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Do therapists have the cash flow for marketing?

Written By: Elizabeth - Jan• 17•12

The good news about marketing these days is you can extremely cheaply make dramatic marketing moves with huge impacts.

The bad news is most therapists don’t know heads from tails around marketing, generally, let alone the internet or technology.

I think a lot about newbies since I’m in that boat.  I’m actually a pre-newbie since I’m safely in the confines of coursework that has almost nothing to do with the actual craft of therapy.  (Yes, I came into this profession with NO rose colored glasses on.)   I do love my classes and believe the information I’m learning is vital to being a therapist even if not the actual craft of therapy.

How to market without a budget?


It is literally unheard of for most businesses, even small businesses, to NOT take out a loan when starting out.  Most every entrepreneurial business magazine or media coverage of them asks “where did you find funding?”

Somehow therapists, with what is quite a tiny set of start up costs, are left in the cold rain.

Debt is bad.  They have debt from school.

Therapy is good.  Seeing clients is good.

But debt is bad.

What do you do when those two conflict?

It is very, very rare for new entrepreneurs to have good cash flow when starting out, without a loan.

Therapy start up costs are so affordable most banks won’t both with such a small amount.  (My husbands office, mostly Ikea quality, with all the equipment, four sturdy chairs, a couch, a work desk, file system, lamps, area rug, side tables (about 4) ran him almost $4,000.  Then a few hundred here or there for various licensing costs.)  His rent is very affordable every month and since it is his waiting area and office he could aggressively sublet if he wanted.

What if instead of a bunch of frugal, penniless newbie therapists staring at their walls day after day, growing more insecure and nervous every day, were told it’s normal and quite expected, to take out a loan.  Even if it’s…gasp… a credit card loan.  It’s pretty easy to get a zero interest card and pay it off (my husband did this in 9 months, so basically he had a no-interest loan.)

There are people out there, myself included, who aren’t super cheap to hire, but the hundreds, even thousands of hours, of knowledge make our time and information priceless.  I often feel like I’ve got a shield up when friends ask me questions and I can safely and easily tell them NOT to spend certain money, or to only spend it after doing X, Y, and Z.   There are just such fantastic sales pitches out there from people who will NOT give the big picture on their service but instead do everything in their power to sound tantalizing, like they have the panacea to all your marketing woes.

I believe a new paradigm is on its way.  More graduate students have decided to say NO to the underpaying, overworked agency jobs where everyone there is dying a slow death.  (Yes, some agencies are awesome, I know.)  More students are saying what is worse: learning to market to serve my ideal client for whom I have undying passion every day, or see a bunch of clients for whom I have no background, training, and who may not actually want to even be in the room with me and for whom the alliance is extremely hard to build because I’m nothing like them.)

In this new paradigm where we newbies are paid what we’re worth, where we set our own hours, live and work where we chose, we are going to have to start talking about taking on debt to make our dreams come true.  We’ve got to talk about good debt versus bad debt.  School is good debt.  Starting your dream business should be considered good debt.  Paying for business and marketing advice is good debt.  Bad debt is taking a bunch of vacations, buying clothes you can’t afford, overspending on office furniture (as I’m sure you’re aware you could EASILY spend $4,000 on just ONE couch.)

And as more of us pursue this paradigm we’ll finally myth bust that this counseling field pays poverty wages and sucks you dry.  We’ll be people like my husband who absolutely LOVES what he does, sees exactly who he wants to see, in the exact office he wanted, and has the freedom to take vacation when he wants.

We will graduate with a plan, financial, strategic, marketing-savvy, and start to serve without shame, guilt, or worry about every penny because we’ll know it takes money to make money, and we’d rather get going making money now and serving our ideal client now.  Even if the cash flow isn’t quite there yet.



did any of you jump in even though the cash flow wasn’t there?  I’d love to hear your stories in the comments below!

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Elizabeth Doherty Thomas is a national speaker, writer, and consultant on therapy marketing online. Her new company is called The Doherty Relationship Institute and is launching soon.

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  1. Hey Elizabeth, great article and thanks for the invitation to post! I DID jump into business without the cash flow, partially out of necessity, partially out of desire to do so. My husband started medical school this fall, and over the next 6-7 years we will move a minimum of 3 times. It didn’t make sense for me to invest in an office space only to pick up and move when it would start to pay off, so I started an online counseling business. This way I can keep the clients I have whenever I move, and be more available to the sub-group of clients that have a difficult time scheduling and commuting due to jobs or lack of local therapist availability.

    I love what you said about “good debt” and “bad debt.” Since I had a low overhead, I didn’t have to take out a business loan, but there are some things that just make good sense to pay for, even if it’s hard to feel you can “spare” the money right now. I’ve found my listing in to pay for itself almost every month in new client calls. But the best marketing I’ve found is free! Write articles, give speeches, give freebies on your website, run a blog, network…and for those things we all have the cash flow!

    Thanks for your article, I enjoyed it!

  2. Casey Truffo says:

    Hi Elizabeth – as always, thanks for such a thought provoking article. You always make perfect sense and do so in such a kind, intelligent way.

    I love the idea of starting out (as needed) with some business debt. And as money comes in, I suggest people take a portion of that coming in for their personal life, a portion for their business expenses, a portion to save for business development (and growth) and finally a portion to repay the business debt. That way, over time, people have the funds to create the successful business they deserve. :)

    To expand further on your point, I think therapists will be well advised to have an ongoing marketing budget. It doesn’t have to be a lot and there are plenty of ways to market for free or low-cost when you are starting out and have more time than money.

    I mention this because therapists in private practice are entrepreneurs and as micro-business-owners need to make sure the world knows about them.

    Finally, Elizabeth, I love what you do and how you help people get the word out about their services. You are awesome!

    Casey Truffo