Psychotherapy Finances

More violence against therapists was in the news recently. A psychiatrist from McLean, VA was murdered by a patient in his home office on July 22. She then turned the gun on herself, according to newspaper reports.

The psychiatrist, Mark Lawrence, was 71; the patient was 62.

He’d just consulted with a colleague about the case after concluding that the patient was becoming paranoid and blaming all of her problems on Lawrence. The colleague suggested the patient see another therapist.

“I went home thinking I had made a good suggestion and that hopefully the patient would agree to seek outside consultation,” Melvin Stern, a friend and colleague who trained with Lawrence at the Massachusetts Mental Health Center in the 1960s, told The Washington Post.

The patient was a former scientist at the National Institutes of Health and hadn’t been working, but neighbors said there was no sign that she’d been troubled.

The Post noted that the murder occurred four years after another psychiatrist, Wayne Fenton, was beaten to death by a teenage patient in Rockville, MD.

The issue of violence against therapists usually arises after a high profile attack hits the news. But it’s something that many practitioners live with on a regular basis.

According to the New York Times, a University of Pittsburgh survey of 1,129 therapists nationwide showed that 58 percent had dealt with violence in their office, and a quarter of them had actually been attacked by a patient.

For resources on the issue, check out a page of resources collected by former APA Ethics Committee Chair Ken Pope: http://kspope.com/stalking.php

- John Nelander, Contributing Editor

We’re closing in on the end of 2011, but many therapists haven’t bothered with a website. It still surprises us at Psychotherapy Finances how few practitioners have put up even a basic nuts-and-bolts site featuring their specialties, location and contact information.

Others have taken partial steps by creating a site in connection with a directory of providers, like the popular list on Psychology Today or those offered by a professional association.

In talking this week to an Oakland, CA clinician, Will Courtenay, I was reminded how taking your web presence seriously can pay off. This is especially true if you continuously update your website and pack your pages with interesting content.

Courtenay now has six websites and says he has other domain names he has not yet tapped. His specialty is men’s health issues. He’s created a real hook with a niche that focuses on men with postpartum depression – it’s the kind of issue that draws the attention of a curious media.

He’s landed interviews with media giants like the Los Angeles Times, Newsweek, Huffington Post, The Wall Street Journal, USA Today and ABC’s Good Morning America. All editors and producers have found him through one of his websites: www.mens-depression.com, www.mens-therapy.com, www.saddaddy.com, www.helpforniceguys.com, www.menshealth.org and www.helpforangrymen.com.

That’s also how almost all of his clients find him.

“I think you have to market aggressively when it comes to men,” he said. “A lot of men look for information on the Internet, so part of what I do is put information out there that I think is going to be valuable to them.”

Courtenay writes all the copy for his websites. That may sound daunting but the most effective route is to pose a problem and then offer a solution – which generally involves setting up a therapy appointment.

In addition, the links on a website to articles or broadcast interviews create a sort of “halo effect” for the practitioner. It sets them up as an expert in their field.

As Courtenay points out, people want to know that the therapist they’re going to see is knowledgeable.

The upshot is that listing your practice on a directory probably isn’t enough. Learn how to attract potential clients to your website where they find relevant information and take the next step in getting some help.

- John Nelander, Contributing Editor

When it comes to marketing a practice, clinicians are keenly interested in new technology – and they’re right to pursue a presence on Facebook, Twitter and even LinkedIn. But these new tools shouldn’t be used in place of some of the old tried and true methods.

They include face-to-face networking, giving public presentations to local groups in your area of expertise, and handing out business cards to everyone you meet.

Of all these techniques, use of business cards is perhaps the most overlooked. Sure, everybody has them, but they are dribbled out here and there. Some people may be lucky if they hand out one a week.

But with business cards the whole idea is to take a scattershot approach. You know that most people aren’t going to pass them on or save them at home for future reference. The more you distribute, though, the more likely it is that one of them will land in the right spot and end up generating a referral.

We’re preparing a new report on best ways to use your business card. Look for this story in an upcoming issue of Psychotherapy Finances in which practitioners talk about how to get the most out of your business cards and what’s worked best for them.

Here are a few things we’ve picked up so far:

* Make sure to put your picture on your business card. That makes it easier for the recipient of the card to remember what it is you do and how your services can help them. Looking at your photo, they will automatically think back to the time they met you.

* Glossy cards may look great and come off as super-professional. The problem is, you can’t write on them.

* Make sure to have a tray full of cards in your waiting room. Yes, clients already know about your services if they’re coming for therapy, but they may take a few to hand out to friends. Or, someone might stop in for information. It’s easy for them a grab a couple of cards and take them home for easy reference.

* Trade cards with other professionals in your service area. That includes other therapists who may have a different specialty from yours, but also people who offer other health related service like yoga classes or physical therapy.

Check back this fall for a lot more ideas on how to get your business card distributed in the community, and also what information to include on the cards. Remember that when it comes to marketing, low-tech can be just as beneficial as high-tech – sometimes even better.

- John Nelander, Contributing Editor

It’s no secret that primary care physicians have been writing a large portion of the prescriptions for antidepressants. And they are written without the benefit of a mental health evaluation. Now, a new study reveals the scope of the issue.

The latest figures show almost three out of four are written by primary care doctors and other non-psychiatrists, according to a study in the August issue of the journal Health Affairs.

“To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers’ prescribing practices, revamp drug formularies, or vigorously pursue implementation of broad reforms of the health care system that will increase communication between primary care providers and mental health specialists,” the study’s authors said.

The lead author was Ramin Mojtabai, an associate professor with the Bloomberg School’s Department of Mental Health at Johns Hopkins University in Baltimore.

The number of antidepressant prescriptions without a psychiatric diagnosis jumped from 59.5% in 1996 to 72.7% in 2007.

“Antidepressant use is becoming concentrated among people with less severe and poorly defined mental health conditions,” according to the authors, who called the trend “worrisome.”

The results were based on data from the 1996-2007 National Ambulatory Medical Care Surveys.

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ValueOptions landed a contract in May with Emblem Behavioral Health Services to provide mental health benefits for its 2.9 million members in New York State. ValueOptions providers, as a result, are being asked expand their network participation to include Emblem clients.

ValueOptions therapists will have 10 days from when they receive a packet from the insurer to apply. The transition date for the contract is September 30.

For more information, contact ValueOptions at 800-235-3149 between 8 a.m.- 5 p.m. EDT Monday through Friday.