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Therapists Learning to Cope With a Glut

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Lucy Van Pelt knows how to get patients. In the Peanuts comic strip, she peddles “psychiatric help” at a lemonade stand for 5 cents a visit.

Maybe it will come to that for real-life marriage and family therapists, who in a market glutted with qualified professionals are increasingly forced to glad-hand and network themselves into full caseloads and decent incomes.

Call it the Therapist Hustle.

The problem is partly one of oversupply and partly one of confusion, and it is focused among the therapists officially known either as marriage, family and child counselors or as marriage and family therapists.

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Whatever they call themselves, there are a lot of them--5,349 in Los Angeles County alone, according to the state Behavioral Science Board. And they share the general title therapist with mental health professionals ranging from licensed clinical social workers to clinical psychologists and psychiatrists.

It Adds Up to a Difficult Time

It all adds up to a difficult time for the marriage, family and child counselors, a relatively new professional designation that requires a master’s degree in mental health or behavioral sciences and 3,000 hours of supervised clinical experience.

“It’s a highly competitive free-lance business,” moaned one newcomer to the field, who after the lean years of schooling and a lengthy internship now must slowly build a practice in an overloaded market.

To survive financially, these therapists are finding that they need to energetically go after business. They take to the library circuit, giving free talks on hot topics (the marriage crunch, self-esteem). They network, join chambers of commerce, sidle up to chiropractors, attorneys and physicians for referrals. Just like salesmen, they learn “how to close.” And they advertise.

Knowing how to help people is no longer enough; it takes knowing how to sell yourself, which wasn’t on the grad school curriculum.

“Therapists need to be in show business,” says West Hollywood therapist Leslie Pam. “They need to get out there.”

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Many must hold onto other jobs until they can build a sufficient caseload for a full-time practice. Often offices are sublet for a few hours a week, just enough time to see two or three patients--their entire caseload--and then go back to their real jobs.

They inquire of each other: “How many hours do you have?” (About 20-25 patient hours are considered to be a good-size practice today, according to Encino therapist Doris Lion.) And often, they turn to Gene Call in Brentwood for advice.

Dubbing himself a “private practice trainer,” Call coaches newcomers and old-timers alike, teaching them marketing techniques to “get their practices cooking.”

“I’ve worked with 2,000 to 3,000 therapists. I’ve taken people from $12,000 a year to $125,000. Or from $125,000 to $250,000,” he says immodestly. “One therapist came to me with no patients and, nine weeks later, he had 26.

Call says that “being a therapist is an isolated job. It allows for more reclusive types.

Passive Vs. Active

“The professional personality is different than the business personality,” he explains. “Someone says to a therapist: ‘I have a friend who might need some help.’ The typical (professional) response is ‘Fine. Here’s my card, have him call me.’

“That’s passive. I teach them to be more active. I teach them to say, ‘Talk to your friend about me and see if I can call him tomorrow. I’ll call you tonight.’ That’s how to close,” Call says.

Call enourages therapists to focus on a specialty. “Just saying you’re a marriage and family therapist is boring,” he explains. “It sounds dead at a party.”

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But specialties are not pulled from thin air. He insists that they examine what he calls their “lifetime fingerprint” to find personal experiences that can be turned into marketing tools.

“A therapist whose husband had a heart attack can specialize in working with heart attack victims and their families. Do you know how many men have had heart attacks?”

Hot Specialties

There are hot specialties and passe ones. “Bulimia was hot for a while,” he says. “Substance abuse, stress--those are good ones.”

The book, “Women Who Love Too Much,” which focuses on women who have a pattern of relationships with men who don’t meet their emotional needs, has spawned a cottage industry for some therapists who can align themselves with the book’s approach to recognizing the pattern and changing it.

Pam, in West Hollywood, is past president of the L.A. chapter of the California Assn. of Marriage and Family Therapists. He says he specializes in working with the “most successful and wealthiest people. I sought out a group of people, learned as much about them as I could and became an expert in that field. These are people who are so powerful that they have no friends. No one calls them by their first names.”

When a therapist gives talks, Pam says, he or she can’t expect to just hand out cards at the end and get calls. “Out of 50 or 60 people at a talk, you try to get 10 to a workshop the following Saturday. And then you move some of them into individual work--but only if they need it, of course.”

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Ken Unmacht, a therapist who is also a lawyer, agrees with Call about specialization: “You have to specialize. I work with people who have mid-life problems. It’s a matter of seeing what you’re good at.”

‘Closing Sheet’

Unmacht gives periodic library talks on his subject, ending the session by passing around a “closing sheet.” This form asks if people would like more information about a therapy group or individual counseling.

Janine Beiderman, coordination director at Hartley & Associates in West Los Angeles, prefers to hold free workshops in her offices. “It helps for people to see you in your own environment,” she says.

She ends her talks by passing around one sign-up sheet for the mailing list to receive announcements of future talks; another is for people who would like a free consultation. And she says her practice had a significant upswing in business (yes, business) since taking out a larger ad in the Yellow Pages.

“If you’re in private practice,” she says, “there’s a certain amount of hustling forever.

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