I just received this e-mail from Ann, a psychotherapist in Washington State: "Casey, for the first time in my 15-year practice, I'm starting to get really scared. At first, a few clients decided to 'take a break' and stopped coming. Then a few more moved from weekly sessions to every other week. I've just balanced my books and realized that I'm making only half of what I did this time last year. What can I do to get my caseload back to where it was before?"

Last week, I had a call from Charlotte, a psychologist in northern California. She, too, said her caseload was down almost 50 percent: "I'm still getting calls asking if I'm taking clients," she told me, "but these calls are few and far between. When I do get new clients, they come once or twice and then realize they can't afford it. I'm starting to negotiate and lower my fees. I need to make at least enough to pay my rent. What can I do to get more clients who can afford therapy?"

The note of desperation in these e-mails is hard to miss. Ann and Charlotte aren't alone. I speak with private practitioners all over the world, and the mood out there is somber. The resounding chorus from private practitioners everywhere is the same: "This economy is killing me! I need more clients. How do I find them and get them in the door?"

Over the years, business coaches (including me) have produced an avalanche of books, articles, courses, and workshops on how to build a bigger private practice and recession-proof…