In 1977, Ilya Prigogine was awarded the Nobel Prize in Chemistry for his work on “dissipative structures.“  Prigogine contends that because dissipative structures are disturbed i.e. shaken up by definition, they are able to change and evolve.  On the other hand, those structures that are too well insulated, and thus unable to be disturbed, will simply stagnate and die.  According to Ilya,  friction is a good thing!

I was reading about Ilya’s work and got to thinking about how friction has served my practice well over the years. Here’s what I’m talking about . . . .

When my referral sources are disturbed . . . they call me to consult when they are in over their heads.  They call me with referrals. Or, they call me wanting referrals.  They do something different.

When my community is disturbed . . . by elections, substance abuse, suicides, natural disasters, my community gets busy!  It get activated! And, they do something different, too.

When my clients are disturbed . . . they are motivated to pick up the phone and call me. They make appointments and come to see me. They follow through with their homework in between sessions.  And, if they are disturbed with me, the tell me!  And, all of that serves me (and my clients) well.  They do something different.

And, when I am disturbed . . . I seek additional information.  Or, I take action.  I tell someone just to be heard.  I take a class or seek consultation. I learn a new strategy.  I, too,  do something different.

Although I’m always up for a new adventure, I must admit, I don’t always relish the unpredictability of my work being disturbed.  But . . . does it help in the long run?  Keep me on my toes?  Sharpen me mentally and emotionally?  Help me stay flexible and alive in my practice?  You bet!  And, that flexibility and willingness to do something different helps my business stay vibrant and thriving.

So maybe tomorrow . . . when chaos looms out of no where to disturb my daily practice . . . . Maybe, just maybe I’ll remember Ilya Prigogine’s ideas and instead of digging in my heels and whining, I’ll say “thank you” for my dissipative practice and the wisdom to see the gift!

How about you?  Got a dissipative practice?  Or have you gone rigid and stagnate?  Needing a little help loosening up and learning to ride the waves?  If so, email me!  I’m happy to help you get unstuck and start enjoying the fruits of a little disruption.

Tags: Change, Continuous Learning, Disruption

Writing and publishing can help you establish credibility, build your professional reputation, and position you as one who makes lasting contributions to your profession.  All of these can, in turn, contribute to your success  in private practice.

Whether you are still in graduate school or you are already hard at work out in the professional world, if you are in need of online tools to help you format your works in APA style, here are some resources for you:

• APA Style
• Purdue Online Writing Lab
• Ohio State University APA Citation Guide
• University of Minnesota Library’s Quick Study on Citing Resources Using APA Style

If you have other online resources related to APA formatting, I hope you will share them below!

Tags: APA Format, Documentation, Website

Although I’m not a fan of  “manualized” treatment of clients, according to professional standards of care and the American Counseling Association’s Code of Ethics (Section C on Professional Responsibility), a professional counselor has a “responsibility to engage in counseling practices that are based on rigorous research methodologies.”

Here are some online resources to help you quickly identify researched based methodologies:

• Society for Clinical Psychology’s Website on Research-Supported Psychological Treatments

• Evidence-Based Behavioral Practices

• National Institute for Health and Clinical Excellence

• SAMHSA’s National Registry of Evidence-based Programs and Practices
  

• Association for Behavioral and Cognitive Therapies
  

And, if you happen to know of other online resources for evidence-based treatment in counseling, I hope you will share them below!

Tags: Ethics, Website

David from Longmont, Colorado wrote  . . .

Tamara, I attended your workshop at the Colorado Counseling Association’s Spring Workshop, The In’s and Out’s of Private Practice. Thanks so much for being so generous with your information!  I remember you encouraging graduate students to go ahead and get business cards.  I am a graduate student and don’t really know what I need to put on my business card before I graduate next year.  Can you help me out?”

Hi, David!  Thanks for attending our workshop.  I really enjoyed working with you guys!  Here’s a link to an earlier post on business cards.  For a graduate student, I would suggest that you include:

• Your legal name;
• All forms of contact information that you are comfortable sharing;
• A statement indicating the graduate program that you are attending – something like “Masters student, University of North Texas, graduating 2012″; and,
• You might also want to include 1-3 areas of special interest.

Once you get your business cards, pass them out liberally. They are your least expensive form of advertising and will help your colleagues and professors remember you years later.

Tags: Business Card, Work with Tamara

While surfing today, I ran across a website that provides resources to counselors in Washington State.  One of the resources I found there is the Dictionary of Initials, Acronyms, and Abbreviations Used by Counselors and Social Workers.  Here are two examples:

CAQH = Council for Affordable Quality Healthcare is a “nonprofit alliance of the nation’s leading health plans and networks that works to simplify healthcare administration.”  As part of this effort they have developed the “Universal Credentialing DataSource” which offers practitioners “a secure and simplified method of navigating the credentialing process.” [Thanks to the Noteworthy column, The Advocate, a publication of the AMACA, July/August 2006.]

NPI = National Provider Identifier, a ten-digit number which will become the standard unique health identifier for health care providers to use in filling and processing future health care claims–replacing common use of the provider’s  social security number or employer identification number.  The National Provider System will begin accepting applications for NPIs after May 23, 2005. Priority will be given to “covered entities.”  Providers who are not covered entities, but who wish to apply for NPIs, are asked to wait at least one year (5/23/06) before applying.   All “covered entities” must have and use their NPI number on all standard HIPAA transactions by May 23, 2007.[Thanks to Beth Powell in News from Washington in The Advocate, March 2004, an AMHCA publication.]“

If acronyms are outpacing your knowledge base, then this is a handy little dictionary to bookmark.  In it you will find both routine and obscure explanations for all acronyms in mental health.

It is also worth noting that in addition to being a terrific resource, the owners of this site are committed to continuing to add other acronyms that you might find useful.  If you have a suggestion, be sure you leave your suggestion here.

Tags: Abbreviations & Acronyms, CAQH, HIPAA, NPI

You may not know that I also host a second blog for my clinical practice.  Last week, I was writing a post for it, titled How to Empty the Garbage (in Your Head).  As I was sitting down today to write, I realized that this post is equally relevant to psychotherapists in private practice.  Sometimes it’s just the garbage in our heads that prevents us from having the practice of our dreams.

If the garbage in your head is what keeps getting in your way, take a moment to check out my other blog to learn a very specific method to extricate that nasty self talk from your path to a bright and successful business future!

Tags: Habits, Self Talk, Social Media

Earlier this month, I was asked to speak to a group of new professionals interning at Aurora Mental Health Center.  The topic was on why it’s important to join your state and national professional associations.  Just in case you are hesitating, here are 23 reasons that I believe you should join your professional associations today.

1. This is your number one career development tool.
2. This is how mental health professionals get things done.
3. Often there are special resources available to you.
4. This is where you go to learn how to be a professional.
5. This is how you stay informed about your profession’s standards of practice.
6. This is where you learn about professional trends and mandated changes in practice.
7. This is where you can build relationships and expand your network.
8. This is where you get continuing education at affordable prices via conferences, workshops, and forums.
9. Often those continuing education opportunities include a free breakfast, lunch or dinner.
10. This is how you protect and promote your own profession.
11. This is where you increase others awareness of your practice or your employer’s visibility in the community.
12. Student memberships are often reduced or no fee.
13. There are always opportunities here to give back to / build up your profession by your volunteer efforts within the organization.
14. There are often opportunities for community service.
15. This is where you go to stretch your own thinking and stay creative in your work.
16. This is where you learn what others in your profession are doing.
17. This is where you can easily establish yourself as a leader.
18. This organization may choose to sponsor your work, research, or workshop.
19. Many organizations offer members free listings and links on their websites.
20. This is who negotiates for the best and most affordable liability insurance.
21. This is where you get free advice on ethics issues.
22. Many organizations offer job placement services.
23. This will allow you to know other professionals to consult with and refer to (and vice versa) as your needs dictate.

I’m sure there are more benefits / reasons to join.  Can you tell me why you’ve joined your professional associations?

Tags: Ethics, Relationships, Workshop

"New Year - Which Direction?" by Randi Hausken

Change Therapy is a free eBook designed to introduce new business development ideas and concepts for the mental health profession.  It is written by my colleague, David P. Diana, a licensed professional counselor and Director of Business Development for a large behavioral health care company.

You can download the book for free at  www.davidpdiana.com.  Enter your name and email in the sign up section on the top right hand side of his website.

Tags: E-book

Before you even decide where you are going to locate your office,

"Mr. Zip, 1966" by Roadsidepictures

you need to conduct market research on possible locations. 

One way to begin that process is to learn about the demographics of different zip codes in your area.

Check out ZipSkinny to help you start your own market research because location matters.

Tags: Demographics, Location, Market Research, Office

Are you still marketing yourself as a generalist?

"Donald Roller Wilson" by Wonderlane

Do you pride yourself as a Jack or Jane of all trades i.e. “I work with everyone!” ?

If so, you are confusing what you do with how you market.  What you do and who you work with may very well include a large variety of issues and clients.  However, if you have too many empty time slots on your calendar, your generalist marketing may be your problem.

There was a time when marketing yourself as a generalist was the hallmark of a go-to therapist.  It was thought that she could do it all.  But things have changed and so should you.

• Today, clients want an “expert” and nicheing lends itself to the perception of expertise.
• Marketing yourself as a generalist makes you forgettable.  And, marketing yourself as someone who has a special interest in X, makes you memorable.
• Nicheing allows you to market your services in a more focused way.  That translates to less money, less wasted time, and more strategic contacts.

So the real question is . . . What’s keeping you from nicheing your practice TODAY?

Tags: Niche

"Mental Patient Strapped to Chair" by Curious Expeditions

If you are in need of diagnostic codes from the DSM-IV or the ICD-9-CM, check out this handy little website at DoctorCodes.com.  By entering the first part of a diagnosis, the site will give you the correct diagnostic code!  Quick and sweet!  Just make sure you are entering the correct diagnosis to begin with!

Tags: Diagnosis, DSM-IV, ICD-9-CM

If you have been marketing to the educational community with little success, you may need to slow down and reassess your own educational history.  Your personal relationship with education may be getting in the way . . . .

Linda L. Lawless and G. Jean Wright suggest in their book, How to Get Referrals: The Mental Health Professional’s Guide to Strategic Marketing, that you ask the following questions when reviewing your educational history:

"Not My Hat!" by Alan Levine / cogdogblog

• Are there any teachers in your family? Are any family members employed by the school system?  What is their input to other family members regarding their work and the system?
• What has been the family response to their vocation?
• What educational levels have been attained by family members?  Did they attend public or private schools?  If private, was it religious or nonsectarian?
• What has been shared about their experience?  What was the quality of the experience?
• What has been your educational experience from kindergarten through graduate school?  Your siblings?  How do you rate it?
• Who were your favorite teachers?  Worst teachers?  In your experience and /or perceptions, what were the characteristics of each that made them “good” or “bad” teachers?  As you reflect on these relationships, what are you feeling now?
• What are your family’s belief systems, biases, prejudices, regarding education and the educational system (school taxes, the school board, election of board members)?
• Did any family members ever serve on the school board?
• What is your trust level of teachers?
• Do you have special training that would correlate with the experiences and needs of educational professionals?
• Do you have children in school?  If so, public or private?  How do you make decisions regarding your children’s education?

It is critical when marketing to the educational community that you feel comfortable and that they know that. Liberally share your unique school stories with other professionals in the educational community.  Use your unique experiences to help guide where you choose to enter the market.  If you attended a private or parochial school, consider focusing your energy on the same.

By taking the time to reflect on your own school experiences, you will increase your comfort and effectiveness in marketing to this community.

Related Posts

Another Strategy for Marketing to the Educational Community:
Collaborating with Your Competitors

Gathering Market Research on the Educational Community

Teachers Needs Vary and So Should Your Marketing Strategies

Tags: School, Stories

Casey Truffo has extended a generous offer to you on her website . . . . Until  9 pm Eastern / 6 pm Pacific on Sunday December 13th , Casey is inviting you to download her entire 300+ page book, Be a Wealthy Therapist, Make a Living While Making a Difference.  You can take advantage of her offer right here.

Tags: Free

When I left employment to begin my own private practice in 1991,

"Question Marks on the Wall" by Lone Black Rider / Filip Bunkens

I started by identifying therapists that I believed to be highly successful.   Then, I picked up the phone, introduced myself, and asked if I could take them to lunch or coffee to pick their brains about being in private practice. Whether you are just starting out in private practice or are wanting to revitalize your practice, that’s a good place for you to start, too.

Most mental health professionals will be flattered if you call.  Let’s face it, it’s an ego boost when someone else thinks that you are successful.  And, many mental health professionals really enjoy mentoring others in the field.

Once you’ve made your phone calls and scheduled your lunches, here are 20 questions for you to ask:

1. How long have you been in private practice? This is really important.  you want to identify therapists who have longevity in the field.  They are who you can really learn from.
2. How did you learn what to do when you were ready to go into private practice? If it worked for him, there’s a good chance that at least part of his learning can work for you, too.
3. What do you know now that you didn’t know when you got started about being in private practice? You might as well learn it now rather than wait.
4. How did your clients initially learn about your services and how do your clients learn about your services now? You want to know about how it was in the beginning for them.  Back then, they were probably on a shoestring budget at best (perhaps like you are now) and still they survived.  In the process of learning what they did back then and what they do now to get clients, you’ll most likely hear how their income and their efforts have changed and refocused.  
5. What mistakes did you make in your early years of private practice? Find out now so that you don’t have to reinvent the wheel.
6. What critical decisions did you need to make about your private practice and why? You may choose to make different decisions but it is often helpful to understand why someone in private practice makes the decisions that they make . . . about policies, workload, billing and fees, etc.
7. Did you ever have a mentor?  Do you now? And, how did you find one? One of the fastest ways for you to jump start your practice is to have a personal mentor to shepherd you on your journey.  Hiring a business coach is one way to find a mentor but it is certainly not the only way.
8. How much time do you set aside to work on the business (not the clinical) of private practice? Successful therapists in private practice spend time visioning, developing, and implementing new ways to grow their businesses.
9. What is your biggest challenge now? Challenges continue throughout the life cycle of a private practice.  Challenges happen; they do not disappear.
10. How long did it take you to turn a profit? The Small Business Administration says that most small businesses fail within the first 5 years and that most successful small businesses take 3-5 years to turn a profit.  I’ve certainly taken it take less time to break even or fail.  However, be wary of those who promise that you’ll be earning big money fast.  Research clearly shows to slow and steady is the way to build a strong foundation for a long-term practice.
11. What do you believe causes a practice to succeed?
12. What do you believe causes a practice to fail?
13. What type of clients do you see? Remember this when you need to refer a client of your own to another therapist.
14. What type of clients do you refer out? If this is a population / issue that interests you, make sure this therapist knows that.  If it is not, then keep an ear open so that you can refer another professional to this therapist.  This is how you network.
15. What resources can you recommend to me as a new therapist that can help me get started on the right track? He may have a favorite website on developing a private practice or an online diagnostic code finder. He may know another therapist looking to share an office or a CPA who can help you set up your quarterly tax payment.  Or, he may have a favorite book or magazine or office supply store to send you to.
16. What do you do to take care of you? Balancing work and home (much less children and additional schooling) is one of those topics that is hardly addressed while you are in school.  Take time to identify now how you will put systems of self care in place.
17. How has your practice changed over the last X (number) of years? It’s important to understand about the life cycle of a practice.  Once it’s up and running, it doesn’t necessarily stay up and running at that level.  Change happens . . . a group practice moves in next door, the local school system has an unexpected need for counselors, an army base closes, you get new clinical training, etc.  Your practice’ life cycle will be different than the therapists’ that you are interview but it is helpful to be reminded that change happens and what you need to do to recognize it as another opportunity for growth.
18. What is the hardest thing about being in private practice? Again, what is hard for him may not be hard for you but knowing about the challenges helps you prepare for them from the beginning.
19. How is your personal life affected by being in private practice? Your professional life and your family’s lives will be impacted by your decision to practice mental health.  When you are in private practice, that impact is even greater.
20. What precautions do you take to keep you and your clients safe in your office? This is another area that is not adequately addressed in graduate school.  There are many things you can do to increase your safety.  Learn about them now.

Remember to take pen and paper with you so that you can take notes.  I’m sure you’ll think of more questions along the way!

If you use this list, I hope you’ll drop back in and let me know how the questions worked for you.  Are there other questions that would be helpful to ask other therapists?

And, if you are a therapist who has been in private practice for a while, why don’t you drop in here  and answer all 20 of these for us.  It’s a good way to introduce yourself and your practice to our community!

Tags: Mentor, Network, Self Care, Vision

Part of growing your private practice includes learning new things.

"Red Thread at WSDP Nepal" by Sara Parker

What books have you been reading to help you grow your private practice and what are you learning from them?

Tags: Red Thread