Book Excerpt: The Blueprint for a Successful Practice, by Gina Spielman

For your reading/sampling/learning pleasure, an excerpt from The Blueprint for a Successful Practice: Methods of Marketing Your Business & Increasing Your Bottom Line by Illinois-based therapist and consultant Gina L. Spielman, LCSW, C.H.

Chapter Five:  Attracting Your Ideal Client

Maybe you would like to attract a certain type of clientele to fill your caseload and have been unable to do so? Of course, working diligently on many of the previous methods and suggestions mentioned should help you meet this goal. This chapter gives some additional words of advice on how to attract your ideal client.

DETERMINE WHO YOUR “IDEAL CLIENT” IS
You might not be quite sure what your “ideal client” looks like. If this is the case, I suggest doing some soul-searching to figure this out. There is a good chance there are certain types of cases you enjoy working with more than others. This is important to identify for yourself and your contentment with your practice. What types of cases seem to fill you up, and which ones seem to deplete you? Which cases tend to make you look forward to sessions, and which seem to make you dread them? Many of you will have a clear feeling or picture here, however there will be some of you that may need to take a bit of time to figure this out for yourself. Once you do, it can benefit you in many ways. The most important way is that it will contribute to your happiness in your work. It will also assist you in writing a professional profile on yourself that will portray your specialties and interests, which will attract your ideal client. Clients may also be able to sense whether you are truly excited to work with them or not, so it is a win-win situation if you know what your ideal clients look like and then they are attracted to you.

GETTING “QUALITY” REFERRALS
Perhaps you would like to learn how to receive more of a certain type of referral, such as non-managed care or higher fee? There are plenty of self-pay clients out there and making yourself stand out will definitely help attract them, many times at your full fee. In my practice, at this point all of us are certified hypnotists in addition to our primary licenses. This has done very well for us in our area, because it is difficult to find a mental health professional who is also a hypnotist. There certainly are not many on managed care lists. So in that way, we certainly stand out in the crowd for clients looking for some hypnosis with their psychotherapy. Therefore these clients are more likely to bypass some or all of their insurance coverage to see us. So think about what additional training you might find interesting and would enjoy doing. Some interesting certifications that I have come across are in the following list. The good news is that none of them seem to be extremely difficult to achieve, yet they serve the purpose of conveying a niche or communicating a specialty:

• Certified Hypnotist (C.H.)
• Emotional Freedom Techniques Certification (EFT-CC)
• Distance Credentialed Counselor (DCC)
• Certified 12-step Consultant (CTC)
• Substance Abuse Subtle Screening Inventory (SASSI) Certification
• Certified Anger Resolution Therapist (CART)
• Stress Management Counselor-Certified (SMC-C)
• Certified Bereavement Facilitator

Whatever your interest is, fully research any possibilities and choose the training that you feel the best about and are able to do. This will make you stand out in the crowd to your ideal clients and their referral sources. Make sure you place this on all your marketing materials and word it such as “Certified Anger Resolution Therapist”, and if you can place the certification letters behind your name that will work well (just make sure to explain all of your credentials so that potential clients can see them clearly and quickly, and understand what they are). So, if someone needs anger management, and you are a CART, they will likely call you first.

On your marketing materials, you can also list major trainings you have attended. Include wordings such as “ICASA/ICADV Certificate: Trained by the Illinois Coalition Against Sexual Assault & the Illinois Coalition Against Domestic Violence”. It does not have to be a formal certification to include it as something important. Doing this increases your credentials and also gives a clearer picture of your professional interests.

You may also choose to join various associations, such as one for Cognitive Behavioral Therapists, to show that it is one of your methods and you keep up on all the recent news about it. CBT is one method or theory that is frequently sought out by potential clients as well as referral sources. So taking something a step further by joining an association, or showing you have had additional related training, will make you stand out.

Having some unique specialties or interests will help. For example our “Holistic Approaches to Well-being” has generated many referrals. I am simply a practitioner member of a holistic health association and have taken an interest in learning new research along with natural remedies. It is my approach to look at the whole person as well as their life and everything around them, in addition to spirituality and energy. This is how I see all cases and it has done well for me and the counselors in my practice. It also draws the clients in. It is certainly not the usual approach clients will likely get from someone perhaps in their managed care provider network.

So, being aware of trends, filling current needs, and making yourself look different than the average counselor will be important. One of the frustrations we hear from clients is that they cannot find a specialized therapist in their managed-care network. So, set yourself apart and demonstrate your true value in the marketplace through specialization. Many people that are in the market for healthcare value specialization.

WHAT IS YOUR IDEAL CLIENT LOOKING FOR?
Ask yourself what your ideal client might be seeking. Know the answers to this question, and make sure all of your marketing materials will be attractive to your potential ideal clients. What are they looking for and what would they like to see? If you want to work with grief/loss, perhaps your ideal client would like to see that you belong to a professional association of grief counselors, and that you have written an article on grief that you have posted on your site. This will be quite attractive to this type of clientele, and none of it terribly time-consuming or expensive.

Another example situation might be where the potential client is looking for someone who has been through a similar problem, and she feels it would be necessary for the counselor to have that type of personal insight and understanding. For example, a client who needs assistance coping with physical illness might search for a counselor who has been through a severe illness herself. So on this counselor’s marketing materials, she may want to mention that her approach to helping clients cope with physical illness comes from dealing with her own past illness. This counselor will definitely stand out in this client’s eyes with this information on her marketing materials. There is a unique understanding here that only someone with these types of experiences can provide, and this can be extremely important for a client like this.

WHERE WOULD YOUR IDEAL CLIENT COME FROM?
Ask yourself where your ideal clients may come from. Might it be from the phone book? Might they come from an EAP plan (an employee or family member of an employee)? Maybe they will come from a certain type of internet website? Or maybe your ideal client attends divorce support groups in the suburbs? Perhaps they will be referred by a specific insurance company? Wherever your ideal client may be, or may be looking, you are going to want to have a presence there somehow, and make sure everything there is complete and looks professional. For example, if they might come from a specific insurance company, make sure that company’s list is completely accurate as far as how and where you are listed. As I mentioned earlier, it would surprise you to know how many times I found my provider information to be incomplete or inaccurate. These lists are what potential clients, as well as referral sources, are viewing.

BE AWARE OF TRENDS
Watch the news and read your local papers to look for trends! This can spark ideas on current needs in your area and how to fill them. For example, after watching and reading my news, I see opportunities for professionals trained in career-oriented counseling, grief/loss, marital therapy, financial counseling, suicide prevention, insomnia relief, and more.

WORK WITH EAPS
Contracting or working with some EAPs can also give you a referral base of clients who can eventually be self-pay or have insurance coverage for ongoing services. (See Chapter One for more on EAPs).

Keep in mind that if you are not the right therapy provider for a client, which may be determined after her EAP assessment, it is usually fine to refer out to another more suitable provider for the treatment piece. So, do not feel like you have to take every EAP case as a long-term therapy case. Just explain to the client that you feel that another therapist would be a better fit for her actual treatment, include the reason(s), and then make the linkage to the treatment provider.

ANOTHER WORD ON SELF-PAY CLIENTS
Often we get clients that are not sure they want their insurance billed for psychological treatment. This could be a legitimate concern as we really do not know what the insurance will do with their confidential information. There may also be a treatment plan or reviews necessary, so there may be additional concern with that. Clients also need to be told that, in the very least, a psychiatric diagnosis will have to be submitted to their insurance for any coverage to be released. This diagnosis could remain in their permanent record. So, if the client is teetering back and forth about whether or not to use insurance, explain all of this clearly and then he may choose not to use insurance. Then you have a self-pay client, at least initially (note: he may change his mind later).

If you have a client that is looking for something specific only, such as hypnosis, life coaching, or career counseling, it is probable that his insurance will not cover it anyway, so there you go! If you are offering services such as sports psychology, career-oriented counseling, or anger management (for courts), the insurance will only pay if there is a covered psychiatric diagnosis that needs treatment. So you will have to explain that to these clients and also that a psych diagnosis will be submitted and will then be on their insurance record. Some will chose not to have it submitted and will rather self-pay.

I also know that marital and family treatment is not always covered by insurance (particularly HMOs). So, if someone calls asking for couples counseling and she has a very limited HMO that you are not in-network for, let her know that she might not have the coverage anyway. Have her call you back if it is determined that her insurance does not cover this, because they might as well see you for their couples counseling then, right?
Some are predicting that if universal coverage gets passed (or if government gets more involved), marriage and family therapy will not be covered. They are also saying that mental health, if it even gets covered at all, will be even more scrutinized for “medical necessity” and “evidence-based treatment” than ever before. They think that people are not going to want to pay taxes on something that is for “personal growth” only. This all may be true, but it might turn out just fine for everyone reading this book, because now you all have the ability to exist without relying on insurance cases alone!

DON’T FRET IF YOU’RE NOT IN-NET!
If you are not in-network for a potential client’s health insurance, try not to let that be the end of the call. Ask if he has a PPO plan or another type of plan with possible out-of-network benefits. Because if he does, there will likely be some coverage for him to see you (and sometimes it is not much different than the in-network benefits, especially when you factor in contracted rates compared to Usual and Customary out-of-network rates, which can be much higher). So, you can offer to give him a receipt for services that he can submit to insurance for re-imbursement. This is usually called a superbill receipt. (See Chapter Three for more information under the section “Use the Superbill Receipt”). In my practice, we like using these, as opposed to submitting to out-of-network plans, because we get paid upfront this way and we do not usually have to deal directly with all the insurance issues that seem to frequently arise. This does not mean you will not get pulled in to help in some situations, but it is usually much easier and more lucrative this way. There are some therapists who continue to bill out-of-network plans because there are some benefits to doing so, such as Usual and Customary PPO rates being quite nice, and clients also usually appreciate the billing service. We have found, though, that many clients will go the superbill or self-pay route just because they want to see a specific person, either because they have the specialty or technique that is needed, they have a desired office location, they came highly recommended, or simply because they felt a connection with the counselor and therefore put that before any payment issues.

There are some clients or patients, however, that simply are not going to be able afford to go the out-of-network route even if they really want to see you and you have negotiated down to your very lowest amount, or even offered to bill insurance for them. Unfortunately, those sometimes have to be referred on to someone else, but always say “call us again if your situation changes”, because you never know what can happen in the future, or who they might refer later on. Always keep a good reputation within the community by being helpful, courteous, competent, and open to new referrals.

Some clients will choose to bypass their insurance altogether. You will find that some people will forgo managed-care, or HMO, reimbursement. So they will self pay for services that are of high value because they can be of higher quality, offer real privacy, offer more control in decision-making (such as length, frequency, location and amount of sessions, or methods used), and are truly customized for their individual needs. You can tell callers exactly this, and still show respect for their insurance carrier at the same time. Leave the client to make the decision, and hopefully it will be an educated one. Remember not to jump straight into offering sliding scale to these folks. Wait to see what their financial situation is first, and then you may decide to offer it if absolutely necessary. You can always try contacting them again in the future to follow-up and further discuss, if you have not heard from them in a while.

MAKE SURE THEY KNOW YOU TAKE CASH!
It is important that you make sure you include statements such as “private pay” or “cash/checks accepted”, as well as “sliding scale fees available (if necessary)”, on your marketing materials. You will want to make sure that non-covered clients know they can see you. As I said previously, we have had clients ask us if we take cash! Ummm, YES we take cash! We have also had clients feeling reluctant to speak to us because they did not have insurance. Well, we had to explain that it is just fine as we do take cash, checks, and credit/debit cards. In addition, we have told clients that we can be very creative with setting up their treatment and payments depending on various circumstances when needed. Some of these have turned out to be exceptional long term clients for us.

SEEK ORGANIZATIONS AND GUILDS THAT LINK PEOPLE TO MENTAL HEALTH AND WELLNESS PRACTITIONERS
As mentioned earlier, there are some new and unique organizations that are creating ways for people to access providers and services that may not be covered by (or involve) their insurance. This avenue can therefore be a way to obtain more self-pay clientele. A few of these organizations are contacting employers to provide a membership card for employees. This card would entitle them to discounted services from provider members. There is no insurance to deal with, and no one to approve or deny sessions. Instead, providers agree to offer their services at a discount to members, and the clients pay upfront. From what I have seen, there is sometimes a fee to become a provider member, however this usually includes a listing in their directories which is an added bonus. So, asking around and searching for “guilds”, as well as topics such as “alternative health care provider lists” and “health savings cards”, may bring you to these types of opportunities.

DRESS TO ATTRACT THE TYPE OF CLIENT YOU WANT
Think about the type of clients you want to attract and how they might dress while coming to sessions. If you want to attract adults that are upper class or business professionals, you might usually want to wear business suits, dress pants or dresses while conducting sessions. These types of clients might be slightly uncomfortable if you are always wearing jeans or something more casual. On the other hand, if you want to attract children, adolescents or more casual (or perhaps blue collar) adults, then wearing a business suit or dress may make it difficult for your ideal clients to connect with you. But if you are usually in jeans, casual pants, or a very casual dress, then it may help you to connect with these clients. If your caseload is a mixture of all types of clients and you want to keep it like that, then I suggest you wear casual pants or casual dresses/skirts during most of your sessions, so you fall somewhere in between and will be able to connect well with all clients.

OFFICE SPACE THAT ATTRACTS YOUR IDEAL CLIENT
Your office space can attract your ideal client and keep them coming back. Therefore, make sure your office always looks inviting because you never know who could be looking in. You will want them to get a positive feeling of what it might feel like having a counseling session in your office. If you want to attract children, then make the office inviting to them. Having toys, small scale furniture for them, colorful décor, and children’s activities all will help. If you want to attract more adult upscale or business-type clientele, then you might want to make the office look more upscale or business–like, and you may want your offices to be located near upscale residential or corporate areas. If you would like to attract the teenage client, then having “cool” things in the office will help, such as certain games, décor or magazines, because if it is fun or “cool” for them there, then teens are more likely to return for services. If you want more hypnosis clients, then make sure you have the appropriate furniture for them to be the most comfortable. If your desire is to work with more handicapped clients, then of course you will have to make certain your space is 100% handicapped accessible. Working with larger-sized clients will require you to have various sizes and shapes of furniture. If your office is small, there are ways to create optical illusions to make it seem more spacious. Get some help in making it feel more cozy if it seems too big. Just make sure the office, and the contents, accommodates and makes comfortable the type of clientele you want to attract and keep.

MAKE SURE YOUR AVAILABLE TIMES AND DAYS MEET THE NEEDS OF YOUR IDEAL CLIENT
Having days and times available that will be convenient for you and your clients is crucial. I have found that a mixture of some daytime, evening and weekend hours works quite well when building a practice. Also make sure the times are tolerable for you because you will not last long if the times you can use the office are not the times you want to work or have a lot of energy. It just will not work in the long run and clients may sense this as well.

TAKE CREDIT CARDS
Accepting major credit cards will most likely attract more self-pay and superbill clients and it might be easier for them to pay for additional services as well. It will also help for any bulk payment situations. (See Chapter One under the “Accept Major Credit Cards” section for more on credit cards).

A WORD ON SPECIALTIES
If you have a specialty where you are highly trained and skilled, but you do not particularly like doing the work, shift the training and knowledge a bit to something you do like. For example, a therapist might be trained in alcohol abuse counseling but may not like doing that specific type of work. She could leverage that skill by working with related topics or populations. For example, she could add to her marketing materials that she works with family members of alcoholics, or codependency, or that she does evaluations only. She could also make a shift to a general “addictions” specialty, which may include issues such as smoking and habit cessation, internet addiction, and so forth. So you can use what you have learned from having previous specialties, and shift it a bit towards the particular issues or populations you would like working with. It will be better for your practice in the long run if you enjoy the work you are doing.

OFFER SPECIAL SERVICES FOR THOSE WHO LIVE FAR
Reaching out to populations that live far can add to your income as you can gain more “ideal” clients as well as increase your “income streams” this way. For example, a beginning hypnotherapist may want to offer longer sessions to those who live far away from her office. Also, someone who specializes in grief counseling may want to market to farther away areas and offer telephone sessions to attract more grief/loss cases. These far-away places might be rural, underserved areas within your state. The possibilities are endless if you think about it.

Find the rest of the book at the WTCI Bookstore.  Gina Spielman is online at www.ginaspielman.com.