He did this in a month by negotiating a 20-percent reduction in his office rent. Next, become more productive. He identified unbilled services that he routinely offered, primarily hours of calls each month with the teachers of his adolescent clients to check on progress; he decided to bill for these calls. Finally, become more efficient. With his open hours, he made inroads into clutter and filing.

Only then, with a cushion of reduced expenses, additional income, and reduced administration time, did we begin to talk about expansion, which in his case meant developing a methodical marketing plan for filling his empty client hours.

"Don't Resist, Assist."

In today's recession, many therapists are finding that they're emotionally or intellectually unprepared to make changes at the pace that their practices require. Sylvia, a senior therapist with excellent clinical skills, told me she was "in the dark ages" when it came to marketing her practice. Referrals had dried up. She wanted a website to attract clients, but she was computer illiterate. She felt she had to master the technical software before she moved forward.

"I know this is ridiculous, but I've been struggling to write and produce a simple website for more than two years," she explained. "I've purchased a website name and a template, but I'm totally blocked. And before you say anything, Lynn, you should know that I have issues about hiring anyone to help me. It feels like I should be able to do this myself. Other therapists I talk to have websites they've created. I feel stupid that I can't produce this website on my own."

In a recession, timeliness—the ability to move forward quickly with a business plan—is crucial. I told Sylvia that her impulses were good: she did need a website, but it was time to assist the forces of change instead of resisting them. I reminded her that it's not, as some say, "the strongest of the species that survive, nor the most intelligent, but the one most responsive to change."

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