Q: I am interested in a cost-effective way to market/expand my private practice. I have a small practice and an even smaller referral base.

A: Several marketing strategies can be found on the American Counseling Association website by clicking on “Private Practice Pointers” (www.counseling.org/

Counselors/). We’ll cite one here that we developed as a method to build or expand a good referral base.

Every client offers a potential opportunity to expand your practice. The obvious way is for a satisfied client to recommend you to others. Another way to expand your practice is through what we call “cross-pollination.” Just as it is beneficial for plants to share pollen, it is beneficial for a therapist to share information. This is done, of course, with all requirements being met for release of information.

At the first appointment, clients are given a client’s rights document to review, and then they sign a release. With this release is a coordination of treatment document (see Chapter 2, “Office Procedures,” in our book, The Complete Guide to Private Practice for Licensed Mental Health Professionals). This document asks clients to allow you to contact their primary care physician because coordination of treatment is mandated by managed care and insurance companies. An example of a release of information is also in our book. Both of these are important professional and ethical responsibilities, but they are also conduits to help market your practice.

When the referral is from a physician, a thank you letter, along with your well-written brochure or business card, is sent along with basic clinical information for the patient’s chart. A follow-up call to discuss the client is not only beneficial for coordination of treatment but also gives the physician an opportunity to see that you are a good therapist. Also take opportunities to drop off fruit or lunch to the hard-working staff. You’ll be on their minds the next time one of their patients needs a referral to a therapist.

Conversely, if a client is a student who has an educational issue, it is an excellent idea to call the counselor, social worker or special education coordinator at the school to ask for input in your treatment planning. I even ask the family to invite me to the student’s individual education plan (IEP) meeting or annual review. I act as an observer at these meetings, giving input only when asked. I am almost always welcomed to leave my card or brochure.

Schools look for competent therapists when they wish to refer outside the district. Most schools have a list of good therapists, and you want to be on that list. Introducing yourself to the schools in this way also puts you in position to request to serve as a speaker at teacher institutes, PTA meetings, district parent education fairs and so on. I’ve even been asked to keynote the beginning-of-the-year teacher gathering and have had teachers from these districts contact me for personal and marital counseling.

If a school refers a student with medical issues and the family has signed the coordination of treatment document, it is wise to contact the physician with a letter or call. This is a courtesy contact to let the doctor know how you are helping the patient with attention deficit disorder, anxiety or other mental health issues.

If your niche is working with adults, obtain client permission to contact their gynecologist or other specialist for coordination of treatment as stated above. The fear that we are irritating the doctor is usually unfounded. Doctors spend about seven minutes with patients on  average, and most M.D.s welcome a therapist ally. When the doctor has another patient who needs a therapist, you — the competent professional — will come to mind.

Also make use of “cross-pollination” when you have a referral from a friend of the client or a managed care company. Managed care companies require coordination of treatment, so make sure you coordinate with physicians, schools and even lawyers if it is appropriate. Remember that professional ethics require that you first obtain a client release.

Of course, the goal of marketing is to help people as well as build your practice. One of the most encouraging comments I ever received from a new client: “I got your name from a friend, and the next day my doctor gave me your card. That is why I called you first.”

Q: I am in need of some guidance about leaving a group counseling practice to start my own individual counseling practice. I have no contract or noncompete clause. I plan on offering my current clients the option of transitioning with me, and I think most will choose this option. Can I copy the client records and take them with me? Is it ethical/legal to start new charts at my new practice even though old notes, intake forms and face sheets will be in the charts at the practice I will be leaving?

A: The only person who should give you legal advice is an attorney. If you do not have an attorney, try calling your malpractice insurance company. Most will have an attorney who can give general advice or direct you to an appropriate resource.

Common sense says to approach the owner or managing partner of the group practice and try to work out the parameters of your departure from the practice by discussing what’s in the best interests of the clients. No one wants upset clients or a potential lawsuit. It is in the best interests of both you and the group practice to part amicably, especially if you are in the same geographical area. While this may produce anxiety, it is best to try and negotiate first rather than after a problem arises.

In any event, whether or not you can copy the old records, you should set up a new chart for each client at your new practice. The client needs to know your new practice’s policies and procedures. All the practice forms (informed consent, consent to treat, HIPAA client rights and disclosure forms, etc.) need to contain your and your practice’s identifying data. Moreover, you can have each patient sign a release of information to the old practice to obtain the records.

This question, as well as others about joining, forming or structuring group practices, gives rise to yet another: “What am I getting into, and what happens if I leave (or am asked to leave)?” With potential partners, it is better to have a clear understanding of all that is expected on the front end rather than at the end.

Robert J. Walsh and Norman C. Dasenbrook are co-authors of The Complete Guide to Private Practice for Licensed Mental Health Professionals (www.counseling-privatepractice.com). ACA members can e-mail their questions to walshgasp@aol.com and access a series of bulletins on various private practice topics on the ACA website at www.counseling.org.

Letters to the editor: ct@counseling.org