Most psychotherapists now have telepractices and conduct video and phone therapy sessions instead of face-to-face ones in an office because the majority of mental health providers switched to all, or primarily, Teletherapy sessions as a result of stay at home orders. While these types of online video or phone services are not for every client or practitioner, many therapists are reporting that, after moving their practices online and doing therapy with clients over several months, they find video or phone telesessions not only effective but convenient—and plan to keep offering some form of Teletherapy along with in-person sessions when they’re once again feasible.
However, clinicians are also reporting that when some new prospective clients find out in-person sessions are not an option they seem reluctant, resistant or unsure about beginning or making the switch to virtual therapy.
When this type of client reaction occurs, it causes psychotherapists to feel conflicted because client consent is needed in order to work virtually—and in-office sessions aren’t an option. Therapists also then wonder if it’s okay to influence a client towards Teletherapy when the client doesn’t seem to want it or is less than comfortable with it. Should therapists address the issue further when this happens or just refer? What's a therapist to do?
While there are many good reasons that people are reluctant to do teletherapy—no private place, no equipment but their phone, etc., it’s important to remember that when in-person services are not available some individuals may initially find it hard to switch to or commit to therapy that’s different from what they’ve thought about, imagined or come to expect. Teletherapy is that kind of different. No couch, just a screen.
While clinicians know that some reluctance or resistance to beginning therapy is usually present in any intake, and are used to addressing that, what counselors aren’t used to is handling intakes where the reluctance is around Teleservices--video or phone--when it's the only option available.
The truth is that many of the issues that are initially expressed as client reluctance about Teletherapy, aren’t actually about the telesessions at all but are really just another manifestation of the client’s issues that are inherent to therapy—and these same types of objections or complaints would come up even if the therapy was face-to-face.
While it's important to keep in mind that online services are not right for every client or practitioner, a client’s reluctance, discomfort, and resistance is most often not about Teleservices, but about entering a new world where they are moving from a familiar way of operating to the therapy context where different rules apply. Our job as therapists begins with helping clients enter, become familiar with, and safely navigate the therapeutic context. We are, and need to be, their guide.
As you read the following information, be sure to remember:
What’s the best way to respond to a potential client who seems reluctant or resistant to engage in video or phone therapy when a therapist isn’t seeing clients in person in the office?
Teletherapy reticence, reluctance, discomfort, and resistance are clinical issues. The therapist needs to take charge of any conversations regarding teletherapy issues. Yes, it’s part of therapy and it’s the therapist’s job to aid-educate-facilitate pre-therapy (intake) or Teletherapy resistance conversations
New clients don’t really know what teletherapy is or what it’s like if they’ve never had therapy or online therapy before. They only have an idea of what it’s like or the description of what someone else told them.
Teletherapy with a clinician who is a good match can be a great option when in-person therapy is not available and many clients are great candidates for video or phone therapy.
Use your clinical skills to address and respond to a client or prospective client’s Teletherapy issues when they come up—just like you would address anything else. Treat the issues that come up about teletherapy sessions the same way you’d treat any other client issue.
Taking it personally = Countertransference!
Don’t take a client’s Teletherapy reluctance and resistance talk personally when clients demonstrate their issues and skill level in dealing with them—take or use a therapeutic stance just like you would about any other topic or issue. Under your guidance clients can then make an informed decision about beginning, continuing or ending Teletherapy.
Teletherapy is definitely here to stay. Its effectiveness is equivalent to face-to-face sessions and the flexible nature of video and phone sessions benefit both clients and clinicians. Add in the ease and convenience of scheduling a video or phone therapy session and talking with a mental health practitioner from the privacy of your home or another convenient location, and you find that these virtual services are a huge draw, especially for many people who are seeking therapy for the first time.
Telepsychiatry, teletherapy, telepsychology, and video therapy are more than just trends. In fact, a good number of mental health professionals are finding they prefer working with clients using teletherapy video and or phone sessions and will not be returning to in-office sessions. Yes, these therapists are reporting that they plan to keep their therapy practices solely virtual when in-office services become available again on a large scale.
Both in-person therapy and Teletherapy have advantages. Some view office sessions as a way to get some distance from problems at home and find it easier to see and deal with challenges objectively. Some clients prefer phone therapy, which works fine in many situations.
While Teletherapy and online services are not for every client or practitioner, online therapy is here to stay, like it or not. Consumers are changing, and so are therapists and their practices. Teletherapy has become another viable option for clients and mental health practitioners. It may not be the best option for everyone but the good news is that it is just as important and effective as the traditional therapist’s couch.
When the vacation or holidays are over, it's time to focus again, and get back to work.
I bet you could use some tips, inspiration, and encouragement to get your networking and marketing going so that you can fill your practice.
So, let’s get right to it!
1. Set Aside Time for Networking and Marketing.
Tip: Track what’s working and then do more of it—repeat what works. Quit what doesn’t work or work well enough.
2. Networking is simply making professional friends and acquaintances.
Don’t wait for opportunities to come to you, make yourself targeted opportunities.
When going to a networking event or a lunch or meeting, decide on your networking goals before you arrive: Who do you want to meet and talk with? How many new people do you want to get to know?
Tip: Read How I Came to View Networking Events as Social Meetups
Tip: Make list of 10 contacts you want to meet—people you want to know or be known by in your community. Then find ways to meet and develop mutually beneficial relationships with them.
Tip: Find others who might be in contact with or serving your ideal client from other professions; find allied professionals who serve your client population or ideal client. Get to know them and let them get to know you, the services you offer, and the type of work you do.
3. Marketing is what you do to help clients—and referral sources—find you, and to get clients coming to you instead of you running after them.
Remember that people are not going to look hard to find you or to find out more about you. Make it easy for them.
Tip: Follow the Two Golden Rules of Therapist Marketing:
1.) Make the act of marketing energy producing instead of energy draining;
2.) Only do marketing activities that fit for you, your client population, your type of practice or service—and ALWAYS within legal & ethical guidelines.
Tip: When clients go to your website, directory listing, and social media pages, what they are really looking for is: Who are you? What can you do for me? How can I contact you?
Make sure your content on your website, directory listing, and social media pages addresses that.
Tip: To market effectively, you need to know two things: what you offer and who needs what you offer.
Think about what you want to be known for, the treatment options you want to be known for, and the target populations you want to attract as clients. Share this content in a way that will get it—and you and your practice—noticed and that will help you build your practice.
3. Referrals: Don’t just rely upon clients, friends, colleagues or potential referral sources to automatically know that you welcome their referrals.
It’s up to you to let them know and to educate them about who are good referrals for you and your practice.
Tip: Directly mention that you welcome referrals by using a brief, and thoughtfully scripted, phrase or statement. This can produce significant results for your practice. You can say things like:
Okay, reading time is up. Now it’s time to get out there and increase your visibility in the community so that your new clients can find you when they need you! Happy practice-filling.
If I’ve learned anything from attending networking events and hosting a monthly practice development lunch, it’s what licensed and pre-licensed therapists and related professionals want.
Top of the list are: full practice or good job; work they love; ideal clients; enough money to support themselves, family (this doesn’t have to mean having a partner or children), and practice without struggling too much; a reasonable number of hours along with time away from work for personal and family life, vacation, networking and professional development, as well as for other individual or professional pursuits
Therapists are willing to work hard for all the above—starting with graduate school and continuing through gaining hours for licensure, and post-licensure or certification, then through the accruing of years working, and the maturing of their career.
How can, and do, professionals attain these highly-desired benchmarks while still serving clients, the profession, and the community?
The good news is that it can be done with any type of practice that suits you best: cash pay, insurance, sliding scale, part-time, online, coaching; day, night, weekday or weekend; rent your own office, share, sublet full day or half day or hourly, etc. It’s your choice. In fact, having the successful practice you want depends largely on the practice being suited to you and the clients you work with.
So how do you grow and fill a practice?
Consistent, effective, and ongoing, local networking is the best way to get known in your community and the fastest way to grow a practice and keep it filled.
What is local networking and how does it work? Local networking is one of the most natural ways of interacting with people—and most professionals find this a comfortable way to get known in their community.
Local networking means raising awareness about your services and getting the word out about how you help people and doing this by regularly connecting with everyone you know and keeping them up-to-date with what you’re doing in your practice or career and maybe even inviting them to check out your website, social media, blog, article or podcast.
Local networking means letting those in your community know what you do and how you help people—relatives, friends, neighbors, social and community contacts, colleagues, those at church or temple, people you worked with at previously or were in graduate school with or a placement—don’t forget professors and supervisors.
Each one of these people is a potential referral source for your practice. Find a way to keep in contact with them and to keep them current on you and your practice. Building your contact list, e-mail list, referral sources, and resource list is a long-term project. Start today!
Getting the word out about what you do and the services you offer to the community also involves meeting new people and making new friends as you increase your practice’svisibility and grow your network.
Who you know, those who know you, and those who refer to you are valuable resources for filling your practice with clients who need your services and will pay your fees.
Think about it this way, when people know about your practice, and are familiar with your services, they can find you or refer to you when a therapist with your skills and abilities is needed.
This type of networking is viewed as a community service, so make sure your community knows how you can be of service to them. The more people, businesses, organizations, and professionals in your community who know about the work you do the faster your caseload will fill.
Local networking can take a variety of forms, in person, online, digital or print advertising, talks, blogs, podcasts, YouTube videos, and any type of social media or online forum. It’s up to you to decide what works best for you, your practice, client market, available time, and budget. Take your pick. You get to choose. Try things out, then see what works best for you.
Local networking also means becoming familiar with your community and how your potential clients move through it via churches, schools, sports programs and teams, athletic and country clubs, theater arts, colleges, yoga centers, hospitals, libraries, parks and recreation, employee assistance programs, and many others.
Understanding the needs of potential therapy clients in your area and how those needs are being or not being met makes practice building easier.
Since therapists are an important part of every community, it’s important that we be visible so that our clients can find us when they need our services. The therapists I know who have a full enough practice with a consistent influx of clients are those who are known in, and know, their communities and keep up regular contact.
Local networking also includes getting known in your professional community. Joining and attending your professional organization is a great way to get connected with other professionals in your area and to develop and maintain relationships and friendships as well as referral sources for your network.
Through monthly networking events, workshops, member events, newsletter articles, classified advertising, and e-blasts, special interest groups, support groups, and special events, Professional organizations provide many networking opportunities for therapists and related professionals to get known in the community and develop themselves and their relationships.
As you can see, filling your practice with the clients you’re meant to work with requires that you find a way to connect with your community and let them know, on a regular basis, that your practice exists, what services you offer—and how people can go about contacting you when they desire your services.
This success formula for attracting new clients, filling your schedule, earning enough income, and having vacations, consists of raising awareness about your private practice in your community.
So, go ahead, announce your presence to the world and raise community awareness about your private practice. Be sure to keep me posted about your progress. I look forward to hearing about your success — and your vacation!
Getting Paid: Talking with Clients About the Price & Value of Therapy is the first article in the Getting Paid: Talking with Clients About Money Matters Series:.
There’s a lot of interest lately in addressing the issue of the amount of money clients pay, or don’t pay, per session for therapy.
The truth is that, as a profession, we as therapists often undercharge, and are underpaid, for the therapy services we deliver.
Fortunately, this seems to be changing as people are becoming more aware of the value of the therapy that therapists provide—and what therapy actually costs to provide.
So, what is the therapy that mental health professionals provide worth to clients and in marketplace?
Overall during money conversations when the price of therapy comes up, we, as therapists, need to focus on increasing people's perception of the value of the therapy services clients receive instead of routinely just dropping our fees.
When clients, or prospective clients, bring up the cost of therapy services during the intake or pre-therapy conversation we have, it’s up to each of us, in our therapeutic role, to engage the client in conversation about what they actually need and can benefit from in therapy.
This helps the client think through and justify paying the session rate, or continue to pay the session rate, we charge for therapy. It’s what we do in every other conversation with clients. Money matters are no different.
Yes, in these money conversations the therapist’s role, or clinical task, is to help the client clarify the value of the therapy and services they need and the results or benefits that therapy can or has delivered to their lives and relationships.
Helping clients look at what they benefit or gain from, don’t have to suffer, or will heal from because they are coming to therapy is an important part of these conversations when clients become over-focused on the price or cost of therapy services. It’s not just about the money or the price of therapy services, it’s part of the therapy itself.
It’s definitely part of our clinical role to help client think through what they need or are coming to or are seeking therapy for and the results and benefits therapy is providing to them or can provide.
When the therapist has this type of clinical client interaction, clients will often hire the therapist or continue coming to therapy even when the therapy costs more than what they originally wanted to pay or thought they could afford.
Remember that clients are paying for the value and benefits that therapy provides for them, not the time—and clients want a price, a number, they can justify paying. One that’s commensurate with the service and benefits they receive and need.
Do you get paid for your time or your expertise? Remember, professionals get paid for their expertise instead of for their time. Charge for your expertise and the value you provide, not just for your time.
Convey to your clients that they pay for your expertise, not just for your time. Clients often forget this when they focus on money and numbers. People will pay in full and out-of-pocket for your therapy services if they see you as a trained professional and an expert who can give them or help them get what they want.
The most common question I receive in my Money Matters workshops and practice coaching is how to respond when a client says, “I can’t afford that,” “I can’t pay that,” “I don’t want to pay that” or “I don’t know how I could pay that.”
Good responses to “I can’t afford it” are clinically based. Work with clients, or converse with prospective clients, to find out how they could pay that amount—what it would take or what they would need to/could do to make that happen.
Treat the issues that come up in these client money conversations the same way you’d treat any other client issue. Maintain your therapeutic stance and approach as you work with the client and their issues during the money conversation.
Yes, I am recommending that you address client fee and payment issues as clinical issues.
Maintaining your therapeutic role or position and confidently taking charge of money conversations works—and is therapeutic for the client. Focus on the value, cost, and worth of the therapy service to the client and their life. A client will pay for that. Clients do pay for that.
Be sure to keep the focus of your interaction on the client paying for services they need and receive not on what the therapist gets or how much the therapist charges.
Remember: a client doesn’t “give you money,” a client pays for services rendered. The client is not in charge of determining much therapy costs, the therapist is.
I wish you the best in your client money conversations. They are always adventures!
March Presentation Summary
Create and Sustain a Successful Private Practice Career
Lynne Azpeitia, LMFT, AAMFT Approved Supervisor
Joint Meeting of SVC-CAMFT and Sacramento Networking District AAMFT
Lynne Azpeitia is a licensed MFT and Approved AAMFT Supervisor. She trained at the California Family Study Center, where she received her Masters in Marriage and Family Therapy.
Lynne worked with Virginia Satir, which was evident in her experiential style of teaching.
Her practice in Santa Monica, CA includes psychotherapy, coaching and work with gifted adults. Lynn brought energy and personality to her presentation. She held our attention while challenging us to envision our ideal careers and practices.
She provided us with a booklet of “Practical & Cost Effective Tools and Approaches”. This was a helpful guide, containing an outline of much of the material that was covered in the presentation. It also provided a resource to be used as we continue to plan strategies to design our own practices.
The following are some of the areas covered
*5 Main Tools to Develop Your Private Practice: Your Introduction – How you introduce yourself Your Business Card – including email
Your Contacts – you Rolodex
Your Website or Webpage
Listings on Web Directories
*The Success Star:
Skills, Expertise & Training
Personal & Professional Reputation
Referral Sources & Contacts
Personal Presence, Awareness, Growth, Consciousness, Vision & Creativity Self Care & Development of Personal Resources
Business Practices – Therapeutic and Business
She addressed the needs of each of the various levels of professional status, i.e. trainees/interns, newly licensed and experienced therapists. Although the emphasis was on private practice development, Lynne also generalized some of the material for agency work.
Individual and small group exercises helped participants evaluate their values and vision of their ideal practice, including the type of clients, setting, as well as their roles. It was an informative and thought provoking presentation that left us with the tools and information to revamp an existing private practice or start a new business.
Submitted by Eva Tak, LMFT
This article was first published in the Sacramento Valley CAMFT Newsletter April 2011
Lynne Azpeitia, LMFT
For 10+ years Lynne Azpeitia has helped therapists to live richer and happier lives through her workshops, private practice and career coaching, and her practice consultation groups which train, support, and coach licensed therapists, interns & students how to create and maintain a successful, thriving clinical practice and a profitable career