"My practice seems to have dried up recently!"

Has this happened to you? You've been in practice for quite a while. There always was a steady stream of clients coming in. You never had to do any marketing other than maybe a good yellow pages ad.

Yet slowly (or maybe not so slowly) your phone rings less often and there are fewer appointments in your book. And you are starting to get disappointed, frustrated and maybe beginning to panic.

If this is happening to you, you are not alone. It is happening to many seasoned private practitioners across the country.

I could write an article on why these previously healthy caseloads might be diminishing - continued impact of managed care, the acceptance of the medical model of psychotherapy, and the perpetuation in the field of the myth "You can't make money as a therapist."

We could get engaged in a lively intellectual discussion of why this is happening. But that won't get the phone ringing.

SO I offer you ...

"Your 5-Step Quick-Start Guide to Reviving an Existing Practice."

1) Understand that to revive a practice, it will take some action - most likely action that wasn't needed in the past but is now. It is easy to be resentful of this change. Please don't get stuck there.

2) Ask yourself: What do I love, what am I known for in the community, and what makes me money?

My first business coach, Lynn Grodzki, suggests using this as a place to start.

It is easy to talk about all the specialties you have (EMDR, TFT, Somatic Experience, Dream work.) But if I asked people in your community, what would they say? Would they say "Oh, that therapist is great with couples." Or "I send children to her - they love her."

Don't be tempted to say "I am not known for anything - ask you colleagues.

3) Do you enjoy that?

If you are known for both eating disorders and Christian counseling, which brings you greater joy? (Although Christians with eating disorders may indeed be a narrow and very good target market.)

If you want to build a self-pay practice in today's market, you will need to market to a specialty. I recommend picking a particular problem that people seek help for.

Let me give you an example. An EMDR therapist said "I help people who are afraid of going to the dentist." She developed a "What To Do When You Are A Dental-Phobe" marketing piece. She gave these to office managers in dentists' offices to hand out to the patients as needed. She visited 3 local dentists offices every 6 weeks to say hi and chat with the staff. They loved her and her practice began to fill - not only with people who are afraid of the dentist but their friends, neighbors and families who had other problems.

4) Where has your money come from in the past?

I like to look at this in two pieces. First, what marketing efforts have brought you the most money? Was it speaking in front of groups at church? Was it your listing on Find-A-Therapist.com? Then look at which individuals or organizations referred people to you. Was it an acupuncturist you know? Was it a family law attorney?

I encourage you to look at the last 6 months of your practice income. Take each client, note how they heard about you and then determine the amount they have spent with you (so far).

Then take a piece of paper (or a create a spreadsheet) and create a column for each marketing effort and each referral source that has resulted in income in the last 6 months.

For example, Mary came to see you and has spent $1,000 so far with you. She heard about you from a talk you did at her daughter's school. She wasn't at the talk but her friend Ellen was there and Ellen picked up a card of yours and gave it to Mary.

So put the $1,000 that Mary has spent under both columns "Marketing Effort: Talk at the school" and "Referrer: Ellen."

As you do this, you will begin to see which marketing activities and which referral sources have worked the best for you.

Identify how you can capitalize on these activities. Perhaps it is reconnecting with one of those former referral sources. Maybe you start scheduling some speaking engagements again.

If you find a doctor has referred to you and you have release forms from the clients, start sending monthly treatment reports to their doctor. This keeps your name in front of the doctor and he or she can see the results you are getting with the patients.

5) Finally, what connections do you have in the community that you haven't yet taken advantage of?

Are you active in the Hospital Guild? Is your mate a member of a professional organization that might want a speaker? Have you shared with your massage therapist what kind of pain you help to reduce?

There are people in the community who like you very much that I imagine don't really know or "get" what you do. Share your passion for the work with them and let them know you have "a few openings" in your caseload in case they know of someone you might be able to serve.

In summary, review what you love and are known for. See what makes you money. And create a marketing plan that helps the community know more about who you are and what type of pain you help to reduce.

This isn't a "quick fix" and will probably take 6 months to a year but with a plan and focused, consistent action, you will start seeing the results you want. Don't quit before the miracle!

Business Coach  Casey Truffo is a Marriage and Family Therapist in southern California. She identified 8 key strategies that helped her business flourish, and began to help other therapists build their practices. Now she devotes her professional life to helping great clinicians learn what they didn't learn in graduate school about how to have a fun, fulfilling and profitable private practice.

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