Cognitive Biblical
Therapy Coursework
Counseling Through God’s
Transformative Word
Course 6 Chapter 5
Chapter 5 Opening the Practice
a. The name of the counseling practice.
b. Advertising
c. Secretarial support.
d. Referral network.
e. Networking with other professionals
f. Public relations work.
Essay Questions: Answering the section questions (red buttons) is a great way to prepare for the end of the Chapter Quiz. Chapter 5 questions will help you review the text material and apply to your present or future counseling setting. The section questions will provide Dr. Wilkinson’s feedback to your answers.
Quiz Requirement: At the end of the Chapter, a score of 75% is necessary on the Chapter Quiz in order to access the next chapter.
Account Access: You must be logged into the coursework page to take the quiz and advance.
Course 6 Chapter 5
Opening Your Private Practice
Counseling Practice Name
We just completed the first part of the business aspects of a private practice, where I discussed with you the needs for a business team, finding a location, issues of the office set up, financial accounting and marketing. And this is the next step, actually opening the counseling practice. These concerns are more related to the actual daily operations of your counseling practice. Some of these steps need to be done before you are literally legal to open your practice.
The first step is the name of your counseling practice, which will have some legal ramifications. For example, state laws will mandate that you register the name of the practice. Often your legal name will be connected to your practice name through what is called your practice’s fictitious name (doing business as or assumed name). The state will know that Dan Wilkinson is working under the name of the Biblical Christian Counseling Center, Incorporated. The office of the Secretary of State (county clerk in some states) will work with you to register the name you have chosen. They will search (can also search online) to see if any other business in the state has that name. You may need to revise your chosen name a bit. Once your business is legal in your state, you have to get a federal and state tax identification number. If you choose to be a sole proprietor, your personal social security number can be linked to your factious name, and you can legally receive fees from clients. Though if you choose your company name to be a Limited Liability Corporation (LLC) or be incorporated you can reach out to the Secretary of State in your state or go through the IRS to get your federal tax number. All of your business income tax will be paid into that federal tax ID numbers account. Those periodic tax payments will be used to calculate what business tax you owe at the end of the year. Your business name also represents the conceptual foundation for your ministry. I wanted mine based on the Bible, hence Biblical, and the basic belief system was Christian. Different religions have more books of the Bible that are unrelated to the 66 books of the present Bible. Your counseling practice name needs to present what you are offering to the public, so that they know the type of counseling to expect.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
One of your considerations in opening your practice will be the name that you choose for it. There will be other considerations such as the fictitious name registration of the practice and other such business-oriented issues. Discuss some of these and how you plan to deal with them as you prepare to open your practice from a business perspective.
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
State laws will in general require that the counseling practice be identified through registration with an individual. The name chosen will be the fictitious name, and the one who owns the business will then be named on the registration of the business name.
This is necessary for tax purposes, which will include such things as income tax -- both state and federal -- or corporate income tax if appropriate. The name also represents the focus of intent of the counseling practice.
Managing a Caseload
Now, when you actually get to open your practice, some of these next steps are absolutely necessary. Earlier, we discussed marketing and building a client referral base. You should have your printed materials or your online media accounts ready once your name is approved by the Secretary of State. Ask God to help you find the resources to fulfill your office and client needs. If you practice at a church or parachurch organization, consider developing relationships with volunteers who may be able to help you and your client.
Another idea is the option of secretarial support. Over some time and when you progress towards a functioning full-time practice, finding some minimum support allows you to spend more time being a professional, either counseling, speaking, holding seminars, etc. For example, my secretary was sick for two solid weeks, which meant I had to pick up doing her work. Even though she worked part time, my task hours jumped up 20 hours a week outside of counseling. If you are doing your own office tasks, you will need to set your caseload accordingly. For example, you take 15 cases per week and monitor how much time it takes for you to support that many people. You will have new clients to begin with, many forms to review, older clients who may need to have invoices prepared, or communications with family members. Phone calls and scheduling will take quite a bit of time. You may need to make copies of materials for your clients. For those 15 cases you will see how your caseload has a spillover effect, which translates into time. So, you're either going to have to limit your caseload to some degree or make arrangements for some sort of volunteer support staff, or even family or friends. Perhaps the secretarial staff at the facility where your office is located will be able to help out.
Understand that the actual daily running of the caseloads and your practice doesn’t stop. If you make the extension of yourself to a client, you enter into an agreement to counsel through the problem, and the needs they have must be met, and often are not controllable. They are going to be there for their sessions. You're going to have to take case notes and take time to score their assessments in preparation for their next session. You may have to network them to another professional. All kinds of things are going to happen that you'll become familiar with, but each one demands time. As a counselor you are in a losing position at times, financially and/or when they are in crisis. Every client multiplies the time for supportive tasks. Having the practice open is different from the setup, and requires you to have made preparations for the demands. You must monitor them as you go, so that you don't end up working 80-90 hours per week, never seeing friends or family, and constantly exhausted.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
An efficient secretary is crucial to your practice. Discuss the different options that are available to you in this area and which one or ones you may choose for your ministry.
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
A counselor can utilize volunteer secretarial support, utilize the secretarial support at whatever facility the office is established in, or hire someone either part or full time. Volunteer help can be useful but unpredictable, as this help is given as one priority among many. Utilizing the secretarial support of the host facility will mean that the host facility usually receives priority treatment unless a previous arrangement has been worked out.
Hiring a secretary is the best solution. Part-time help, though, can mean that work is not a first priority -- attending college or family may come first -- or that the full-time cost of a secretary is a high expense item and not necessarily affordable in a smaller private practice.
Building a Network of Providers
In order to have a functional practice, you need to have established a good referral network made up of medical and legal professionals. When clients need skilled help that you don’t have, whether it is medical, psychologists, legal or financial. This is the only way that you can competently help your client find answers to these specific problems. Your referral network, in other words, provides additional services when your client needs them. Your ability to provide this for your client is part of what makes you credible. These professionals will also distribute your name and your practice to other professionals who can refer clients to you in the future. It's essential that you have a good network, so that you have a solid reputation for meeting your client's needs, both in the pure spiritual realm and in the secular realm.
I found that one of the easiest ways to do set up a referral network is to simply contact people in these different areas. You need to be very straightforward and honest in telling them what you need and who you are. I have called probably a dozen psychiatrists over the years at least, and said, “I'm Dan Wilkinson. I have a professional counseling practice. It's based on Biblical principles that are based on the Christian beliefs. What is your opinion about that type of counseling? Are you open to working with me on a referral basis, in which you will give me access to your opinions, your reports, your records, and discuss with me the facets of this case so that I can understand both your perspective and relate to you mine when that's appropriate.” I have had to explain my credentials and be willing to undergo the other person's scrutiny, so that they knew that I was ethical and professional. A psychiatrist would use terms that I had to understand, especially when seeing their input on the client’s diagnosis, treatment plan and their recommendations. The result is having access to professional help with clients. I've been given access to psychiatric wards. I've been treated, in essence, as an equal. I've been able to go on wards and provide treatment to clients who were in inpatient treatment at a psychiatric wing or hospital or ward.
I have sent people to attorneys who have called me to talk about legal ramifications for cases. I have been able to ask them questions about cases where I had to testify in court. Do not be afraid to be blunt and upfront, while sounding calm and professional. You must be about your Christian beliefs and Biblical standard, because having a Christ-like professional character works well to help you work with other professionals. This builds credibility, and most of all helps your client get the resources they need. So be honest and prayerful. Question them thoroughly, ask them to check you out, and be prepared for some people to see you as a quack and an idiot, to take offense at your Biblical principles, to doubt your credentials, to even threaten you with investigation for being a religious cult. People, who are your professional colleagues, are going to have their own personal problems with God, and your willingness to be that honest, professional, and open is going to offend them. That doesn't happen all the time, but probably 20% of my inquiries were not those who would support my goals with counseling.
Remember that building your network takes time. You should probably start building this six months before you open your doors. At the minimum, your network should include at least one in each field: psychiatrist, medical doctor, psychologist, lawyer and accountant. You will be able to add to this list as you build your practice. Build a professional relationship, take them to lunch, bring snacks to their office staff, talk to them more than once, and do the things it takes to discern their Spirit. Ask God directly to help you find those who will support you. This will be an additional service to your clients and to your practice.
Now another need is to network with other professionals and helping agencies. Networking isn't the same as a referral, it's much broader, and your contact is less. Your depth is less. When you network to other professionals, you're looking for people and agencies who can provide things such as food, clothing or shelter for battered women. Some contacts or agencies that are able to help clients with utility payments or even free legal advice. You check them out first to see how they deal with people, and the potential help they can offer. Many times, you can't provide as good of a referral as you wish, but with a larger network, you can offer some hope and options. For example, everyone can’t afford a $2,000 retainer to an attorney for a legal action, but a women’s shelter, county victim’s assistance department or legal aid organization may be an option. You can begin building this network through the pastors you meet, other counselors, and your own research online. Try to find ways to meet some of these needs, because they'll have other needs than counseling and they will appreciate your resourcefulness and recommendations. People are going to have needs that amaze you, so the network to other professionals will help you meet them.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
One of the keys to marketing is the establishment, maintenance, and utilization of a referral network. What is the purpose of the network and what does it accomplish in regard to the name recognition and reputation of your practice?
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
The referral network is there to provide additional services when the client has a need that is beyond the counselor's expertise -- such as a physician, lawyer, certified public accountant, or psychiatrist. The ability to provide for all of your client's needs in a professional manner states to the public that the counselor is credible, and also distributes the counselor's name and practice to other professionals who may refer clients in the future.
It is absolutely essential to make sure that the counselor has a good network established so that a solid reputation can be created both within the public and professional communities.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
Networking is another marketing tool which enhances the effectiveness and reputation of your practice. How does networking accomplish this?
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
Networking involves knowing numbers of other professionals or how to get in touch with others who might meet a need for a client. It is not in the same vein as the referral network -- the depth of contact with each professional is less. A network may include professionals or agencies that could provide food, clothing, or shelter.
It may also involve shelters for battered women or contacts for agencies that may be able to help with utility payments during the colder months of the year for those who would otherwise have their utility shut off or restricted in some manner.
Public Relations
The next idea is probably the most critical one and deals with public relations work. And one of the two ideas I had was traveling to meet pastors. The practice that I built was built on contacting churches (see Letter of Introduction form) and extending Biblical counseling to them. But every time you make the contact, you are doing it sort of blindly. You don't know the pastor, you don't know the congregation, you don't know if the pastor just left. You don't know if it's a strong church or a weak church. Maybe it just split. There can be a million different things that happen and the needs of the pastor change quickly sometimes. I contact them every three months, with invitations for me to come to the church to meet the pastor, or for him to come to my office so that we can talk, or go out to lunch. Connecting this way is extending yourself to new people, new pastors which allows you then to find the people who want Biblical counseling, and will refer clients to you. In January each year, I send a letter of introduction stating that I would like to visit him. Your purpose is to introduce yourself and Biblical counseling. As important is discerning the spirit of the pastor by asking questions about his vision for the church, and how you may fit into that vision. It could be his need for a friend, consultation, prayer support, seminars, or someone to share his counseling load. I learned about these needs while being a part of a pastoral team in the first church where I opened up my counseling ministry.
Your support can endear you to the pastor, because their job is very difficult and they work alone, sometimes against opposition. They also struggle to help people grow spiritually. They get responses from people that range from resistance, to indifference, to apathy. They don't have anybody really to talk with or to share their woes with, except other pastors where it is not wise to share a real depth of honesty. When you offer support to that pastor, and you are submissive to God in helping him care for his people, that honesty will make it safe for the pastor to send you clients. Most clients will get help. Those who don't, sometimes carry wild stories back to the pastor as to why. Once you build trust with the pastor, he will be open to hear your side of the story. He will call you and you can talk like friends who care about these people. He can help you understand their patterns, and he stands up for you. He can feel confident to continue to refer people to you, because his trust and confidence remain intact. Send copies of brochures, business cards for him to distribute and any newsletter that you write every three months. Always leave yourself open and vulnerable. You'll always get some responses each time you send out, especially your newsletter in January that introduces your practice.
You need to balance your time seeing pastors with counseling and everything else you do. So, don't run yourself crazy. Make a plan that paces it within your ongoing obligations. Once this base is established with pastors, former clients will begin to refer people. I found pastors will become about 40% of your referral base, while about 60% will come from former clients. It is crucial for regular contact with your referral base. They may lose your card, forget your contact information, or leave to another church.
Another idea for public relations will be providing seminars, speaking engagements and workshops, even though they are less productive as far as referrals, but critical for name recognition. Even two years after holding a seminar, someone called me for help. They are most valuable for name recognition, but they take a lot of time. They're good to do, but you should probably plan how many you're going to do in a year. I have found that four per year can be realistically done. You can also have an open house, invite pastors to a group lunch, speak at meetings of pastors or do “Lunch and Learns”. Take advantage of making connections with pastors and other professionals. What is best depends on your setting and size of your practice.
The last idea is the actual practice of acknowledgments. It takes some time, but it's good to do. Yearly Christmas thank-you cards acknowledge the referrals that were sent that year. Each time you get a referral during the year, you send a letter that says, this person came. Thank you very much for your referral. I'll keep you posted and also update. Sometimes, the pastor will say, call me in a month or so and tell me how they're doing. The only issue here is just time. It takes time to do that sort of thing, and you have to keep some sort of contact list of your referrals to do this.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
The success of the Biblical Christian Counseling Center has been built upon personal contact with pastors and word of mouth referrals from clients. Discuss your understanding of how this type of contact has served as an effective marketing tool and how you could adopt this strategy to your ministry.
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
The target market that built this counseling ministry came from seeking out denominations and pastors that wanted Biblical counseling and would refer others for that kind of counseling. The letter of introduction sent in the original mailer stated that if the pastor wanted a follow-up visit, one would be made. The point of the visit was to introduce the Biblical counseling process, to introduce the counselor to the pastor, to find out the pastor's vision for that particular church, and to see if BCCM, Inc. could be a part of that vision -- through seminars, workshops, case consultations, or counseling referrals.
Once referrals were made, word of mouth referrals became the second source of counseling referrals. These two sources, along with a quarterly newsletter, a yearly letter of introduction, and a business brochure and card, form the strategy. The most essential part is to become part of God's potential plan for the church you are in contact with -- which requires submitting perceptions to God, listening to the pastor's sense of God's guidance, and praying over the interface between the church and the counseling center.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
Seminars, workshops, and speaking engagements all serve to give you better name recognition to the general public. Discuss the effectiveness of this kind of ministry, the cost to you as the speaker, and the balance that you have to seek between your counseling practice and speaking engagements.
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
The effectiveness of seminars and workshops, at least on a small scale, is nominal. The cost to the counselor in terms of time and effort is phenomenal -- in general it is not worth the time, cost, and effort to put on seminars and workshops. There is some value in the name recognition built through workshop exposure, but this is more useful while the practice is being built than after it is established.
The balance to be maintained is between how many workshops a year are presented and how much time is lost from daily counseling and counseling income. In general, if the counselor is going to counsel full time, three or four workshops or seminars a year are about the most that can reasonably be handled.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
One effective tool in building good will between the counselor and other professionals involves holiday and referral acknowledgements. Along with this, updates on a client's progress to the referring individual are also effective in building trust and confidence. Comment upon this and suggest a few ways in which you could realistically integrate this procedure into your counseling practice.
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
An initial letter of referral acknowledgement can be sent in a form letter by the counselor through a secretary or some form of office help. This helps the referring individual to know that the referral contact has been made and that counseling has begun. It also helps the referring individual to know that the client is receiving help, and that he or she can support the effort through local contact at church or through whatever the relationship may be.
Running the Practice
From managing your caseload, networking with professionals/resources and public relations, we now move to the “Running the Practice” section of Course Six. You may have taken this course to learn the nuts and bolts of a counseling practice, though now may be feeling overwhelmed by all the intricacies, nuances and expectations for your practice. Many of us who entered the field of counseling or a counseling ministry, we just wanted to help people, not run a business. If you have not had any experience in running a business, you will soon find out the freedom you have to counsel when you do the hard work. The operational structure of a counseling practice/ministry provides, protects and sustains your ability to independently counsel others as a professional, a pastor, a new practitioner or as a lay leader. Even if you practice under an agency, a church, or a parachurch organization, it is best to be well informed or handle the day to day operations of running your practice.
Fee Collection
Now the first step in running your practice is fee collection and billing. We will cover insurance, payments, taxes, business cards, monthly evaluation, tracking the practice through statistics in the next several chapters. This step of fee collection holds a great deal of significance that can be impacted from any underlying insecurity, shame or distorted ministry expectations that can be destructive financially. If you choose to ignore it, you will find the unsettled feelings will be burdensome in regard to outstanding fees owed. You will realize how much of your time and emotional energy is spent by ongoing follow up of fee collection.
Let’s discuss how collecting counseling fees can cause a sense of embarrassment when you are discussing the cost of counseling, collecting the payment at the end of a session or following up on an outstanding bill. The embarrassment or uneasy emotions can come from feeling inadequate or inferior. If you are not able to collect enough fees to support yourself you can feel stupid, like you've been duped, frustrated like people used you, or you are not good enough or smart enough to be paid more. You may feel that you really weren’t called to counsel. You can’t believe this call is for you and your family to starve to death. There can be many issues tied up there. Being destructive financially has to be avoided by being realistic about what your personal financial needs are. How many hours can you work without destroying your health, marriage and family? What percentage of cases should you have as “pro bono” as your gift back to God? I have a sense of wanting to pay the Lord back just out of gratitude for the good life I have, the redemption I've experienced, and the maturity I'm going through.
There are many issues to think about, and uncollected fees can be burdensome in one way, but just processing payments each week takes time. When I first started to counsel and collect payment, I never developed a system for even keeping track of unpaid fees. Because of this error, I estimate that I lost somewhere around $14,000 in the first years of my practice. I was more concerned about helping people than I was about my survival as a counselor. People owed me money. I didn't bill them. They slipped through the cracks, and I lost the income permanently. That is one part of the burdensome side of it. The other side is the time it takes each week to use the accounting system to process your fee payments. The larger your practice grows, the more difficult it becomes to keep track of all those issues, income per week, billing, client statements. Your accounting system must be able to process those fees and billing, produce reports and all of that takes time that is in addition to your counseling time.
Copyright 1987, 1990, 1993 by Daniel D. Wilkinson. All rights reserved. For more information concerning this material, write to:
The Biblical Christian Counseling Ministries, Inc., 2730 Radcliffe Dr., Florissant, MO 63031.
Any reproduction of this material without the express written consent of the author is prohibited. Printed in the U.S.A..
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
Collecting and billing the client for fees can create a sense of embarrassment within the counselor, be destructive financially if not dealt with consistently, and become burdensome in regard to outstanding fees owed. Discuss where this sense of embarrassment comes from, how it is overcome, methods of fee collection, and what percentage of the counselor's income should consist of uncollected fees.
Pasting is disabled for this answer box. Please type your answer in your own words.
Dr. Dan's Answer:
The sense of embarrassment can come from low self-esteem, a lack of knowledge in how to ask for payment, from intimidation by the client, or from an overly acute desire to help others at the cost of personal well-being. The destructiveness comes from operating a business that does not take in enough income to meet operating expenses.
No more than ten percent (10%) of the counselor's income should ultimately consist of uncollected fees -- this should include gratis counseling sessions. The sense of embarrassment is overcome by time, having a policy for fee payments, and a policy for unpaid sessions (no more than one unpaid session at a time).
There is a need for the counselor to see him or herself as worthy of his or her hire -- which comes with time, numbers of counseling sessions, seeing people get help, and learning the business side of paying bills and meeting the needs of people, including the counselor's own needs.
You are ready to take Course 6, Chapter 5 Quiz.
Quiz Requirement: A score of 75% is necessary to continue to the next chapter. Remember, it may be necessary to retake the quiz to score 75%, as a part of your learning experience. If so, no worries, give yourself grace and time to absorb the detailed text.
Account Access: You must be signed into the coursework page (which is separate from the main CBT website) to take the quiz and advance.
Checking your login status…
One moment please.