Marketing for Therapists: 2 Ethics Mistakes Therapists Make Marketing in Private Practice
Ethics, Marketing and Private Practice
Good therapists who don’t understand the what, how, and why of marketing for therapists can make ethical mistakes- even as an employee. Today we’ll dive into a few of the top mistakes that could be ethics violations that involve marketing. Guess what! You don’t have to be actively marketing a private practice to make these mistakes. You could be employed by someone marketing unethically and still be responsible based on your code of ethics!
Let’s be clear, today is NOT about scaring you. It’s about helping you AVOID or FIX some of these common mistakes so you can be the ethical, amazing therapist you are meant to be!
Side note: You can watch a recording of our training on ethical marketing here: Client-Centered Marketing Messages: How to Write an Ethical Marketing Message to Fill Your Practice.
Knowing the Ethical Codes for Marketing as a Therapist
Ok, so let’s start at the beginning: When is the last time you read your ethical code and really gave it a deep exploration? Has it been years? Was it before you were in private practice, or employed by a big tech company? A LOT has changed in the last few years. It’s great to go back and give it a read and really ponder what the ethical code means in light of the world today.
In this article, we are going to be focusing on the ethical code of our State organization, the California Association of Marriage and Family Therapists, for the purposes of an example. When looking at ethical codes, we highly recommend looking at not just national organizations, but also state organizations. State ethical codes are often more closely aligned with the laws and regulations in your state that you’d be held accountable to if there was an ethical or legal complaint made against you.
As Licensed Marriage and Family. Therapists, we could look at the AAMFT code of ethics, and any other professional organization that we are a part of. Examples could include Brainspotting International, EMDRIA, or any other organization. We HIGHLY recommend you read over the code of ethics or code of conduct for any professional organization you associate yourself with. We have read some code of ethics that were quite alarming over the years. And with that- let’s talk about the biggest mistakes therapists make that could go against their code of ethics.
Ethics Mistake #1: Accepting clients for money reasons only
Let’s start with a quick review of one area of the code of ethics that could apply here “1.8 FINANCIAL GAIN: Marriage and family therapists do not maintain therapeutic relationships solely for financial gain.” “5.11 SCOPE OF COMPETENCE: Marriage and family therapists take care to provide proper diagnoses of psychological disorders or conditions and do not assess, test, diagnose, treat, or advise on issues beyond the level of their competence as determined by their education, training, and experience. While developing new areas of practice, marriage and family therapists take steps to ensure the competence of their work through education, training, consultation, and/or supervision.”
These probably aren’t new phrases to you, even if your ethics code might word them a little bit differently. But, have you sat lately to think about how this is really showing up in your work? In the people that are referred to you, assigned to you, or that you are accepting as referrals and scheduling?
Do you even know what you are really great at, and what kind of clients get the best outcomes working with you? Do you know who you consistently do NOT get good outcomes with? (Check out our free Outcomes Driven Practice training here.)
Maybe you are like us, where many times along the way you were told referring out wasn’t a possibility. Or, you were punished or even fired for upholding ethical standards about the kind of care clients get. It can be hard and scary to do the right thing when your income is tied to it. And yet, that is why ethical codes are created. To help us do the right thing when things get sticky.
Is every client you are working with someone you can get great outcomes with? If not, why are you not referring out? Is your client ready to graduate? If you are in private practice, we want your marketing to be so in alignment that you have too many clients coming to you so that you never have to feel torn between your income or ethical duty.
Great marketing isn’t just about being full. It is about attracting people that you can do great work with and that you have the skills to truly help. If you are working for an agency or for or with an online tech employer like BetterHelp or Alma who provides clients- do they understand your clinical skill and limitations? Do you have the ability to decline inappropriate referrals? Are you actively reviewing every client before the first session to see if they are appropriate and not wasting people’s time if you know you can’t help?
Ethics Mistake #2: They accept more clients than they for whom they can provide exemplary service
Oooo… This is a juicy one that we see ALL. THE. TIME. Let’s start at one area of the code of ethics and then dive down deeper! “5.3 CLIENT/PATIENT RECORDS: Marriage and family therapists create and maintain client/patient records consistent with sound clinical judgment, standards of the profession, and the nature of the services being rendered.”
Most of us start our training and work in organizations where we have some support for the clerical, clinical, and logistical support (including the business side of things). So, we go in, do a few meetings, and primarily see our clients. Often the percentage of time we see clients compared to the amount of hours we get paid for is quite high. However, when we move into being a business owner OR our employment comes with more clerical or business tasks, this percentage can change over time.
Side note; If you are a 1099 employee AKA contractor you are a business owner NOT an employee.
As a business owner, your duties expand dramatically: marketing, bookkeeping, billing, clerical work, hiring, firing, cleaning toilets, tracking outcomes, and so. much. more! You can’t expect yourself to see the same number of clients as a business owner as you did as an employee. Ok… so where does this come back to ethical considerations in private practice and marketing?
If you don’t have time or energy to get your documentation done at the end of the session or the end of the day, are you providing ethically sound services? Client records and documentation that are maintained and updated are an ethical obligation beyond a legal one or something related to getting reimbursed by insurance companies. If you are seeing so many clients or have so little rest that you are days, weeks, or months behind on documentation it is time to really dive into what is actually sustainable in your caseload.
And yes, it is easy to just default to “I’m bad at doing notes” “I’ve always been behind on notes” or maybe even “My neurodivergence makes note taking hard.” The whole story is that there should be time to lean into these aspects and find some ease and time for you to do notes in a way that works so you can serve your clients well. And, having coached thousands of therapists from all over the world since 2010, we’ve found over and over again MOST therapists struggling with documentation are simply grossly overworked! The average private practice therapist can sustain about 17 clients per week and feel in balance emotionally, clerically, and from a business perspective- some a little more, some a little less.
Now, let’s look at this second code of ethics that may apply here: “1.3 TREATMENT DISRUPTION: Marriage and family therapists are aware of their professional and clinical responsibilities to provide consistent care to clients/patients and to maintain practices and procedures that are intended to provide undisrupted care.”
Are you saying yes to so many clients in your private practice that the frequency of treatment is determined by your availability? If you are scheduling new clients that you can’t possibly see more than 1-2 times per month without regards to that being the appropriate level of care, is this ethical?
One example: A therapist in private practice, let’s call her Miranda… well because it was Miranda (me) noticed the following: If she saw two clients both for 12 sessions, but one came weekly and the other came 1-2 times per month- the weekly client got better outcomes, consistently. So, she made the decision to only accept clients on a weekly basis of frequency to ensure clients investing the same amount of money and time into therapy got the same availability of outcomes.
You could say she just wasn’t trained well in how to get good outcomes with clients who came in less frequently, and yet most all of her training (outside of the psychiatric hospital) was with clients who came less frequently to therapy. And, in fact, she is not alone. Erekson, Lambert, and Eggett (2015) found that more frequent therapy sessions were associated with quicker recovery rates. Robinson, Delgadillo, and Kellett (2019) replicated that weekly sessions promoting faster improvement. Think about how long clients typically wait after they know there is a problem before seeking treatment. According to relationship expert Dr. John Gottman unhappy couples wait an average of SIX YEARS before starting couple’s therapy. Do you think they have time to wait to feel better?
What is really ethical here in your marketing and in your treatment as a therapist?
Ok, so back to the ethics. If you are taking on so many clients that you can’t provide them the right frequency of treatment is that ethical? OR, if you are attracting and keeping clients who would benefit from more frequent services but they can’t afford that treatment with you and you aren’t referring them out- are you providing ethical treatment?
Here at zynnyme, we want you to know your numbers. Know what really works for you financially to provide great outcomes, amazing customer service, and for YOU to live a balanced life as well. There is no shame about numbers here. And, we don’t think your fee is about your worth as a human. You are priceless! Therapy is priceless. Your fee is simply a reflection of the expenses you’ve incurred becoming a therapist, running a practice, and living a life where you happen to live right now. That is all your fee is!
Okay… but does is this really a marketing mistake? YES! Great marketing should attract people that:
You get great outcomes with
The fee or insurance is a match
The frequency matches
The availability
The mode of treatment matches
Marketing should NEVER just be about a therapy mill of attracting as many clients as possible to get services without focusing on the BIG picture. Whether you are a business owner, an employee, or a contractor AKA business owner you are ethically responsible to make sure that things are lining up between the marketing and the services you are providing.
Final Thoughts on Ethics and Marketing in Private Practice
To be honest, when we started writing this blog we thought we might include the top ten ethical violations- but clearly this got long quite quickly with just a few examples! We’d love to hear from you- was this helpful? Would you like us to continue sharing the others we’ve noticed? Share in the comments below.
And we hope you’ll join us for the FREE training: Client-Centered Marketing Messages: How to Write an Ethical Marketing Message to Fill Your Practice.
References:
California Association of Marriage and Family Therapists. (2019). Code of Ethics. Retrieved from https://www.camft.org/Membership/About-Us/Code-of-Ethics##responsibility-to-clients
Erekson, D. M., Lambert, M. J., & Eggett, D. L. (2015). The relationship between session frequency and psychotherapy outcome in a naturalistic setting. Journal of Consulting and Clinical Psychology, 83(6), 1097-1107. https://doi.org/10.1037/ccp0000027
Robinson, L., Delgadillo, J., & Kellett, S. (2019). The dose-response effect in routinely delivered psychological therapies: A systematic review. Psychotherapy Research, 29(1), 79-96. https://doi.org/10.1080/10503307.2019.1566676
Looking for more support for your solo or group practice?
Imagine a practice that’s not about surviving, but thriving. Where your income goals are not only met but exceeded.
Where burnout is a thing of the past and where you have a profitable, sustainable business that lets you live the life you’ve always dreamed of.
Sounds like a fantasy? It’s not!
Pop your name and email address below to get INSTANT access to our on-demand training on how to build a profitable solo or group practice
