Promotion is an art and a science, a gamble, and a moving target. Few things about building a practice perplex people more than promoting it. In this column, I dispense with style and cram as much advice as I can into 1000 words. Enjoy!

Be a Disciplined Advertiser

Never take a “big blind swing” with advertising. Invest only where you can test advertising effectiveness without blowing your budget. You never want to be in a place where you “need” any one advertising campaign to work. Most advertising won’t produce a positive ROI (return on investment). That said, once you find an outlet does produce a positive ROI consider an increase in your investment with that outlet.

Ad Salespeople Are Not Your Friends

Logic would suggest that people who sell ads want you to be successful so that they can foster a long term, mutually beneficial, relationship. In my experience, persons selling ads are looking for a quick sale. Be very careful. Remember that you’re the one spending money and you have power when negotiating for exposure. Some media (such as magazine and radio) are desperate for advertisers—so negotiate hard on price and terms.

Offline Promotion and Marketing

Professional Networking

For those who do it well, nothing compares with the results one can receive through good “old fashioned” networking. However, networking isn’t easy, and while you’re not spending many dollars, you’re spending lots of valuable time. The president of Business Networking International recommends a minimum of 6.5 hours a week for networking success. If you’re not interested in putting in those hours, at least initially, networking might not be right for you.

Unlike advertising, networking isn’t about exposure—it’s about relationships. Here’s how it works. Say you want to grow a child therapy practice. You might visit a pediatrician’s office, introduce yourself and offer to bring breakfast the next week. Then, at breakfast, you give a 3-minute presentation and shake some hands. Later, you drop off some literature. Then, you host a lunch. Then, you drop off more information. Over many visits a relationship builds. Finally, when they need to refer a child to counseling, guess who they think of?


Print advertising is usually overpriced, and often too expensive for small businesses. To test the waters in print, you’ll want to advertise for 6-months in a monthly publication, or 6-weeks in a weekly publication. Usually, advertisers lose money and additional tweaking and testing is needed.

Direct Mail

People today open their mail over the garbage. If you decide to try direct mail, focus on potential referral sources, not potential clients. Mail churches if you offer Christian counseling. Make an offer they can’t refuse in your literature. Consider calling everyone in advance to let them know your mail is coming.


One challenge with radio and TV is that the audience range is very wide. Generally, people want to find a counselor within a few miles of their home or work, and a small station might have a 50-mile radius. Hence, most people watching or hearing your ad aren’t even in your market. Also, before you spend a penny listen to “Advertising in America: What Works, What Doesn’t, and Why” By Roy H. Williams.


Every billboard is a one-second reminder. Billboards work best when persons already have a perceived need and exposure to your brand (i.e., I’m hungry. I see Big Mac.). There’s little time when driving 45 miles an hour to learn about your counseling services. You might see thousands of cars pass by, but you’re unlikely to get thousands of calls.

Public Relations (PR)

Advertising is paid for, PR is prayed for. Getting a mention in the paper, on the evening news, or anywhere in media can help to build you brand. “As featured in” mentions help potential clients see that you’re a step above your competition. That said, don’t expect a spike of calls after a media event. Last month, my company was featured on The Doctors. The phones didn’t ring any faster (but the logo sure looks good in the “as featured in” section of our website).

Online Promotion and Marketing

There are many important things that go into good online promotion. I can only mention a few here.

Google/Bing /Yelp Ads

Google and Bing sell ads by auction, and prices can climb fast. To keep them under control, be conservative with (1) your daily budget, (2) ad radius, and (3) the words you bid for. Regarding the later, if you bid for “depression” you’re bidding against every pharma company that’s promoting their antidepressant. Instead, bid for the more specific term “depression counseling.” Yelp might be more expensive than Google and Bing, but Yelp is also at the very bottom of the sales funnel; meaning that people go to Yelp for one reason—to buy.


To rank on the first page of Google or Bing, one important thing to consider is backlinks.

Backlinks continue to be an important factor that Google/Bing use identify one site’s value relative to another. Earn quality backlinks from reputable sources: From a non-profit you’ve donated time to, from a school you gave a scholarship to, from your local news station’s website after they’ve quoted you, or from a dentist in town after you wrote an article for her website titled, “3 Tips for Overcoming Your Fear of Seeing the Dentist.”


Online reviews aren’t just for restaurants. Potential counseling clients are reading online reviews to determine what counselor could be a good fit. Check the ACA Code of Ethics and the review guidelines of Facebook, Yelp, and Google, and then consider what you can do within the rules to achieve the coveted 5-stars your practice deserves.

A Moving Target

Promotion is a moving target. What works in some areas won’t work in others; and what works today might not work tomorrow. Remember, it wasn’t long ago that a half-page ad in the yellow pages was a must. Lastly, trust your gut. My experience might not be yours. Prove me wrong, and tell me when you do on Twitter @Thriveworks. And good luck!