The therapist marketing playbook has changed - has yours?

Five plus years ago, you could build a thriving private practice by creating a directory profile, attending a few networking events, and simply being available. For many clinicians, that was enough. It isn't anymore.

The field has changed, and your marketing needs to change with it.

When I started in private practice in 2020, things were pretty straightforward. I remember throwing a bio up on a directory—we all know the one—networking with a few physicians and providers in the community, and within months I was full with a waiting list.

A lot has changed since then.

What Changed?

It started, of course, with the pandemic. The expansion of telehealth and legislation that made it more accessible opened the door for a significant increase in private practices. Suddenly, geographic and financial barriers mattered less, and more clinicians were able to start practices than ever before.

Around the same time, at least here in Massachusetts, insurance companies began allowing supervisory billing to help meet the growing demand for therapists. As society reopened, the demand for therapy leveled out somewhat, but the number of clinicians entering private practice continued to rise.

Part of that is the increasing emphasis on private practice as a career path in graduate programs. Many of us have been there—we're taught about the freedom, flexibility, and autonomy that private practice can offer. Those are all real benefits, but they also mean more clinicians are entering an already competitive market.

Then came the venture capital-backed companies. I'll save my full thoughts on those for another post, but the reality is that they have marketing budgets that most solo or group practices simply can't compete with. Whether it's through investor funding or subscription-based revenue models, they have resources to consistently put themselves in front of potential clients.

None of these factors, on their own, explain why clinicians talk about a "decrease in referrals." They're all pieces of the same puzzle.

In fact, I don't think the biggest challenge is actually a decrease in referrals. Many practices—including my own—still maintain waiting lists.

The challenge is that the marketing strategies many of us are using haven't changed, even though the landscape has.

Why the Old Marketing Doesn't Work

For years, the formula was simple.

Start with a question like, "Are you depressed?" or "Are you struggling to get out of bed in the morning?" Add a list of modalities using acronyms that most clients don't understand—CBT, DBT, ACT, ERP—and finish with a paragraph about your clinical experience and an invitation to schedule a free consultation.

Sound familiar?

The funny thing is, we all borrowed it from someone else's website, who probably borrowed it from someone else's. Before long, every therapist website started sounding the same. At times, they almost read like an SSRI commercial script, and many still do.

Historically, that worked because it was a clinician's market. In places like Boston, many therapists were out of network, and clients were often just looking for someone who had availability. Being listed was enough.

Today, clients have more choices. More clinicians are accepting insurance (especially with the venture capital companies doing the heavy admin lift). More practices are competing for the same referrals. Clients aren't just asking, "Who's available?" They're asking, "Who feels like the right fit?"

Good therapy has never stopped mattering. Word of mouth is still incredibly powerful. Referrals still happen every day. What has changed is that people have more options than they did five years ago. Being an excellent clinician is still necessary—but it isn't always enough for someone to find you.

What Works Instead

The first step is identifying your niche.

If you already have one, great. If not, it's often easier to figure out than you think.

Ask yourself: Who are the clients you genuinely enjoy working with? Which sessions leave you feeling energized? What kinds of problems are you most passionate about helping solve?

Once you know the answer, write your bio for that person.

Most therapists write bios as if they are looking to impress other therapists. Clients don't care that you're Level II trained in a particular modality if they don't first feel understood. Before someone wants to know how you help, they want to know whether you understand what they're experiencing.

Speak to them in plain English.

Remember, when they sit across from you each week, you won't be reading them your résumé or listing your certifications. You'll be building a relationship by helping them feel seen and understood. Your marketing should do the same.

The added benefit is that having a niche naturally differentiates you from other clinicians. We all have different strengths, and when you're known for something specific, you become the person people think of for that issue. It also makes it easier to build genuine referral relationships. Instead of competing for every client, you can confidently refer to colleagues when someone falls outside your expertise, and they'll be more likely to do the same for you.

People Connect With People

The other thing I recommend is a little bit of appropriate self-disclosure.

That doesn't mean sharing your life story, and everyone has a different comfort level.

For example, I once had a consultation with a provider whose bio openly discussed surviving childhood trauma. Personally, I realized that wasn't the right fit for me because I prefer not to know much about my therapist before we meet.

On the end of the spectrum, I've also noticed that providers on my team who are initially a bit more closed off don’t receive as many referrals as those who even share a little about themselves, such as a pet they have or their hobbies. People feel like they already know them. That sense of connection starts before the first session. Or even more so before the consultation call.

Self-disclosure isn't the only way to create that connection, but authenticity matters. Clients are looking for someone they can trust, not just someone with impressive credentials.

The Bottom Line

The client well hasn't dried up.

While I have strong opinions about venture capital-backed companies, I don't think it's accurate to say they're single-handedly taking all the clients away. The demand for therapy is still there, and great clinicians are still building thriving practices.

What has changed is how clients make decisions.

Ten years ago, many clients were simply looking for availability. Today, they're looking for connection.

The practices that continue to thrive aren't necessarily the ones with the fanciest websites or the biggest marketing budgets. They're the ones that have adapted their message to today's clients instead of relying on yesterday's marketing playbook.

If your marketing still looks the way it did before 2020, it may be time to ask yourself a simple question:

Has your marketing evolved as much as the profession has?