Mila Tecala has an overall goal: helping people put their lives back together. It also is what she likes best about being a clinical social worker.
“I got this really nice note,” she said. “It said ‘One of the things you taught me in therapy is instead of cursing the storm, I learned how to dance in the rain.’ That’s one of the comments that makes my work worthwhile.”
An MSW, clinical social worker and NASW member, Tecala named her Washington, D.C., private practice the Center For Loss and Grief.
“Death or loss is the most common occurrence for all of us,” she said. “I named the center because it describes what I do.”
“Although it seems very limited — loss and grief — it actually is not that limiting. Divorce, illness, trauma and how we deal with it; it’s how we deal with life. I like the idea of helping people rebuild their lives. That’s what my goal is.”
There are more than a half-million social workers in the United States today, and the demand for more social workers is increasing. As the number of those on the job grows, more will likely open private practices. Seasoned clinicians say whether a practice is new or established, and no matter what the focus area or niche is, promoting your practice is an ongoing task.
There were 649,300 social workers in the United States in 2014, and even more social workers will be needed in the 10-year period from 2014 to 2024, according to the Occupational Outlook Handbook, 2016-2017 Edition, which was released in December by the U.S. Department of Labor’s Bureau of Labor Statistics.
“Overall, job prospects should be good, particularly so for candidates with a master’s degree and licensure,” the handbook states.
Social worker employment overall is projected to grow 12 percent from 2014 to 2024, which is faster than the average for all occupations. During that same time period, employment of child, family and school social workers is projected to grow 6 percent, about the average for all occupations; employment of health care social workers should grow by 19 percent; and the projected growth for mental health and substance abuse social workers also is 19 percent, according to the BLS handbook.
The Bureau of Labor Statistics does not have a breakdown for clinical social workers, said Sean Martin, an economist in the BLS employment projections group. The data is gathered from two surveys. National employment statistics are released every year, and new Outlook Handbooks are published every two years, he said.
Additional BLS data on social workers can be found at www.bls.gov/ooh/community-and-social-service/social-workers.
The Association of Social Work Boards also did not have a breakdown for clinical social workers, but did say 18,265 clinical examinations were taken in 2015, up from 10,803 exams in 2013.
Prior to going into private practice, social workers must obtain two years of postgraduate supervised experience in a clinical setting and obtain a clinical license in the state(s) in which they plan to practice. This requirement helps prepare clinical social workers for many challenging situations they may encounter in private practice.
Experienced clinical social workers say this supervised experience also provides the opportunity to begin building relationships with colleagues, providers and clients — all of whom can become important to marketing a private practice. And, it’s during the supervised work period that many find their niche, which could alter some promotional campaigns.
Tecala began her social work career at Georgetown University Hospital, where she found her niche while helping cancer patients.
“I became very interested because some people do very well with it, and some people don’t,” she said. “There’s some psychological component, I think, that has a lot to do with a person’s ability to deal with the grief.”
Tecala stayed at the hospital for 10 years.
“You need to have experience,” she said. “You need to have supervision to prepare to go into private practice. It’s not such an easy thing to do. All of a sudden, you’re responsible for this person or this family. You sink or swim.”
“You have to be really skilled with tools as a clinician, because that’s what matters most. If you don’t know how to help people, your practice isn’t going anywhere.”
Tecala built her practice by speaking about her niche.
“I spoke to groups, churches, organizations, anybody who wanted to learn about grief and loss,” she said. “It’s probably the best marketing tool I ever developed. I still speak.”
She also does interviews with radio stations and newspapers.
“That gives me visibility,” Tecala said. “Whenever I give a lecture, I bring brochures or business cards.”
NASW-California member Paul Royer, LCSW, specializes in behavioral analysis in his Pasadena, Calif., private practice. He works primarily with adolescents, young adults and their families and focuses on mood disorders, substance dependence and struggles with ego formation and development.
After Royer completed his initial degree in educational psychology from Cornell University, he decided he wanted to work in the mental health field with at-risk teens. That was his focus through graduate school.
“I knew that was a fit for me,” Royer said.
He worked for three years at a residential home for troubled preteen boys, which he said was a good opportunity because working under supervision allowed him to develop the skills to work with that population.
“You really work in a collegial atmosphere,” Royer said. “It’s a learning process: you learn from your peers. If you do it long enough, you have an understanding of diverse populations.”
He then worked in the adolescent unit of a psychiatric hospital for seven years.
“I personally believe working in a hospital setting is really beneficial when you’re coming out of grad school,” Royer said. “It allows you to see the different kinds of problems people struggle with. You’re around lots of other people, whether psychologists, doctors or nurses, who see things from another perspective.”
It also establishes relationships with other professionals who begin to see you as a competent professional, he said. “In my opinion, that’s the most essential piece.”
Besides adding skills, understanding and confidence, it gives you time to decide if opening a private practice is really what you want to do, he said.
“Opening a private practice is a very, very complex thing,” Royer said. “You have to develop a very strong structure. Are you going to have a staff? How will you organize your paperwork, do billing, organize and store your notes?”
“There are a lot of pieces to the business of being in private practice, because it’s not just sitting down with a patient,” he added. “It’s not that easy.”
Royer uses community education to promote his practice, including speaking to PTAs about topics like how to communicate effectively with teenagers, providing panels with teachers on how to deal with students, and speaking about prevention strategies.
“Once you decide what population you want to work with, it’s really, really, really important to get connected to the other people who are interfacing with that population,” he said. “I connect with high schools, administrators, teachers. When they see kids at risk, my name is one of the things that pops into their heads.”
Royer said that serves a dual purpose: it provides education and prevention processes, and it allows him to market himself.
“The number one, most important thing to a successful private practice is getting to know other professionals out there in the community who are working with the population,” he said. “Ask yourself, ‘Where are my clients going?’”
“I’ve gotten myself out there,” he said. “Going in and offering to be part of the program gives me a good opportunity so when something comes up, they’ll send them to me.”
Carol Seacord believes a social work graduate should do two things before going into private practice: “Work in the trenches for a while” and undergo therapy themselves “to work on your own issues that might get in the way of therapy issues.”
Seacord, LMSW, ACSW, BCD and an NASW-Michigan member, graduated with an MSW in 1981. She had prior counseling experience that started in 1975. After graduation, she worked in a mental health setting from 1981 to 1986, started a part-time private practice where she worked from 1986 to 1989, then joined a group of colleagues who she worked with full time for 15 years before beginning her solo private practice in Ada, Mich., in 2004.
She handled managed-care cases in the mid-1980s, working with teenagers and eating disorders, and then joined managed-care panels.
“That offered me the opportunity to get many referrals over the years,” Seacord said.
She also worked with Employee Assistance Programs, which offer shorter-term sessions.
“The thing I liked about that is it offered me diversity within short-term therapy,” Seacord said. “When I started with the panels, I built a relationship with a lot of insurance companies. That’s why I’ve never had to market my practice. It’s kind of nice.”
Seacord does have a website, which she says she does absolutely nothing to, and she texts with patients who like doing that. It does require getting written and signed permission.
“Joining all the panels got me name recognition doing long-term and short-term therapy,” she said. “I’ve moved away from that particular specialty. The last few years I’ve focused on the overall wellness of a person, both physical and mental.”
She became a Certified Master Forensic Social Worker, a skill she said she has not yet fully utilized, and she completed various training programs, including life coaching and hypnotherapy.
“I use a more integrated mental health approach, so I apply a lot of different techniques,” Seacord said.
She also became involved with NASW on a volunteer basis for about 17 years.
“That gave me a wonderful exposure to many facets of the profession,” Seacord said. “The biggest part of marketing is exposure. Wherever you go, you pass your card out. Exposure is so important.”
When NASW member Doris Tomer was in graduate school and wrote a paper on eating disorders, she had no idea it would become a niche in her practice — or that it would hand her practice some valuable publicity.
“I came to work at a women’s college, where I saw the whole spectrum of eating disorders,” she said. “That got me more interested in it. It seemed like it was pretty much a women’s issue, and I was working in a women’s environment. I kind of fell into it.”
Tomer, CSW, LCSD, ACSW, BCD and a private-practice therapist in Troy, N.Y., said she now sees the issue in a broader perspective — how it changed over time.
“For some, eating disorders can turn into rather serious — and in some cases — life-threatening cases,” she said. “It often happens during times of stress. A person is more vulnerable then.”
Tomer worked in the mental health center of a hospital for three years before going into private practice in 1992.
But she said it was when she was teaching a course on eating disorders that her forte in the area really sprang to life.
“A TV station did a story on it, and a newspaper wrote an article about it,” Tomer said. “These were things I did not actively go after. For me, personally, word-of-mouth is one of the best ways to promote your practice.”
She still relies on word-of-mouth as well as physician referrals.
Tomer gives speeches to support groups, in high schools and to PTAs.
“I volunteer my services in those ways that get me out in the community,” she said.
The only ad Tomer has used is a listing in “Psychology Today” because, she said, people often find you in a number of ways.
“I think things are different for a practitioner now,” she said. “With all the technology, people like to check you out before they contact you. One person called and said ‘I picked you because you have kind eyes.’”
“I think the consumer these days is a little more active about what they want — a female, a male, someone who’s not too young or too old. It’s kind of a changed market in that way. In the past, somebody’s doctor would say ‘You need to see a therapist. Here are three names.’”
NASW-member Lynne Spevack, LCSW, is a therapist and practice-building consultant who conducts workshops, does personal consultations and chairs a committee of the NASW New York City Chapter’s private practitioners group.
“My therapy approach is eclectic,” she said.
Spevack uses a nonmedical approach that she refers to as “biologically informed therapy to improve mood, reduce anxiety and help borderline personality disorder and (obsessive-compulsive) disorder.”
That began with treating people who were experiencing the winter blues, which also uses biologically informed therapy, or chronotherapy, she said.
“It treats the mismatch between our lifestyles and what our bodies were formed for: We’re too sedentary and we spend too much time indoors,” Spevack said. “It’s an approach to help people feel better, calmer, sharper. It’s a big passion of mine.”
She also employs cognitive therapy and is known as a “therapist’s therapist.”
“That came about kind of organically,” Spevack said. “I began doing workshops about things I’m really passionate about and also was running the private practitioners group monthly meetings.”
“That put me in front of a lot of people. It gave people a taste of who I am. And some sought me out as a therapist.”
Spevack worked for agencies for seven years, including two years of institute training, and began a part-time private practice by working evenings and weekends while working full-time at the agency.
She recommends several years of supervised training before considering launching a solo private practice because “it’s a big responsibility to be working independently.”
“One litmus test is whether they’re prepared to handle emergency situations themselves without having a supervisor to call or a colleague down the hall,” Spevack said. “If you’re in a session with a client who’s on the verge of homicide or suicide or you see child abuse or elder abuse, you have to make that decision right now.”
Even if you screen clients, she said, you are going to have emergencies, “and you’d better be prepared to deal with it.”
When working with others to promote their practices, Spevack said she’s found one common problem.
“What I find that’s the biggest problem clinicians have is, it’s scatter shot,” she said. “They’re putting the cart before the horse; they don’t have a strategy.”
“Private practice is a business. You have to come up with a strategy. Consider your passions, needs, skills and strengths and the needs and interests of your clients,” Spevack said, then you need a unique selling proposition.
“First, ask yourself what distinguishes my practice from everybody else’s,” she said. “Second, what is your unique selling proposition? What is your niche? Do you have weekend hours? What methods do you use? Are you in an underserved location?”
Next, research your plan to see if it’s viable, and translate it into what Spevack calls the “elevator introduction.”
With the elevator introduction, she said, avoid jargon, state what the problem is, then state what the benefit is.
Take seasonal affective disorder as an example.
“First, to the general public, avoid jargon and call it the winter blues,” Spevack said. “Second, the problem statement: About half the people in New York suffer from winter blues. Third, the benefit: What I do is help people learn approaches so they can feel better. That’s an elevator introduction.”
Once you’ve done that, use strategy development as you move into market approaches, she said.
“That might be a combination of the traditional newspaper ads, workshops and writing, networking and use of the Internet and online directory listings,” Spevack said. “The mistake a lot of people make is they don’t use strategy to develop a unique proposition.”
And clinicians need to remember one thing about marketing a private practice, she said, marketing is an ongoing activity.
“You’re never done,” Spevack said. “It is integrated with whatever you do.”
She uses a combination of traditional methods: workshops; writings; tours — she does tours of the nearby Brooklyn Botanical Garden; some Internet marketing like LinkedIn, a Psychology Today ad and her winter blues website. Social media, generally, is not a good way to market a private practice, she said.
“A combination is what I recommend,” Spevack said. “But it’s whatever that particular practice needs. When you’re establishing a practice, use the same steps; have a strategy; use the clinicians needs, skills and strengths; consider the needs of the public; research a strategy; market the strategy.”
Seacord believes one of the biggest challenges for those in her field is compassion fatigue.
“Pay attention to your own ability to be compassionate and the toll it takes on you,” she said. “You have to be able to nurture your compassion.”
But, she said she has had plenty of rewarding moments, like when she sees the light bulb go on.
“That’s one of my favorite things to see,” Seacord said. “I love when someone comes to me and we sit down for an hour and they say they’ve seen another therapist for a year and a half and I’ve been able to touch something the other therapist has been unable to touch. That’s so rewarding.”
She is not alone in finding such satisfaction in her work.
After decades as a social worker in private practice, Tecala, who was named an NASW Social Work Pioneer® in 2004 by the NASW Foundation, is content with the direction her career has led her.
“I started private practice when private practice was an unknown territory for clinical social workers,” she said. “I chose the road less traveled, as Robert Frost says, and that has made all the difference.”
NASW resources for clinical social workers
• 2017 new Website, visit the Private Practice section and Clinical Social Work section for more tools.
• “Clinical Social Workers in Private Practice: A Resource Guide” can be purchased at naswpress.org
• A March 2014 NASW News article on changes in the claims and reimbursement processes for clinical social workers. See the Archives.