In a recent issue, we looked at several therapists treating adults for issues pertaining to anger. But the sub-niche of angry children might be even more fertile. Referral sources include schools, physicians, and other mental health professionals who aren’t prepared to treat this population. Insurance benefits often cover treatment--and even when they don’t, parents are motivated to find a solution to a trying problem.

In this report, we get advice on working in this niche from four clinicians, from Florida to California. Together, they offer a set of ideas any therapist can use to get started.

1. When it comes to potential referral sources, says Tara Moser, "there are almost too many to count." Although she’s only been in full-time private practice since 2006, Moser’s developed a 25-session-per-week practice with angry children as a cornerstone. She ticks off seven referral sources she’s used to good effect: school guidance counselors, school psychologists, physicians, police departments, clergy, the Association for Play Therapy (APT), and an organization called "CARE Suicide Prevention," where she does talks on child anger.

2. A comprehensive website devoted to kids’ issues is important, says L.A.’s Charlotte Reznick. About half of her 25-client-per-week practice is devoted to this population. And a standard therapist’s website just won’t attract parents’ attention, she argues. A banner at the top of Reznick’s site, www.imageryforkids.com, promises: "9 tools to help your child cope." She also offers a free list of the "top 10 things kids want and need from their parents."

3. Group therapy is a good match with this specialty, says Nancy Brooks in Bailey, CO. Her "anger management group for kids" is held weekly, with just 3-5 kids in each group. There’s a different focus at each session, and Brooks keeps the pace quick to accommodate limited attention spans. She usually starts by simply defining anger for them. "Kids need to understand," she says. "The majority of them don’t have any idea what people are talking about when they tell them they’re behaving in an angry way."

She works with group members using the trigger response model: what triggers the anger, and what they need to do to deal with it. They role-play, and discuss anger, working on ways to keep from getting angry. Brooks’ group fee is $45 per 50-minute session, with an eight-week format.

4. Write a book, or even a short monograph on the subject, so parents have something to chew on before they send their kids to see you. Florida clinician Norm Hoffman has the most eye-catching book title that we’ve seen lately: Bad Children Can Happen to Good Parents: A survival Manual for Parents of Difficult Children. (Hoffman has a small private practice, spending most of his time on forensics and child custody.)

Cynthia Reznick wrote a book with a more upbeat title: The Power of Your Child’s Imagination. She’s also selling a pair of relaxation CDs she put together herself, titled "Climbing a Mountain of Success," and "Finding Your Special Place." As well as serving a marketing function, these products provide what business professionals call "multiple income streams"--which is a just fancy way of saying "making money in more than one way."

5. "Get qualified by the school system to teach teachers," says Norm Hoffman. "Instead of holding seminars in your office, you need to go where the parents and kids are. Hold presentations for teachers at the school--and do them for free."

Depending on where you practice, he goes on, you may have to get school board approval for your teacher education program. The first step is to draw up a proposal stating the problems you’re addressing, and the goals you’ll meet. "Keep it simple and straightforward...Then be prepared to wait six to eight months. You have to keep calling--so be sure to have a contact person." Once you’ve successfully sold a program, Hoffman adds, it gets easier to go back for more.

(Hoffman also recommends working with family courts--he has referral relationships with a couple of judges, and about 12 attorneys. He gives free workshops for the Florida Bar Assocition.)

6. Blogging can actually help in this specialty. We’ve spoken to plenty of clinicians who’ve tried to get a blog off the ground. But for the most part, it’s an enjoyable hobby, not a marketing tool. But Charlotte Reznick started doing a blog through Psychology Today a couple of months ago--and says 600 to 1,000 people have been reading each entry, leading to book sales on her own site as well as inquiries from potential clients. (There’s a link to her blog on her homepage, www.imagreryforkids.com.)

Tara Moser is also blogging, and tells us it helps promote her practice, although the direct benefits aren’t as obvious as in Reznick’s case. See her two blogs at: www.throughtheeyesoftherapydogs.blogspot.com, and http://dfcbooks.blogspot.com.

7. Don’t be locked into the 50-minute hour, says Nancy Brooks. Once the situation is stable, she tells us, her patients don’t require a full session. Instead, Brooks has them come in for a weekly "check-in" session of just 30 minutes.

"I ask how things are going at school and at home, then make suggestions." She reminds them to write in their journal, and to keep up with other homework she’s assigned to help them transition out of therapy.

Her standard rate for a 50-minute session is $100, but half-hour check-ins are just $50. (Obviously, this makes it easier for parents to go out-of-pocket, or to keep their kids in therapy longer.)

Overall, all four clinicians report, third-party reimbursement for this niche is not a problem. But Charlotte Reznick in Southern California and Tara Moser in Florida prefer to run on cash, or out-of-network benefits. Reznick charges upwards of $190 per session, and Moser’s fee is $100. (Moser’s clients pay upfront, she reports, and are able get $60-$80 reimbursed.)

It’s an unhappy reality that child behavior problems are increasing. Therapists who can help deal with this reality will be more in demand in the years ahead.

Contacts: 1) Nancy Brooks, Bailey, CO, (303)838-2283, email: nancybrooks @earthlink.net; 2) Dr. Norm Hoffman, Ormond Beach, FL, (386)677-3995, www. drnorm.com; 3) Tara Moser, Cape Coral, FL, (239)540-1155, www.deltafamily counseling.com; 4) Charlotte Reznick, Los Angeles, CA, (310)889-7859, www. imageryforkids.com.