Is there one word, a single word, that sums up all of your hopes, dreams and needs for your practice this year? One word that names your most important mission or purpose?
Good branding conveys a factor of trust for a winning combination.
What is your brand — the defining feature that identifies your small business?
Is it your name, specialty, or office location? Do you primarily promote the issues you address, the methods you use or the results you deliver? What sets you apart from the rest of the many professionals with similar credentials, who may be offering similar services in your zip code?
Twenty years ago, Tom Peters wrote an article titled “The Brand Called You” for Fast Company Magazine. It was a remarkable call to action, well ahead of its time. He urged people to think of themselves as being as important and distinct as the brand of clothing they might select, or brand of snack food they sought out in a grocery store.
According to Peters, it was a “new brand world” and branding was an essential strategy for success. With a good brand, people had a chance to stand out, to learn, and improve. “Everyone has a chance to be a brand worthy of remark.” His ideas are still relevant today, maybe even more than twenty years ago.
Why You Need a Brand
To see the importance of branding, look at the profession of therapy. There are over half a million therapists working in the United States. We know that therapists are not generic; not all therapists are the same. That is clear to us as therapists, but not so obvious to the average client.
The average client looking for a therapist does not understand the distinctions between you and another therapist, such as those based on your training, experience or methods. The average client (as well as many of your less sophisticated referral sources) need to know, in plain language, the following: Given the sea of therapists available — what is different or better about you?
A good brand educates potential clients about who you are and what to expect when choosing you. A good brand becomes a mission statement of what you stand for, personally and professionally.
Your brand is both macro and micro, a summing up of your message to the world. As such, it also defines your marketing approach. There is no one, right way to brand yourself or market yourself, but as Peters says, “When you’re promoting brand ‘You,’ everything you do — and everything you choose not to do — communicates the value and character of the brand.”
When I work with therapists, coaches, and healing and helping professionals, I recommend one more thing to consider when defining your brand: don’t overlook the importance of conveying a sense of trust.
Branding and Trust
According to marketing surveys, trust is the #1 most influential factor when people purchase costly services (like therapy and coaching.) Its more important than location, return on investment, or price. When you are in a relational business, your brand must focus on building trust.
Take a moment and think about the essence of trust. Many of us are familiar with the core developmental stages, explained by Erikson. The first challenging stage a child encounters is trust versus mistrust. When trust is present, based on a secure attachment, the child feels hope. Having a brand with trust creates a felt sense of hope.
How is Trust Conveyed?
Trust needs to be a feature of your brand; it reaches beyond the concrete aspects of a practice, such as your technical expertise, training, population you work with, or your specialty. Branding with trust is not reliant on the methods you use, the variety of services you provide, or the fees you charge.
When you are engaged in marketing your practice, trust is communicated primarily in the way you relate. Its more show than tell.
As with any marketing strategy, developing the “Brand Called You” and making sure that trust is communicated requires that you take some steps. Let me show you some of the specific soft skills of trust, 3 questions to ask yourself, to consider how your level of trust is communicated to others, and then a few basic action steps that I recommend.
Soft Skills of Trust
Trust requires softer skills within marketing, including an ability to not just tell others how you work, but shows them your qualities, such as:
- Careful listening
- Willingness to educate
- Curiosity and caring
- Ethical behavior
- Follow through
- Measurable results
I know that these are skills that many of us use when providing services. But for marketing/branding purposes, take this one step further.
Are you communicating your level of trustworthiness to others? The questions to consider are:
1. Would current clients say that I embody these skills?
2. Do potential clients understand my commitment to these skills?
3. Do my referral sources carry this message about me to those they refer?
If you are unsure about the answer to any of these three questions, there is some work you can do on branding yourself with trust.
What You Need to Do
As with any marketing strategy, developing the Brand Called You and making sure that trust in a feature of the brand requires a set of steps. Here are 3 actions to take to move forward:
Craft your basic message—the brand called you: Start by identifying the qualities or characteristics that make you distinctive.
What have you done lately—this month—to make yourself stand out? What would your colleagues or your clients say is your best quality? What are you known for? Who do you help and why? What results do you consistently achieve with clients? (Need more help? Defining your basic message is reviewed in depth, with examples, in my book Building Your Ideal Private Practice, 2nd Edition (W.W. Norton, 2015).
Add elements of trust that you can show, not just tell: Telling someone that you are empathic is not as compelling as showing it.
Use your writing, speaking, and daily interactions with others to express elements of trust (show), and then emphasize what you are doing (tell.) Connect the dots for others.
In your office, with clients, be willing to identify and then claim your varied expressions of trust right in the moment. (Example: “Right now, I am trying to support you by listening carefully and validating what you are saying. How does it feel to have me relate this way with you? What can you learn from this, right now?”)
On your website, in your networking, and in your workshops, explain who you are. Give examples. Show it in action. In this way, start to educate referral sources and existing clients about what you stand for.
For example, in my role as a business coach, I brand myself as a trusted advisor. Over the past 30 years, I have consciously tried to align my words and my actions with this brand. I believe in the values and viability of our profession, so I give freely via writing, speaking, and mentoring. I believe that a rising tide lifts all boats. The more therapists and coaches who succeed–who make a good living while helping others–the more grateful I am that our important work continues to thrive.
Have a deliberate marketing plan: Branding is a marketing strategy. You need to treat it as such, and have a clear plan of action.
Who do you need to communicate with (public, other professionals, specific organizations, etc.) What are the steps you will take? What resources do you need (time, money, access to others, etc.) What are the measures of success you hold yourself accountable to achieve? Accept the amount of follow through and repetition any plan requires in order to produce success. Commit to the long term of your practice. Sow seeds for future growth.
There is some urgency to this concept of branding. Peters says that the only critical factor in branding is that you start to do this immediately. I will let him have the last words. “It’s this simple: You are a brand. You are in charge of your brand. There is no single path to success. And there is no one right way to create the brand called You. Except this: Start today.”
We have a hidden crisis in therapy: Clients leave therapy before they can see the results of treatment. They leave too soon, in large numbers, without warning, abruptly. This is both a clinical issue and a business one, because it undermines the efficacy of your services and weakens your business. To learn what you can do to reduce client “ghosting” and improve client satisfaction, read more below.
The Problem of Client Ghosting
Do you have clients who dropout or disappear before finishing treatment and don’t respond to your attempts to connect?
Having a client leave therapy prematurely can be upsetting and unsettling. You wonder: What happened? What might you have done differently? What was wrong with the client?
Like most therapists, you do your best to provide empathy, caring, and solid treatment methods. When a client ends treatment abruptly, without explanation or notice, it can feel like a bad breakup: You were dumped, with no real understanding as to why.
The rate of clients leaving treatment before getting the results they need and want is a bigger and broader problem for our profession then you may know. It’s a serious concern for all of us to consider.
Improving Client Retention
Since improving client retention is both a clinical and a business issue, we need solutions that address both aspects. Here is some data about the scope of the dilemma we face as a profession:
Studies show that from twenty to fifty percent of all therapy and counseling clients leave therapy long before they see results of treatment.
Over fifty percent of clients never come back after the first session; a slightly smaller percentage leave within the first five sessions. We need to change something about our treatment process to stop this pattern. In any industry, this would be cause for alarm.
The Reason Clients Leave Too Soon
What are the reasons for this significant rate of dropout in the therapy profession?
Let’s set the context: Few clients are happy to find themselves in a situation that determines a need for therapy. Clients usually seek therapy at a low point in their mental health and/or their lives. They seek us at their most vulnerable moments. And they often are embarrassed or ashamed about their need for us. In our culture, therapy is often viewed as a sign of personal weakness or failure. The act of coming to therapy can provoke anxiety by itself, given that the nature of therapy can be uncovering difficult feelings and thoughts.
Given this, its essential that we not compound the problem. Having made the significant effort to find a therapist and then come to a session, a client needs to leave feeling that it was absolutely worth the time, money, and effort. Clients need to know that they are making clear and noticeable gains. Even better is if the client feels compelled and motivated to return. Too often, the opposite is true.
Disappointment and Dissatisfaction
Surveys suggest that the number one cited reason clients stop treatment is a lack of satisfaction with the therapy process. Their dissatisfaction is a combination of ambivalence or negativity about their therapist and a lack of tangible results gleaned from one or several sessions.
We know that for most therapy to work, repeat visits are necessary. We have to be more proactive in helping engage clients to stay longer, to see treatment results. We must make an effort to help clients see clear and concrete measures of success.
What can you do to take responsibility to help a client stay in treatment? How can you increase a client’s understanding and sense of value and satisfaction about your services? Can you reduce client disappointment in the therapy process?
I suggest that a strategic model of client retention be part of every therapist’s treatment plan.
A Strategic Model of Retention
I have been interested in resolving the problems of poor client satisfaction and low retention for a long time and written and given workshops on this topic.
I have a chapter on this topic in Building Your Ideal Private Practice: 2nd Edition, titled “Retaining Today’s Clients” that explains why those coming for therapy now are often even more difficult to engage than those clients who sought therapy in earlier times.
My new book, Therapy with a Coaching Edge: Partnership, Action and Possibility in Every Session (W.W. Norton, 2018) takes it one step further. I offer a new model of psychotherapy that embeds a strategic model of retention and client satisfaction into the structure of each session. Its easy to apply and can help clients understand the value of a therapy session more clearly, in the moment. Here is how it starts:
First, stay alert for obvious and hidden signals of client confusion and disappointment, beginning with the first session.
Have you heard clients say the following during a session? If so, failure to return may be imminent:
- “I can talk to a friend and get the same kind of help you are giving me”
- “I am too busy for this”
- “You therapists charge too much.”
- “I don’t see what good this is doing.”
- “How long is this going to take?”
Stay alert to these and other objections. Think of these comments as feedback. Invite direct, consistent client feedback as a way to open a conversation about client satisfaction. I ask clients to share their therapy experience with me, in real time, during a first session and then in subsequent sessions. I listen non-defensively. Keeping this line of communication open during each and every session reduces unexpected dropout.
For many vulnerable clients, therapy is hard to fathom: They wonder “Is it working? Am I getting better? Does this really help?” If therapy results are couched in psychological jargon and kept vague, clients feel torn about returning. They can’t figure out the process and they don’t know if what you are doing with them even helps.
You won’t know how your clients feel about services and whether they are pro or con about returning unless you ask. You will need to ask often, to stay on track.
How to Ask for Feedback
I like to set up therapy sessions with some structure, so that each session has a beginning, middle and end. On the front end of any session, I ask a client what the session needs to focus on and how we will measure, as the session proceeds, to know if we are making progress together during the session. During the middle phase, as we work through the issues on our agenda, I take time to pause and see if we are progressing in the direction that the client understands. On the back end, I encourage feedback with a few questions that I ask to consolidate gains of the session.
This takes time away from the therapy, many might say, but I suggest that this kind of transparency is essential to the therapeutic process.
The ending process is especially important in the process. I leave the last ten minutes of a therapy session for a time to help my clients articulate the progress and value made in the session. (For more specific examples of this session process, see Chapter 5, “Results in Every Session” in Therapy with a Coaching Edge.)
I take an active role in making this structure work, especially in ending well. I think of this role as a form of therapeutic responsibility and leadership. I watch the time with a purpose in mind: I want to see if our objectives have been met and help my client identify what has been useful and helpful. I want to observe, with the client, what progress has been achieved in this session. I want to anticipate what we can expect for the next time. This is an example of how I combine a coaching approach with therapy, to be very strategic about the goal, progress, and completion of each and every session.
I don’t assume that because I thought a session went well and see its value, that my client agrees or can articulate the same results. I want to hear this in the client’s own words. I don’t presume that a client, even one who seems pleased with our session, will return–unless I can help provide a compelling reason.
If a client can’t identify any value in the session, I am glad to educate them with what I will be putting in my notes.
When I take time to end this way, summarizing gains, it’s not unusual that a client will indicate the she has already forgotten some of what has just been talked about or worked through. This makes sense, because a client is absorbing new ideas, and integrating on both a conscious and unconscious level. Some questions I might use to help this consolidate gains include:
- What will you take away from our session?
- Did you get results or make gains you wanted?
- Do you feel a need or see a reason to return?
- May I share what I think was valuable from our session?
Finding the right words to sum up may be difficult for a client, so I am willing to collaborate with a client in this task.
Helping Clients to Stay in Treatment
At the start of this article, I said that better retention was both a clinical and business issue. Clinically, helping clients stay longer involves building a better connection with your client and giving them a sense of how and when and why the therapy is moving forward. With this feedback conversation in place, clients have the language to articulate to themselves and others what they are doing in therapy and how it is helpful. It shows clients how and why therapy works and helps them to value a long considered vague and mysterious service.
From a business perspective, helping clients to see a return on their investment, to increase their satisfaction, is always an important factor in terms of increasing referrals and enhancing the chance of returning customers. It strengthens your profit picture.
The time and cost of replacing clients who terminate early means more marketing, advertising, networking, outreach, and continual intakes to get new clients settled in for treatment, clients to replace those who leave too soon. Staff who are ready to see clients may sit with empty hours unfilled. Office space sits empty, adding to a lack of productivity. You need engaged clients, those who appreciate and make good use of your services. You want clients who feel glad that they have taken the time for therapy and are willing to make the effort to complete their treatment, not a revolving door of unsatisfied clients who come and go at will and feel that “therapy just didn’t work for me.”
So my challenge to you is that you consider how you might help to reduce this professional problem and help clients feel more satisfied and invested in their treatment. I look forward to hearing your experience and what works for you in this regard.
Dr. Bernard Schwartz and John Flowers: How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients, 2010.
Joshua Swift and Roger Greenberg: Premature Termination in Psychotherapy: Strategies for Engaging Clients and Improving Outcomes, 2014.
Ryan Howe: “4 Reasons Not to Ghost Your Therapist” Psychology Today.
Sometimes, confidence matters as much, or even more, than competence. Learn how to boost your confidence when it’s needed.
By Lynn Grodzki, LCSW, MCC / copyright Sept 2017
I have been fascinated by a number of studies about the role of confidence and how it affects those in business and leadership. They confirm what I have observed as a business coach over many years. Whether or not you have sufficient confidence can directly impact your level of private practice success, including your bottom line.
The Importance of Confidence
Recent studies suggest that for those in business, confidence acts like a source of fuel, allowing people to go further and faster.
Those with more confidence are able to persist in their goals longer with a higher chance of completion. They find and get more resources. They accrue better information. Because they sound confident, they are listened to and talked to with more respect.
In terms of public perception, those with more confidence rate as more talented when compared to those who are equally trained and talented, but more modest. Higher confidence even equates with more money earned and other financial benefits.
How Confidence Affects Private Practice
As a business coach, I have seen that confidence affects 3 key areas of private practice;
- The perception of you and your business by others (think potential clients, referrals sources, colleagues)
- The energy and drive you have for your projects (accomplishing your goals)
- The felt sense you carry that can encourage or block your daily tasks (your feelings and emotions about your work)
In light of the studies and my observations, I wondered: How does confidence develop, especially in those who are new to the profession? What is the best timetable between competence and confidence?
Confidence versus Competence
Just to clarify terms:
- Competence speaks to your ability: this would include your training, methods, certification, results, experience and expertise.
- Confidence reflects your attitude: this would include your level of belief about yourself, self-assurance, and how you express this to others.
As clinicians and practitioners, we are usually taught that competence comes first and that with time, our level of self-confidence will naturally develop.
But now, based on these studies and my observation, I think we need to build confidence along with, not after, competence. I see it as a skill, as important as any other to develop when building your ideal private practice.
I recommend that you develop both confidence and competence, as early as possible.
Let me show you how to develop more confidence.
Do You Have Sufficient Confidence?
As a business coach, I can often spot what seems to be a confidence gap. For example, do you:
- Have difficulty talking about your work in a way that generates new business?
- Worry that if you express your competence, you will be seen as bragging?
- Set goals that are too small or give up too soon?
- Default to getting more and more training when you have doubts that you are not good enough?
- Hope that others will see your value, rather than having to say it yourself?
- Struggle with the “imposter syndrome”?
If you feel that your level of confidence could use a boost, let me show you some basic steps to close the gap. These simple steps can confer some positive effects for your business in a lasting way.
First, it helps to understand what can block the development of confidence.
Common Blocks to Confidence
If you experience a confidence gap, here are some common reasons why, according to research I have read:
Hormones further behaviors, some of which seem to help to project confidence. Men, in general, appear more confident than women, according to studies, perhaps because testosterone fuels risk taking and tolerance of conflict. In areas of leadership and business, the ability to invest in a project, experiment, or stand up for an idea connotes assurance and belief in oneself.
Introverts appear less confident than extroverts, especially in a public setting. Many of us who are primarily introverts are empathetic, quiet, and reflective; this makes for a good therapist, but may not translate to looking like we have confidence in business. Extroverts are more expressive and tend to talk and emote more, which is perceived as appearing more confident.
Learning to be overly accommodating as a child, or the need to be seen as “good” or even perfect by parents or others can hinder a sense of ease and experimentation that leads to confidence. Perfectionism is especially difficult to overcome, sowing seeds of self-doubt and making it difficult to assert oneself or act positively. Those who are easy going or appear less anxious seem more secure and trustworthy by the public.
Some in our profession suffer from “imposter’s syndrome.” Its hard to master the craft of psychology and psychotherapy and claim expertise, especially in a public arena or online. Others fear disapproval by their colleagues. They resist speaking up or looking confident due to the “tall poppies” pattern: the tallest flowers tend to get cut down first. They don’t want to appear boastful or egotistical for fear they will be “cut down” or discounted by peers, supervisors or mentors.
How to Build Confidence in Business
The good news is that higher levels of confidence can be taught, learned and applied, like any other skill. I have been helping those in private practice to build confidence, in order to meet their business goals, for many years.
I recommend using any or all of the following six possible strategies for boosting your confidence in business:
- Persist: The amount of effort that is needed to build, sustain, and maintain a business is probably more than you consider. Your level of persistence in service of your private practice goals is key to developing confidence. Confident business owners are persistent. They follow through, over and over again. Don’t give up too soon.
- Risk: Learn to tolerate some risk. Stretch. To expand your level of confidence, experiment. Go a bit beyond your limits. Remember, small steps count. What can you do, try, or test that might be new behavior? Who can you call, contact or reach out to meet? What event can you attend?
- Voice: In my book, Building Your Ideal Private Practice, 2nd Edition, see chapter 8: “The Brand Called You” for ideas to help define your basic message, a way to talk about yourself and your work based on your values, passion, and areas of interest. Can you bring your work into your conversations? Find your voice and assert who you are and what you do in a way that feels true to your nature.
- Refute: When you have doubts or anxiety about work, develop more confidence with the technique of refutation, explained in Martin Seligman’s book, Learned Optimism. Use self talk to answer back to any doubts or pessimistic thoughts, especially those that may pull you off course. Use objective statements to counter overly negative thoughts and build self-assurance.
- Act as if: A certain degree of projecting confidence is akin to performance. You may need to “act as if” you are confident before you really feel it. As many of us know, this one strategy is a quick fix. Act as if you feel calm, have a voice, can take a calculated risk, and have energy to persist with your desired goal. Acting as if you are confident leads to feeling confident. Practice makes perfect.
- Get support: I am a big believer of the value of teamwork. Who do you turn to support you when tackling any or all of these new behaviors? Who can you support in kind? We all need collaborative partnership to succeed. Who is on your team?
Hope this list of strategies spurs you to move forward with new behaviors and an improved level of confidence.
Some links to additional articles and studies on this topic:
Professor Tomas Chamorro-Premuzic explains our inability to differentiate between confidence and competence.
The role of self confidence and career paths.
How lack of confidence holds women back.
Why confidence matters as much as competence.
The secret to career success is not talent, hard work or education, but sheer, unashamed confidence.
By Lynn Grodzki, LCSW, MCC / copyright August 2016
A well-known business mantra is let go to grow.
This means that at key points in the evolution of a business, you, the owner, need to let go of something so that you and your practice can move forward.
Let go to grow is more than a motto for a savvy business owner: It’s also a challenge for each of us to look at our routines, behaviors, tasks, or long-held ideas.
What needs to change right now or at least be gently retired before the end of the year so that you can advance?
Here are some examples about how you can let go to grow. Commit to find the courage and confidence to take the next steps in your private practice.
Step 1. Decide What Needs to Go
What are you holding onto that no longer makes sense? What slows you down? What stops you from making your small business easier or better?
You may need to let go of:
• Thinking too small about your future.
• A lack of boundaries for your practice policies.
• Routines that sap your energy.
• An insistence to do everything by yourself — denying yourself help and assistance where needed.
• A belief that you can’t raise your fees.
• Sticking with an insurance-only business model.
or maybe you need to stop:
• Letting fear win.
• Operating without a business plan.
• Undercharging and then feeling resentful.
• Hesitating to reach out to those who need to know about your services.
• A reluctance to brand yourself or find your niche.
Step 2. Let Go with Grace
I have been thinking a lot about the process of letting go on a personal level, because I just physically moved my home and office. Although I moved within the same city, I still needed to let go of 30 years of stuff, familiar routines, and a neighborhood I loved. Not easy tasks for me.
To really embrace the change meant I needed to open up. I needed to have the space inside myself to allow in the new. What made it easier was an inspiring contemporary piece of poetry that gave me another framework for letting go. It helps to have the right mind-set when letting go.
You can read it here, with permission of the poet:
She Let Go
by Rev. Safire Rose
She let go.
Without a thought or a word, she let go.
She let go of the fear. She let go of the judgments. She let go of the confluence of opinions swarming around her head. She let go of the committee of indecision within her. She let go of all the ‘right’ reasons. Wholly and completely, without hesitation or worry, she just let go.
She didn’t ask anyone for advice. She didn’t read a book on how to let go. She didn’t search the scriptures. She just let go.
She let go of all of the memories that held her back. She let go of all of the anxiety that kept her from moving forward. She let go of the planning and all of the calculations about how to do it just right.
She didn’t promise to let go. She didn’t journal about it. She didn’t write the projected date in her Day-Timer. She made no public announcement and put no ad in the paper. She didn’t check the weather report or read her daily horoscope. She just let go.
She didn’t analyze whether she should let go. She didn’t call her friends to discuss the matter. She didn’t do a five-step Spiritual Mind Treatment. She didn’t call the prayer line. She didn’t utter one word. She just let go.
No one was around when it happened. There was no applause or congratulations. No one thanked her or praised her. No one noticed a thing.
Like a leaf falling from a tree, she just let go.
There was no effort. There was no struggle. It wasn’t good and it wasn’t bad. It was what it was, and it is just that.
In the space of letting go, she let it all be.
A small smile came over her face. A light breeze blew through her. And the sun and the moon shone forevermore.
Step 3. Take the Right Steps
Once you identify what to let go, then you need to know what to start doing instead. You will need to have a plan for letting go to grow.
For example, here are 3 goals many small business owners desire:
• More money
• More full fee clients
• More time
And here is a quick strategy I offer for each goal, so you know what to let go of and what to focus on to achieve growth in each area.
What to let go:
- Working without a financial plan
- Negative beliefs about negotiation
- Resistance to running a business, not a hobby
What to focus on instead:
- Tracking your income and expenses on paper so you can see the reality of your money at a glance
- Learning the basics of successful negotiation to handle conversations about money in a confident and therapeutic manner
- Adopting the mindset and practices of an ethical business owner
What to let go:
- Old ideas of marketing and mistrust of new technology
- Negative beliefs about your low value
- Resistance to how much it takes to stay visible with referral sources
What to focus on instead:
- Make sure that you have a strong and compelling online presence
- Identify your clinical strengths and the return on investment your clients receive from their work with you
- Scheduling marketing activities with a new marketing plan you feel is within your comfort zone
What to let go:
- Time drains including distractions and procrastination
- Hopeless and helpless thinking
- Resistance to delegating, hiring others, or using technology for practice management
What to focus on instead:
- Protecting and safeguarding your time and energy
- Countering negative thoughts with positive action steps
- Exploring strategies for streamlining tasks
Do you need help to take the next steps in this plan? Let’s talk. I can be reached for an Intro session here: https://privatepracticesuccess.com/individual-coaching/coaching-fees-and-logistics
or email: email@example.com
Private Practice Success Newsletter
by Lynn Grodzki, LCSW, MCC / Sept 2015
In a small business, it’s not just the way you talk to others that grows your practice; it’s also the way you talk to yourself. Negative, self-deceptive internal dialogue can derail a business owner. Instead, learn how to tap into a better and truer voice, that of your inner entrepreneur.
How Self-deception Works
It’s Monday morning and you have a list of business tasks to do this week, apart from seeing scheduled clients. Your list reads: Make an overdue marketing call, rewrite your website homepage, complete all client notes, do the monthly billing, clean off the office desk.
You have set aside time in your calendar for each task and feel assured that you can accomplish all the items on the list.
You start with the marketing phone call. You have a colleague that you respect, someone you have made several referrals to over the past year and although you are friendly, you have yet to have a referral from her. You decide to be more direct after saying hello, to tell her that you have some openings in one of your groups and ask for a referral. This feels like a bit of a risk since you tend to be unassuming, even a people pleaser, but you want to practice being more direct about your business needs.
As you get ready to dial her phone number, you pause. A series of thoughts go through your mind. “It’s not fair that I have to make this call. I help her, why doesn’t she automatically just help me back? Why do I have to work so hard for referrals anyway, its easier for everyone else but me. Forget it. If she wants to refer a client to me, she knows where to find me.” You decide not to make the call, feeling upset but justified.
Unknowingly, you have just become the victim of your own self-deceptive thinking.
Self-deception is a process of thinking based on misleading ourselves and rationalizing our resulting behavior.
We convince ourselves that what we think about a situation or even ourselves is true, despite evidence or information to the contrary. We justify our mistaken beliefs because it keeps us feeling momentarily safe and self-righteous. With self-deceptive thinking we can explain why we don’t make an important call–to avoid possible rejection– even though this course of non-action means that our business misses a potential opportunity to grow.
Self-deceptive thinking interferes with a critical element in being a successful business owner: having an entrepreneurial mindset. An entrepreneurial mindset means you have an equal measure of both optimism and pragmatism. When you tap into your “inner entrepreneur” you can hold a vision of what’s possible while, at the same time, assess reality.
An entrepreneurial mindset gives you the fuel for taking action: you stay hopeful and focused on your goals. When self-deceptive thinking creeps in, filtered with negativity and bias, it has the power to stop you in your tracks.
I see three patterns of self-deception that commonly occur in those who own and operate a private practice. Here is an explanation of each destructive pattern and tips to correct it immediately, so that you can follow through with all your Monday morning action lists.
Those who studied the work of Aaron Beck and David Burns, known as Cognitive Behavioral Therapy, are aware of the long list of cognitive distortions– thinking patterns that inhibit desired behavior. (See a list of common cognitive distortions here in a short article by John Grohol http://psychcentral.com/lib/15-common-cognitive-distortions)
A small group of these distortions are called “the fallacies.” Three of these fallacies contain highly self-deceptive patterns of thinking that I see especially problematic for those in business:
1. The Fallacy of Control – when your practice doesn’t develop the way you think it should, you feel like this is your fate (you have no control) or that you alone are to blame (you control everything)
2. The Fallacy of Fairness – you feel resentful based on the lack of fairness inherent in business—bad things happening to good therapists doesn’t seem right
3. The Fallacy of Heaven’s Reward – you have trouble reconciling the large professional sacrifice you have made and the subsequent little lack of compensation you receive
Do any of these sound familiar? If so, welcome to the world of business and self-deception. Read on to better understand how each of these 3 fallacies works and my tips to overcome and correct each one today.
The Fallacy of Control
We yearn for control of our lives and our practices.
When we see little result from our best efforts at marketing, writing, networking or other business actions, we can start to feel like we are up against something bigger and more difficult than mere business realities. We can feel cursed by fate, or at odds with the energetic forces of a larger universe.
Therapists and other helping professionals I coach may tell me that a workshop didn’t fill with clients, or a Psychology Today directory listing got no response, or a meeting with a colleague yielded no referrals. As we talk, I often hear self-deceptive thinking about control. Some insist that the fault is an outside force, like fate. Others take full blame themselves, as though it is a reflection of their inadequacy.
The answer is more often a mixture of factors. Our best efforts are always affected by many factors outside of our control, such as timing or a crowded marketplace and by factors within our control, such as having the right business strategy or a willingness to follow through with the sheer amount of personal effort and expense that most business strategies require to succeed.
Take marketing, for example. I often remind therapists that all of their marketing effort is really marketing research. No one knows for sure what any given marketing effort is going to produce. Given a lack of control over the outcome, the most you can do when marketing is test out the marketplace with an idea and then try to assess the results as feedback.
Then you have to decide to repeat, tweak the idea, or try something else, and of course, retest.
The bottom line is that we have limited control in business, as in life. Some find it is easier to deal with the lack of control by self-deceptive rationalization that a business task is “not meant to be” or “not meant for me.” Others collapse in blame and feelings of failure. Neither is good for the health and welfare of your private practice.
Tip: When faced with issues of control, tap into your inner entrepreneur for better self-talk, such as: “I won’t let myself feel victimized by fear and become inactive. I detach from immediate results and choose to continually take action that furthers the direction of my vision and goals.”
The Fallacy of Fairness
Therapists and other helping professionals often feel that the success of their private practice should follow their own definition of fairness. But if fairness means justice or worthy or even rightness to you, then you will find that business results are rarely based on what is fair. For example, the rate of all new business failure in the US remains at 50% and this is not necessarily about who is more deserving or who tries harder. As with the above fallacy of control, there are many other causes at play.
The fallacy of fairness can occur in many ways. A counselor in a busy metropolitan area says, “If I do good work with clients, the work should speak for itself. It’s not fair that a caseload is based on an advertising or Google adwords budget rather than the skill and effectiveness of the clinician.”
A life coach says, “I have been in practice twice as long as my colleague, yet she got asked to present at a conference that I was dying to speak at and it’s not fair.”
Harold Kushner’s book, When Bad Things Happen to Good People, challenged the idea of fairness, trying to reconcile the concepts of divinity with randomness. Business success unfortunately carries the same degree of circumstance. Two therapists in the same city having the same training, specialty and even the same work ethic, can have quite varied degrees of practice success. Business results are not always fair.
Tip: Rather than emphasize fairness, you do better to focus on a clear list of business goals. If we were working together, I would ask questions like these to help shift the internal, self-deceptive conversation:
• What do you specifically want and need?
• What is your plan to achieve those goals this month?
• What additional resources do you need?
• How much time and effort can you devote to each goal?
• Who can help support you as you move forward?
The Fallacy of Heaven’s Reward
The helping professions require sacrifice, in terms of extending caring beyond session time and a host of uncompensated efforts. For example, we think about our clients outside of client sessions, we continually train to improve our skills at our own expense; we read and study throughout our professional lives. Many of us work hard for relatively low income and bemoan the lack of recognition that our profession merits.
Some rationalize this by believing that their commitment, sacrifice and self-denial will be rewarded over time. If the reward does not occur in the way it was expected, they feel betrayed. This is the deception of the Heaven’s Reward Fallacy.
This fallacy is a particularly tricky form of self-deception because it addresses an often unspoken, but expected and inherent trust about the act of helping others. It feels important that helping and giving should result in getting back.
Therapists tell me, “With the intrusion of insurance-based regulations and increasingly difficult caseloads, I give so much and at times, get back so little.” Many are left shaking their heads and wondering if their career was worth it.
I see this fallacy play out in private practice in ways both large and small: the therapist who slides her fee for a client in need then feels angry when that same client tells her about the wonderful vacation he just booked to France; the consultant who agrees to work Saturdays outside her regular work week to accommodate a client and then feels taken advantage of when the client suddenly quits for another consultant who charges less.
If you regularly violate your own policies or practice boundaries for clients, or agree to unacceptable working conditions based on some future expectation of appreciation, you are vulnerable to this fallacy.
Tip: Stay focused on the present. Respect your policies and practice boundaries. Take time for self-care and address any secondary trauma. Find ways to reward yourself for your work, using intrinsic rewards.
Intrinsic rewards are those within your control, based on the here and now. Boost your feelings of satisfaction, joy, and pride based on your work. Keep a list of your “business wins” each week and celebrate your achievements with others you trust. After a major effort, plan something big, to celebrate yourself. Don’t wait for others or even society to see your efforts. You know what you have accomplished, make it count within yourself.
by Lynn Grodzki, Private Practice Success Newsletter, May 2015
In March 2015, I presented at the prestigious Psychotherapy Networker Symposium as part of a panel titled “The Future of Private Practice.” LISTEN TO FREE AUDIO
Each of the 4 experts gave a Ted-style talk: a 20-minute focused snapshot of their take on the most critical economic and social forces shaping today’s practices.
When I wasn’t on stage, I listened and took careful notes to pass along to you. Here is what I heard, in the order of the speakers on the panel (my talk was second and I have added the link to audio there as promised):
1. “Therapy on the Run”by Ofer Zur
Ofer Zur, whom many readers may know from his workshops and writings (http://www.zurinstitute.com) offered a checklist of 68 business “key ingredients” — in rapid pace during the 20 minutes he had to speak! Her is making his checklist available to my readers, see it HERE.
He started by asking if people felt like business owners or just clinicians; then he asked the audience to identify their areas of expertise. He differentiated between passion—where your heart is—versus your areas of expertise, because these are not always the same.
His checklist included the need for budgeting money, tracking data, getting office help, maintaining secure records, and risk avoidance in terms of ethical violations.
The last topic is one near and dear to Ofer, who works as a forensic psychologist concerning ethics. To avoid risk, he recommends that you have forms (ones that you create for this purpose) covering any unusual practices (willingness to see family members of an individual client, ability to confer with outside therapists on a case, etc.) and get them signed, to eliminate any misunderstandings between you and your primary clients. Explain how you work, set your boundaries and policies, and then back it all up with written forms.
He said that one of the top risk management issues that land therapists in court are those that push a therapist outside of the scope of work –writing custody letters to support one parent over another tops the list. “Don’t write any letters or documents putting you in a role outside of the normal scope of your work.”
Ofer strongly advises therapists go back to basics and balance online marketing with tried and true community outreach. Early in his career, he built a full practice quickly after giving a series of public talks on an issue that was affecting families and children in his locale—domestic violence. His first talk was on “Fighting and Loving.” Even though his talk was somewhat controversial because he addressed the role of the woman in domestic violence, this immediately helped establish him as an expert in the community, led to other talks, and eventually filled his practice.
2. “Navigating the New Psychotherapy Marketplace” by Lynn Grodzki
For my 20-minute talk, I first gave an overview of the change in the therapy market and some promising news: The numbers of people needing therapy is growing, due to Obamacare, a growing acceptance of therapy, and mental health parity.
A big, new, expanding market is opening up right now for helping professionals. But most of these new clients are finding their therapist from the Internet and as such, present some new challenges for their providers.
I talked about both the opportunities and challenges this market presents, and for the bulk of my talk I focused on the 3 top skills you need to reach and retain these new clients and make your work relevant.
The skills I outlined are:
I showed how these are both business and clinical skills –and gave case examples to explain and highlight the application of each skill. You can hear it all, I have posted my 20-minute talk right here: LISTEN TO FREE AUDIO
3. “Creating a Brand for Your Practice” by Joe Bavonese
Joe Bavonese (www.uncommonpractices.com) is a specialist in Internet marketing and also consults on group practices. In this talk, which he immediately said would be less about branding and more about business essentials, he traced his own route in private practice from uncertainty to prosperity.
Joe became a model of a therapist who embraces a business mindset and skillset, using organizational systems to streamline his group practice. He spent considerable time and money learning how to market online effectively. Along the way, he also learned how to manage others and be a boss.
He was willing to try anything that might work and see opportunities and abundance. Joe admitted that not everything he has tried succeeds, but it is his willingness to respond to change.
One application was his ability to learn about Internet marketing. He studied business, and was willing to capitalize his business in a way that many therapists will not (many believe that a private practice should be run on a shoestring.) He spoke about the “lifetime value of a referral” how much the average client brings to a practice and what would you be willing to pay for this. He developed systems for every aspect of his practice.
Joe emphasized that Internet marketing is about getting found. Most searches are now happening by cell phones and to help your website get found, it must be mobile friendly. Google will now penalize your ranking if it is not.
How to be mobile friendly: Go to this Google link:
and put in your website domain to analyze if your website is mobile friendly. If it is not, don’t despair. It might be an easy fix, just installing a “plug-in” or at most, you may need to get some help from a web designer to shift the template to make it work with a phone format.
4. “Learning the Language of Integrative Health” by Rubin Naiman
Rubin’s message about the future was clear: Therapists need to stay part of medical care, now more than ever since so many illnesses have a psychological component.
We have to develop a shared language of health and wellness to be able to talk with and educate physicians. Rubin should know, he is a member of an Arizona Center for Integrated Medicine with Dr. Andrew Weil.
Rubin makes a distinction between illness and disease. Disease is a measure, illness is the experience. Therapists speak to the personal, subjective experience of feeling sick. Psychotherapy brings to healthcare the concept that patients “can be sick in a healthy way.”
He encourages a dialogue between therapists and physicians about body and mind experience. Most psychotherapy is symptom expressive, where medicine is symptom suppressive.
Therapists need to learn the language of medicine, attend grand rounds at the hospital, read medical literature, and call clients “patients”. We need to help doctors understand our needed role in health and wellness.
Hope this is helpful, to hear more from the Networker Symposium, go to the recordings at their website:
Private Practice Success Newsletter
by Lynn Grodzki, Oct 2014.
Last month, I attended a remarkable event: I went to the memorial service for my former psychotherapist and mentor, Marilyn Ellis, that was attended by many of her clients from her long career.
I know that speaking publicly about one’s therapist is rare; most of us who have been in therapy tend to keep the experience private. But I wish that people would talk more openly about their experience with therapy, sharing the good that therapists do.
I want to pay tribute to Marilyn. Tribute, an old Latin word which is defined as an act, statement, or gift that is intended to show gratitude, respect, or admiration, feels like an appropriate expression to someone who had a huge impact on my life and work.
Marilyn was not a therapist superstar. She never wrote a book, went on a speaking tour, recorded an audio or gave a Ted talk. She didn’t even have a website. But at this memorial service, her legacy was clear. Over and over, attendees celebrated the good fortune of having Marilyn for a therapist.
Some spoke about her unique style–a dizzying combination of fearless toughness and deep compassion. Some told funny stories about their time with her. People were laughing and crying and nodding their heads to say, that happened to me with Marilyn, too.
I saw a number of people I know, her clients who are themselves therapists, coaches and healers. Marilyn loved her work and made service to others look like a good profession to pursue; like a heroic salmon swimming upstream, she left dozens of next generation therapists spawned in her wake.
Carrying the Message
Having Marilyn as my therapist changed the course of my life. During the many years we worked together she helped me to first identify and resolve my personal issues and then supported my progress as I remarried, changed careers, became a therapist and later, became a coach and author. She was passionate about the importance of personal growth. She pushed me to be true to my purpose and be my best self. I try to carry these same values to those I work with every day.
So many people at the service spoke about her combination of compassion and directness that they try to embody in their own work and lives. After the memorial, I thought about her lasting impact. Marilyn’s legacy was in the people she helped, and, in turn, in the people they help. It goes well beyond what even she might have understood.
The Person versus The Process
Marilyn was known for being eclectic, combining multiple techniques as a therapist. She was a lifelong student, learning new methods and then integrating them into her work, evolving over time.
But regardless of what method she was using, it was her presence that was the resounding element of her work. At times, many of us who are also engaged in learning new methods forget that the process we use is only a small part of our impact. Who we are, not just what we do, makes the difference.
Marilyn clearly made a difference to her clients, far beyond her skills and methods. I am grateful she was my therapist.
Articulating Your Essence
I talk about this last distinction, the person versus the process, with therapists I coach. We all need to find ways to articulate who we are, not just what we do. Both are essential to the results we deliver.
If you want to enhance your ability to communicate your essence, here is a quick list of seven questions on the website for you to think through.
To Describe Your Essence, Answer These Questions:
- What are the benefits of working with you versus another therapist, coach, healer or helping professional?
- What do you offer that is unique and different?
- How does your personality and non-professional experience add to your professional presence?
- What do clients value about you as a person and you as a professional?
- What do clients value about your practice, office, and services?
- What successes have you had and why?
- What can clients anticipate or expect from their work with you? (Hint: Think about outcome, process, and accessibility.)
copyright by Lynn Grodzki, 2014, all rights reserved. Reprint by permission only.
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Lynn Grodzki, LCSW, MCC, LLC