I started my own private practice in a burst of optimism, but at an unpropitious time. It was 1992, and managed care had begun looming, King-Kong like, over the land of psychotherapy. At that point, although I was filled with enthusiasm for being a therapist, the idea of running my practice like a business seemed completely foreign, if not distasteful. After all, I told myself, if I’d wanted to be an entrepreneur and sell stuff, I wouldn’t have spent all those years getting a PhD in psychology. This, then, is the story of how an entrepreneurially clueless therapist came to accept the facts of financial life and, in his own bumbling way, sought an answer to the question all therapists face today: how can I ensure that my family and I remain solid members of the middle class—without selling my soul, or selling out my clients? At the heart of the tale is how he accidentally created a brand for himself and his therapy, and then learned how to promote it, consciously and consistently, through 21 tumultuous years of change in the psychotherapy field.
Some therapists might recoil in horror (or assume a fetal position under the bed) at the thought of “branding” their practices. We are, after all, healers and mental health professionals, not hawkers of cosmetics and cornflakes. Indeed, to many of us, the thought of promoting ourselves and our practice seems crass, undignified, and, perhaps, a tad narcissistic. But before we throw our hands up, let’s take a breath and consider what branding really means. First, if you think that what you do as a therapist is helpful, worthwhile, and maybe even unique (after all, you are the unique person doing it), it’s a short step to believing you have a duty to let people know these things. How are all the people who’d benefit from your services going to get help unless they know where and from whom to get it?
In today’s world, the traditional means of getting the word out—a discrete ad here, a few hints to colleagues there, some folders or business cards sprinkled around town, even a website with your impressive credentials listed in chronological order—won’t remotely cut it. In a sound-bite-saturated world of massive information overload, frenetic tweeting, continual advertising, and endemic cultural attention deficit disorder, having a brand that stands out is probably the only way you’ll have a chance of capturing the attention of potential clients.
But what is a brand, and why would you want one, anyway? A brand is a marker, often personal, of the specific identity and special attributes that propels something—a product, person, service, organization—out of the vague, undifferentiated backdrop of “somethings” and “somebodies.” Your brand individuates you and what you do from the huge, generic category of others. As a therapist, you may be barely an anonymous face in the crowd before developing a distinct brand; but now you’re visible, and your target audience knows what’s special about your service, and what specifically you can do to improve their lives. A successful brand conveys a meaning, tells a story, and elicits strong feelings. Notice what distinct thoughts, feelings, and images come over you when you think of these brands: Starbucks, Jon Stewart, Fox News, Google, Nordstrom. And in our own field, we have APA, NASW, Dr. Phil, John Gray, John Gottman. You may like or dislike these brands, but you know what they stand for.
Unfortunately, we often think of branding as a somewhat shady attempt to mislead, to sell something that maybe isn’t quite good enough to stand on its own merits (some of the iconic brands above may suggest as much). Branding, however, is about creating and managing an image and a reputation. Only when the product, service, or person isn’t so wonderful does branding become an act of inventing a false image and massaging a poor reputation.
You may be surprised to learn that you probably already have a brand. As a therapist, your brand is your invisible identity, perhaps built without your realizing it, based on how people in your community see your business. Consequently, this accidental branding may be neutral, positive, or negative. Clients might refer friends to you based on your excellent work with them. Conversely, they might define you by discussing how long it takes you to return phone calls, the techniques you use, your unavailability between sessions, how you tend to space out while they’re talking, the bland colors in your waiting room, the length of your sessions, the way your voicemail message sounds, or the comfortable furniture in your office.
So if you have a particular specialty, a unique way of working, a particular focus or interest, a record of success with certain kinds of clinical populations, as well as a reputation in the professional community and among former clients for doing genuinely helpful therapeutic work, then you already have an outstanding brand. You just need to clarify it and promote it to the people who could most benefit from your clinical expertise. In a way, you’re not just promoting yourself: you’re doing a service by letting your own light shine brighter so the people who need you can easily find you. While that may sound straightforward enough, it took a long time and an impressive number of mistakes for me to understand that I needed a brand, then to figure out what my brand was, and then to hone it, sharpen it, and promote it to the public.
The Naive Beginnings
In 1992, I was the clinical director of an outpatient mental health and substance abuse clinic, supervising 15 therapists, seeing about 25 clients a week myself, and already looking for an escape. Not only had managed care invaded our clinic, but the owner of the clinic had a tone-deaf habit of creating a demoralizing work atmosphere, and I realized it was time to go. While keeping my day job, I found two therapist friends to share a tiny office and start a small practice on the side. This move was a breath of fresh air: no managed care, no boss, no one telling me how to write my notes or how to do my sessions. It was heaven!
Initially, I didn’t have to do anything to promote my practice: colleagues from my day job sent me referrals. Soon, I was seeing 10 to 12 people a week, in addition to spending my regular 50+ hours per week at the clinic. But that’s when I hit my first snag: I had no free time. I wasn’t sleeping enough. Conflicts with my wife increased. I got no exercise and, worse, began eating fast food regularly. Realizing this pattern wasn’t sustainable, I dreamed of quitting my day job and doing private practice full time. How hard could it be? After all, I was getting referrals, doing good work, making good money. If I were in private practice, I thought, I’d have more hours for all those new clients I felt confident would flow my way.
Of course, these rosy images of an untroubled future clashed with what many experienced therapists told me: “Don’t be a fool! Keep your day job. You’re lucky to have one. Private practice is dead! No one can make it that way anymore.” Furthermore, I was sent a flurry of articles about therapists whose private practices had been devastated because they’d ignored managed care (as I planned to do). What if they were right? What if my referrals dried up? Where would the money come from? Was I kidding myself? I rationalized these worries by deciding, quite arbitrarily, that getting to 15 clients a week would somehow prove beyond a shadow of a doubt that I could succeed in private practice. Assured of my future as a private practitioner, I’d then confidently quit my job. And it actually came to pass: I finally managed to squeeze in 15 clients two weeks in a row, and I gave my notice.
Within three weeks, however, I’d gone from triumph to terror. I had hours and hours of open time slots to fill, but was unable to get more than 20 clients a week consistently. Without the daily contact with therapists at my old clinic, referrals slowed down substantially, and I had absolutely no idea how to promote my practice. When I asked my private-practice colleagues how they managed, they said, “Oh, it goes up and down; that’s just the way it is. Get used to it.” One colleague told me just to say affirmations; another said I should talk to doctors or join the Chamber of Commerce. All this advice seemed unhelpful and lame.
So I bumbled along. Eventually, my wife, Shirley, an MSW, joined my practice. We both loved working to help people find more intimacy in their lives, whether it meant turning a lifeless roommate marriage into a fulfilling partnership, or helping singles avoid repeating the pattern of attracting partners that would hurt, disappoint, or cheat on them. We’d always gotten great feedback on our work, but to make sure we were concentrating on what potential clients needed in this area, we organized a series of focus groups. We contacted the directors of four local singles’ groups and found two couples’ meetings through a church and a synagogue near our office. We provided dinner for these groups, and asked them what types of services they and their friends might want. We asked questions, took copious notes, and got feedback on different workshop ideas and business names.
Without realizing it, we were taking the steps necessary to create a distinctive and viable brand. We wanted to do therapy and workshops for singles and couples from a psychoeducational, rather than a traditional psychodynamic, perspective, and we didn’t want to scare off people who were intimidated by therapy. Based on the focus group feedback, we started a drop-in support group for singles, an eight-week psychoeducational workshop for singles called Creating Lifelong Loving Relationships, and two workshops for couples. Also, we offered individual, couples, and group therapy. We chose the name Relationship Institute, with the tagline “Teaching the world to love.” This name emphasized the learning aspect of our approach, and conveyed the idea that singles who were alone and couples who were unhappy were not that way because of intrapsychic deficits, but because they’d never been taught the essential skills for healthy relationships. Several colleagues made fun of what they said was our highfalutin name, noting that we were too small to be an institute. But undeterred, we marched on.
We hired a graphic designer to create a logo and a professional brochure. The brochure told our story about how we’d spent a great deal of time and money in individual and couples therapy ourselves, learning how to have a more fulfilling relationship. It stated that we could now help others learn to do the same, but much more rapidly and inexpensively. As therapists, we had all the elements of a successful brand: a unique visual image, a unique business name, and an emotionally engaging personal story to tie it all together. We gave free talks about healthy dating practices at singles groups, and performed skits to illustrate red flags in dating. We spoke at churches and community centers on healthy communication for married couples. In the process, we refined our shtick and learned how to promote our brand and tell our story to generate steady referrals. I was soon seeing about 22 clients a week in addition to running two groups and leading bimonthly workshops. Hey, I thought, maybe this isn’t so hard after all.
Necessity Is the Mother of Invention
We had our first child in 1995, and it soon became more difficult to get out in the community for those business-generating public meetings. We were still taking turns leading workshops in our office, but getting out as a couple became hard to pull off. And it just didn’t work as well when only one of us presented, because our relationship was the living embodiment of our brand. Still, we were doing fine with our income—until our second pregnancy the following year resulted in the birth of twins. Our children’s food, clothing, and medical bills were going to triple. I panicked as the carefully constructed financial spreadsheet I’d created unraveled before my eyes. My only thought was that I needed more clients—a lot more clients. At this point, I learned that having a good brand was necessary but not sufficient on its own for a successful practice. I now needed to go further and learn how to promote the brand more effectively.
For help, I turned to the Michigan Psychological Association and the American Psychological Association, but found both were worthless in offering practical advice. The business books I turned to not only were incredibly boring, but seemed to have nothing to do with running a psychotherapy practice. In desperation, I searched nationwide for help, and discovered a small business-marketing guru named Jay Abraham in Los Angeles, who was purported to be a brilliant out-of-the-box thinker who’d helped hundreds of small business owners become millionaires. While he normally charged $15,000 for a weekend workshop, he was planning a kind of sale event—a 3-day workshop for the bargain-basement price of $3,500. I reluctantly signed up, too embarrassed to tell anyone but my wife that I was paying for something 10 times more expensive than any clinical workshop I’d ever taken.
Soon I was sitting in a large, noisy conference room with 425 people at a hotel near the Los Angeles airport. To my horror, I discovered that I was the only mental health professional in the room. Not only did I feel terribly out of place, but, while brilliant, Jay seemed manic and wrought with attention-deficit issues. Nonetheless, the workshop, a sort of crash course in Small Business Marketing 101, created a sea change in my attitude and mindset. I discovered that I was a small business owner, not just a psychologist, and that I had to work on my business, not just be in it. The workshop propelled me through a series of humbling insights. It led to a powerful call to action when Jay took the branding concept deeper by introducing the idea of a unique service proposition (USP), which encapsulates what problem in the world your product or service addresses and what its specific benefits are. He taught us how to craft a USP and then distill it into an elevator speech of 30 seconds or less. We did small-group role playing and tested out our brands, and we refined them based on feedback from others. I got more and more pumped.
Jay also taught us the concept of the Lifetime Value of a Referral—every new client, on average, brings in a specific amount of money (your fee times your average number of sessions before termination, which for most therapists is more than $1,200). If you spend half of this amount to get a new client, you’ll get a 100 percent return on your investment. Really? I thought, spend $600 to get one new client? That’s insane. But the numbers didn’t lie. This concept, along with the USP, helped me break out of my limiting beliefs about what was possible in my practice growth.
I left the weekend realizing that I needed to figure out a better way to bring my brand to not just a few dozen people through community presentations, but to thousands at once. Difficult as it was to grasp at first, I found myself increasingly guided by the Lifetime Value of a Referral concept, and began placing expensive display ads—$300 to $500—in various print publications. The ads used my USP-enhanced brand, along with the four-part advertising formula Jay outlined: start with specific problem statements in the language of potential clients; follow with the benefits they’ll receive after a successful experience working with you; add unique features of your training or how you work; and end with a way to contact you. I wrote articles for local publications, started a public-relations campaign targeting local media, and began tracking my referrals, income, and expenses with extreme precision. Within six months, my caseload was consistently averaging 35 clients a week, and when the twins were born, we had plenty of money to support our growing family.
I thought I was doing great—until my accountant mentioned two things that can chill the heart of anybody who’s not among the top 1 percent of earners: college education for the kids and retirement for me and my wife. The problem was, I realized, that even if I kept getting more referrals to meet these financial needs, there was nowhere to put them. A week contained only so many hours for me to see clients, and my clinical acumen declined rapidly after a certain point without rest or relief. Also, I did occasionally want to actually see the family I was working so hard to support. I’d always thought a full practice was the only ticket I’d ever need to a great life, but economic reality proved me wrong.
Expanding the Brand
I was going to have to make my brand work even harder for me if I wanted to get past the income ceiling I’d hit. During the course of several more business trainings, I learned about leveraging my time more effectively. Instead of trading one unit of time for one unit of money, as I’d always done, I began thinking of ways to generate multiple units of income per unit of time. One of my business coaches repeatedly said to me, “Therapy doesn’t scale,” meaning you always have to provide one office, one therapist, and one client to make one chunk of money. But scalable services can multiply the results of your work. You do the work once and your income multiplies from that point on, as with books, large group workshops, or DVDs. After reviewing various options, I decided that hiring therapists to work under our brand was the smartest choice. The idea was that I’d generate referrals for the therapists and get a percentage of the fees collected. My income would rise as more clients were seen by more of my contracted therapists.
I’d embarked on a path I’d never have imagined traveling, but everything seemed in place. Thanks to my successful brand and Jay Abraham’s ideas, there were plenty of referrals for everyone. The problem was that since I had no idea how to run a business with staff, at first, I kept messing up. I hired the wrong people—too young, too inexperienced, too controlling—or I paid them too much, not knowing that my practice wouldn’t turn a decent profit if the therapists made more than 65 percent of the session fees. I also wanted them to like me too much—which led me to overlook clinical shortcomings or unresolved personality issues. I didn’t know how to fire people who weren’t performing, and I wanted to do everything myself, which resulted in even more hours at the job and less profit than before.
After several years and thousands of dollars and hours wasted, however, I began to see the light. I kept studying business and management principles, hired office staff, delegated tasks, learned how to create systems to run the practice more efficiently—and my monthly passive income began to grow steadily. I was working fewer hours myself and making more profit per month than ever before. I still remember my gleeful shock the first time I came back from a vacation and saw more money in the business account than when I’d left.
As technology evolved, I took several advanced trainings in Internet marketing and discovered the profound opportunity that the Internet presented to savvy marketers. Instead of me reaching out to potential clients, they were now searching for people like me. It was a startling 180-degree shift. All I had to do was create an online presence optimized for local search, making sure that when someone Googled “marriage counselor” in any of the three cities we had offices in, our website would show up on the first page. Using this online strategy, I doubled our practice in five years. Currently, at least 70 percent of our monthly referrals come from online sources. Our brand is firmly established in both the local and online worlds.
Creating Your Brand
While branding is central to business success, the best brands are an authentic expression of who you are as a human being. Don’t choose a brand simply because you think there’s a large pool of potential clients out there with a specific issue. For example, the National Institute of Mental Health’s website states that anxiety disorders are the number-one mental health issue in America, with 18 percent or 40 million adults experiencing an anxiety disorder in a given year. So you might think you should brand your practice around anxiety issues. But if you don’t love sitting with people with obsessive compulsive disorder, post-traumatic stress disorder, or other anxiety- and phobia-related issues all week long, you won’t be effective in helping them, and will probably burn out quickly. Psychotherapy is among the most rewarding types of work when you’re passionate about the issues you work with, but if you don’t truly love what you do, your brand will fail.
To help you realize how much creative latitude you really have in crafting your brand, consider an example from a well-known company in another industry. One Sunday evening in 1997, I remember watching grainy black-and-white video clips of Gandhi, Bob Dylan, Martin Luther King, the Dalai Lama, John Lennon, and Albert Einstein floating across my television screen. Steve Jobs had just returned to Apple after a 12-year hiatus. “Here’s to the crazy ones,” the narrator said softly. “The people who are crazy enough to think they can change the world are the ones who do!” The ad was 59 seconds long, and ended with the Apple logo and just two words: “Think Different.” Jobs’s message was clear: Apple computers are creative tools, which unleash your inner genius and help you change the world.
Did this bold, audacious attempt at marketing work? Absolutely. Four years before the iPod and 10 years before the iPhone, this ad was Jobs’s first effort to rebrand a company that was two months away from bankruptcy—the first step in the most remarkable business turnaround in history. This is the power of a brand when brilliantly executed, and the concept of branding is as relevant to private practice as it is to large corporations. As management expert Tom Peters said, “Branding applies as much to the one-person service as to Coke or Pepsi. Your brand is the emotional connection point that transcends your product or service. . . . It’s about passion . . . what you care about, what’s inside you, what gets you out of bed in the morning.”
Because of inaccurate portrayals of psychotherapy in the media, many people still think if you’re in therapy, you must lie on a couch, have a serious mental illness, and only talk about bad memories from your childhood. But just as Jobs turned a dull gray electronic box into an exciting, creative adventure, you have the ability to reframe those associations with therapy into anything you want. What do you want people to feel and think about when they hear your practice name or think of working with you? What are you doing to create that in your clients’ minds?
In today’s world, one of the best ways to express your brand, to tell your story in the most direct, authentic, personal way possible, is through video on your website. Unfortunately, too many therapists still tend to be uncomfortable around technology—which limits their ability to connect with a vast Internet-based audience of potential clients. But there’s a simple solution: if you aren’t comfortable using technology yourself, hire someone who is, or get your 15-year-old nephew to help you set up a website with all the bells and whistles you need to generate new business.
Amazingly, the cost of connecting with potential clients in this profound way today is negligible. A website costs less to maintain than the phone in your office, and high-definition video can be created, edited, and uploaded to the web for free using just a smartphone. You can tell your story in your own voice while looking directly at potential clients who are seeking the exact help that you provide. This way, you can convey your passion and humanity, establish rapport, validate that you understand their situation, shape their perceptions of your practice, counter any misconceptions about your type of therapy they may have, and invite them to experience what you have to offer. Here’s a sample video script from an eye movement desensitization and reprocessing (EMDR) practitioner I know that accomplishes all of the above in less than two minutes.
“Hi, this is Dr. [name]. If you’re experiencing anxiety, depression, or limitations in your career or relationships because of past trauma, I can help. You may have tried to work on these issues before in talk therapy, only to find that it didn’t really help. I was frustrated with the limitations of talk therapy myself and began exploring alternative methods of treatment several years ago. What I discovered was a remarkable technique called EMDR. In all my 22 years of practice as a psychologist, I’ve found EMDR to be the most effective method I’ve ever seen for rapidly resolving past traumas and emotional blocks. This well-researched experiential technique bypasses your normal resistance and helps you resolve your emotional issues quickly, giving you the freedom to create the life you prefer. If this sounds interesting to you, give me a call at [number]. Let’s set up a time to talk, no charge, just so I can learn more about your situation and discuss specifically how EMDR can be of help to you. I hope to speak with you soon. Thank you for your time.”
In this one short video, speaking in plain nontechnical language, this practitioner has clearly stated his brand in a much more engaging way than even the cleverest wordsmith could do with text on a page. Auditory, visual, and emotional connections are made simultaneously. Viewers with any serious interest in therapy will be curious about this technique, and there’s a high likelihood that they’ll inquire about the next steps.
Even if you’ve developed a powerful and informative brand, however, you’ll waste all that effort if you make the common mistake of using your own name as both your practice and web-domain name. Listing your practice as Jenny Smith, LCSW, Clinical Social Worker and using jennysmithLCSW.com for your website would be fine if your name itself was already a brand, as is the case with best-selling authors. But for the rest of us, we need people who’ve never heard of us to find our information online. For example, if you’re living in Chicago, having panic attacks, and searching Google for help, which of the following would you be more inclined to click on: jennysmithLCSW.com or Anxiety-Center-of-Chicago.com?
Malcolm Gladwell, in his best-selling book Blink, discusses how many choices in life are made unconsciously in an instant. The decision to click on a name that shows up on a search engine list happens in a split second, and the name that conveys the most meaning to a potential client often gets the click. So whenever possible, choose a brand name and a web-domain name that says something specific about your work. Here are some great examples in our field: coping-with-loss-and-grief.com, eatingdisordertherapyla.com, lifewithoutanxiety.com, theteencounselor.com, and depressionanxietycounselingaustin.com.
As therapists, many of us still carry around the idea that our profile in the world is supposed to be discreet and modest. To toot our professional horn in public—and even worse, to make money doing it—would be unprofessional, and perhaps even inappropriate. But that old attitude has become a crippling handicap. These days, our brand needs to be highly visible and energizing, offering an authentic picture of who we are and what we can do for people who need our services. It’s an essential form of communication that helps us attract the people whose lives will benefit from contact with us. And the more people we connect with, the greater the good we can do in the world. It’s finally time for therapists to realize that doing good work doesn’t mean we can’t also do well for ourselves.
Illustration © Christie’s Images / Corbis
Joe Bavonese, PhD, is the director of the Relationship Institute in Michigan and the co-director of Uncommon Practices, a service that helps psychotherapists create their ideal practice.