A year ago, in my Build Your Full Practice workshop, I met an energetic, young therapist named Marla. She was fidgeting in her chair as we started the introductions. When it was her turn, she told us that she'd opened her private practice the year before and still had very few clients. "I've tried doing what my mentors have told me to make it grow, but it doesn't seem to be working. I wrote a couple of articles and put some ads in the local paper. I've dropped off my practice brochures at my doctor's office. I attend my local therapists' networking meeting each month. But my phone still isn't ringing! So I'm here to learn how to get more clients."
Almost every head in the room nodded. This isn't an uncommon situation. As a practice-building coach for the last seven years, I've met a lot of therapists who are working hard to implement marketing strategies that just don't work in today's therapy environment, although they worked well in the past. So what's changed?
One word: the Internet.
From grade-school students to my 80-year-old dad, everyone is searching the web these days. It's estimated that there are 500 million Google searches every day. More and more consumers are using the Internet to find products, services, and service providers. They're searching the web for counselors too. Yahoo gets about 150,000 search requests each month for marriage counseling. Judy Gifford, CEO of Find-a-Therapist.com, an online therapist locator helping the public find counselors in their area, reports that her website had 4.5 million hits last year. I predict that, in the coming decade, online searches will be the primary way therapists attract clients.
When I explained this to Marla, she said "Technology! I don't know anything about computers and the Internet! My kids do, but I don't."
This is a common reaction. As therapists, we're comfortable in face-to-face interactions, and we've spent a lot of time mastering therapeutic theories and techniques. But our anxiety rises---if we don't go into full-blown panic mode---when we think of plunging into the world of electronic interactions. The idea is especially daunting for seasoned therapists, who've never had to market their practice before. I explained to Marla that she didn't have to learn everything in a day, and that some of it might be easier---and maybe even more fun---than she thought possible.
The other attendees looked doubtful, but several wanted to know how they could get started. I said there are three things they needed to do to get under way:
- Establish a "web presence"---a way for people to find them on the Internet
- Help web browsers get to know them and their practice
- Make it easy for browsers to become clients
Establishing a Web Presence
How do you create a web presence? Here are a few possibilities.
Develop a website. The most obvious and common way to create a web presence is through a website. A website doesn't need to be a complicated, multipage entity, with fancy graphics, photos, articles, links, and whatnot. It can be a simple, one- or two-page affair, and still be effective. Constructing a site can be easy. Some web-hosting companies, such as LunarPages.com, offer templates that let you to fill in the blanks, click some buttons, and create a website. If even that seems too daunting, computer gurus and graphic designers can help. A great resource for web designers is Elance.com, where you can "post" what you're seeking---for instance, "Design a simple, two-page website"---and freelance designers will bid on it. All you have to do is view their portfolios and select the designer and bid you like best.
The availability of vast amounts of information about products and services on the web has spoiled consumers. As a result, even a prospective client who's received a referral will no doubt want to do a personal web check of the clinician before calling for an appointment. So put yourself in your ideal client's shoes and figure out what that person would want to see. A common mistake therapists make is to talk mostly about themselves and their services on their website---their degrees, their specialties, their philosophy of treatment. But what clients really want to know is whether you'll understand what they're going through. Make sure this comes through in your website text. Open your website with headlines that speak to the client's worry: "Parenting a teen can be a very tough job." Or "Tired of having the same old fight with your mate?" Or maybe "There's been an affair. Now what?" Then in the next paragraphs, speak more about the problem. "While it may not have been easy for your parents when you were teens, today's parents worry about everything from the Internet to life-threatening STDs. It can be scary raising a teen today. Even the best parents have questions. If you could use some support, I'd like to help." Contrast that approach with websites that open with "I am a cognitive-behavioral therapist with EMDR certification who has a specialty in adolescents."
Once you have a website, put your web address on everything---on your business card, your stationery, and in your e-mail signature. Make it easy for people to find your site so they can get to know you better.
Start a blog. Instead of a website, or in addition to it, you can create a blog---short for "web log." Originally blogs were online personal journals, often with daily---or hourly, or up-to-the-minute---entries. They're inexpensive, easily updatable alternatives to websites. In fact, many therapists' websites are actually blogs, and no one can tell the difference just by looking at them. If you can send an e-mail or create a Word or WordPerfect document, you can create and maintain a blog.
Why would you want a blog instead of a website? For one thing, it's easier and requires less technical knowledge to update and change the content of a blog than that of a website—you can amend it, adding and deleting material at will. It enables you to create a virtual community on the spot. You can write articles, post them on your blog, and invite web visitors to comment or share their ideas. For example, if you specialize in working with clients battling cancer, you could write an article about how the diagnosis can impact those they love and post it on your blog. You can then invite readers to share their thoughts and feelings about the issue. When one therapist did this, someone wrote back about how distant some family members and friends became after they heard about the cancer. Others agreed and shared their experiences. Responses were anonymous and yet a support community was created. Her blog readers returned again and again to read others articles she posted and to share their feelings and experiences. The usefulness of blogs for getting your own name out on the web is obvious: as visitors who are interested in the topics you include return to the blog to see new articles and comment on them, they begin to feel it's one of their own familiar "places" online. Should they feel they need to consult a therapist, yours is the name that'll probably come to mind and the phone number they'll most likely call.
Setting up a blog takes some technical skill, but it isn't difficult. For those just starting out, I recommend the blogging service at TypePad.com. They have many templates to choose from and take you through the steps to create your own look and feel. Hosting a blog can cost between $9 and $15 a month. Again, if you don't want to set up your blog yourself, you can post it as a project on Elance.com and get some inexpensive bids (less than $100) for someone else to set it up for you. While the hosting costs of a website and a blog are comparable, the savings with a blog come in when you want to make changes or updates. Web designers can charge $50 to $100 per hour to update the content on your website, but after a blog is set up, you can make the changes yourself.
Vondie, an energetic young therapist in California, was a self-described "technophobe," but she was bright enough to see that technology would play a huge part in building her practice. She now has a blog, with articles of interest to her target market of young women and a list of upcoming events she's organizing. Young women are finding her on the Internet and subscribing to her newsletter. She's seen as an expert in her niche because of her blog postings, and is being interviewed for a TV show.
Join a Therapist-Locator Service. A third way to create a web presence is to subscribe to any of several online therapist-locator services, which are now considered the new "Internet yellow pages." How do they work? For a fee (between $9 to $30 a month), you can post information about yourself and your practice on these services. When people search the Internet for a therapist, say by going to Google and typing "therapist, Framingham, Massachusetts," these services will come up high in the rankings. Potential clients can enter their zip code or the problem they're having, and the therapists matching their entries will be displayed.
For example, at Find-a-Therapist .com you can purchase a package allowing you to put your listing on as many as four separate therapist-locator sites. You can choose from a long list of sites, including NewYork-Therapists.com, 4AngerTherapy.com, MensTherapy .com, ChildrensCounselors.com, and ChristianTherapists.US.com.
Both Find-a-Therapist.com and Counsel-Search.com are great places to get started if you don't have a web presence, but want to start one in a low-key way. Your listing with both of these services will come up as a one-page website for you. It will display whatever information you put into your listing; it's basically a one-page site where you create the content. As an added bonus, if you select the one-year membership with Find-a-Therapist.com, they'll create a press release for you. You can submit this to your local papers to become better known in your community. Since the online therapist-locator services work hard to rank high in search engines, like Google, Yahoo, and MSN (meaning, they're likely to be near the top of page 1 and not buried at the bottom of page 43), you don't have to. The beauty of the online therapist locators is that you can show clients and prospective clients how much you care about the problem they're having. You can fill in several paragraphs to show potential clients that you're compassionate and knowledgeable and want to help. For example, "Does it seem like everyone but you is pregnant? When a woman wants a baby and hasn't conceived yet, it feels like she's the only one on the planet without a child. If this is happening to you, I'm sure you understand the rollercoaster of emotions that can come up---happy for your pregnant friends and sad for yourself. Sometimes it's hard to find someone who can understand these feelings. You aren't alone. I'd like to help."
A therapist in Los Angeles told me she was on the Psychology Today online therapist locator, but wasn't getting much response from her listing. The first problem was that her listing was all about her. It talked about her credentials, her eclectic style of therapy, and her training at a psychoanalytic institute. What it didn't talk about was her target market---couples. When we changed her listing to open with "Tired of having the same old argument?" she started to get more response, but still not many clients. We checked and there were 56 therapists listed on Psychology Today in her zip code. No wonder! Most people on the web aren't going to look at 56 listings before choosing a therapist to call. So, before you choose a service, check how many others are in your zip code. If there are more than 25, I'd recommend using a different online therapist-locator service.
Pay-Per-Click Advertising. Once you have a website or blog, one way to get people to your website is with sponsored ads or pay-per-click advertising. Here's how it works.
You identify the geographic area---such as "East Lansing, Michigan"---where you'd like a short text ad to appear and the terms that your potential clients would be searching for on the web. For example, the headline in your short text ad might read "Counselor for my teen" or "Psychologist, East Lansing." You then have one or two more lines in which to put more ad text. You might say, "Helping frustrated parents and teens get along better. Call today for an appointment." The next step is to create a "bid amount" for each search term. You can bid $.05 and up per term. The services will recommend a bid amount for you. They might tell you, for instance, that if you want to be in the third position in the sponsored listings, you'll need to bid $.80 per search term. Then when someone searches the Internet in Google for that term, your ad will come up in the "sponsored listings." Each time someone clicks on your ad, you'll be charged whatever you bid for that search term. The pay-per-click advertising service I recommend is Google AdWords. They have great tutorials that show you exactly how to set it up.
Just one more thing. Don't forget to set the city and state where you want your ad to appear. I once lost $400 in a weekend because I forgot to do that. People in China and New Zealand were clicking on my sponsored ad for my counseling practice in Irvine, California.
Helping People Surfing the Web Get to Know You and Become Clients
After you have a web presence, then what? The purpose of a website isn't only to help web visitors locate you, but to help them get to know you and become your clients. Here are some tools for doing that.
You can offer web visitors a free report or newsletter, filled with tips and strategies of interest and value to them, which they sign up to receive as often as you choose to write it. Janie, who works with teens and their parents, writes a monthly online tip sheet titled "Surviving the Teen Years." Parents will often call and say, "I've been receiving your e-mails for a while and now we've decided it's time to make an appointment."
Online Appointment Scheduler.
Another refinement to your web presence is an online appointment scheduler. Let's say that a potential client visits your website. She likes what she reads and decides she'd like to make an appointment. You can ease her effort by giving her an opportunity to do it right then, online. To offer this feature, you need to subscribe to an online calendar service, such as Appointment Quest.com, which can run between $15 and $40 a month. You indicate on the scheduler the times that you have open to see clients, and include on that same page a button that says, "Schedule an appointment." When a person schedules an appointment, you're sent an e-mail notifying you of the appointment. The system keeps track, so there are no double schedulings for the same time slot.
This can be a great feature for your existing clients too. Many therapists have found that it reduces the "telephone tag" around rescheduling appointments. You can even arrange to have reminder notices e-mailed to clients a day or two before their appointment.
There can be drawbacks, though. John, a therapist in Texas loves his appointment scheduler for its convenience, but he found that there was a higher no-show rate among new clients that scheduled with him online. With no personal connection between a potential client and a therapist---not even a voice on the phone---there's less sense of obligation to keep the appointment. John reduced the number of no-shows considerably, however, by calling clients within 24 hours after they scheduled their first appointment online. That personal connection made a big difference. He still believes it's an excellent idea to have the online calendar, because it allows him to make an appointment with a perspective client before he's actually gotten to talk with him or her, and usually the first therapist to connect with a person seeking a therapist is the one who gets the client.
Let your web visitors hear your voice. The problems caused by lack of voice contact can be offset by including an audio message on your website, something quite easy to do these days. When visitors find Nancy's site on relationships, for example, they can click on a button and hear her welcoming them---which helps them begin to feel connected with her.
Other Ways to Use Technology to Build Your Practice
Consider recording your community presentations and offering them for free or for sale on your website. You can burn a CD of your talk on your computer and give it out to referral sources or at a health fair. Or you might want to consider creating a relaxation CD as a marketing tool. Most computers will allow you to record directly into the computer. You can offer online assessments or self-tests that help people decide whether counseling is right for them.
What about taking credit cards as payment for psychotherapy services? Therapists used to send out monthly bills. Then the ceremonial handing over of the check after each session took over (still probably the commonest mode of payment). But now, in a society awash with credit cards, therapists, too, have the option of accepting plastic. There may be reasons not to go this route, however. I recently received an e-mail from a colleague, saying, "I've purposely chosen to not accept credit cards. My thinking has been that it is not healthy for clients to go into debt to pay for sessions. But I am open to your ideas."
This practitioner has a point, of course. Many people do need therapy, but perhaps can't afford the weekly outlay, so the temptation is there simply to charge what they can't afford and pay the piper farther down the line. Is it a good idea, or really ethical, to let them run up debt?
In the first place, of course, paying by credit card doesn't mean they can't afford it---perhaps, like me, they prefer to charge most of their expenses and pay in full at the end of every month, rather than write multiple checks. Beyond this, however, I believe that if we don't offer credit-card options, some people may not get the treatment they need. So it's better to give them a way to pay for it over time. Also, many clients ask me if they can charge their session on their credit cards so they can get reward points or airline miles. There's also the added advantage for us that the financial arrangements are really between the client and the credit card company, which means we can focus solely on giving our clients the best possible treatment, and not worry about issues of payment.
There are different kinds of services that'll allow therapists easily to take credit-card payments for sessions. Some of these services are Internet based, while others involve renting or purchasing a "swipe machine" to be hooked up to a telephone or fax line. Whichever you choose, make sure you understand all the costs involved before you sign up for a credit-card-processing service. Some services require that you have a business checking account. In addition, you'll be charged a statement fee and a per-transaction percentage from the credit card processor. Depending on the service, the statement fee may be $9 to $14 per month, and the per-transaction charge may be 2 to 5 percent. So if a client charges a $125 session, you'll pay the credit-card merchant $2.50 to $6.25, depending on the agreed-upon rate. While this may seem like a lot, most clinicians find that people want to come more often if they can pay for their treatment with a credit card. The increased income usually more than offsets the cost. Two therapists in California recently told me that their practice income doubled after they let their clients and prospective clients know they accepted credit cards.
Marketing on the Internet seems scary at first to many therapists, who tend to be wary of technology, but with a little help from their techie friends at online companies set up to get them started, it really isn't, as they say, rocket science. Basically, what you want is some sort of noticeable web presence, which makes it easy for your web visitors to get to know you and become your clients.
With some trepidation, Marla, the participant in my workshop who was initially afraid of technology, began marketing her practice online. She chose to have a blog as her website and had a tech-savvy friend set it up. Since it's easy to update, she not only puts new articles on it frequently, but also adds other attention-grabbing and informative features. For example, she has pictures on the blog of a recent seminar she did and plans to put up a 15-second video clip of her presentation, so web visitors can get a better sense of who she is. She sends out a monthly online newsletter filled with relationship tips for her target market: young people who want relationships. Because more and more people are hearing about her and reading her blog, she's been getting more speaking engagements. Her practice has taken off, and she's excited about the new clients coming her way. She now gets two to four new referrals a week. Last week, she asked about how to get started with pay-per-click advertising. Recently, she said to me, "I never thought this would actually be fun, but it is! And if I can do it, anyone can!"
You can do it, too. If the Internet continues to grow in importance as a communication and information medium, as it almost certainly will, it'll increasingly be the most effective way for you to attract clients. Getting started on the web really isn't that difficult, and there's plenty of help out there, so, I say, go for it!
Business of Therapy