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.