by Clinton Power

In 2006 the Better Access Scheme was introduced so Australians diagnosed with mental health disorders could access rebated mental health services. This meant a person had to receive a diagnosis of a listed mental illness from the “bible of psychiatry” called the DSM- the Diagnostic and Statistical Manual of Mental Disorders- to be able to receive up to 5 rebated sessions under Medicare.

As it currently stands, if you receive a diagnosis you can access mental health services from Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule. This also includes psychological services provided by appropriately qualified psychologists, social workers and occupational therapists.

Counsellors and Psychotherapists were omitted from the list of providers, primarily because the industry of counselling and psychotherapy has been largely unregulated in the past and lacked Australia-wide minimum training standards. There was a collective outcry from therapists and counsellors throughout Australia at this decision.

Since then, the major counselling organisations of Australia- the Australia Counselling Association (ACA) and Psychotherapists and Counsellors Federation of Australia (PACFA) have formed ARCAP- the Australian Register for Counsellors and Psychotherapists- in an effort to create a national register of counsellors and therapists that will need to meet minimum standards and accreditation to be listed on the directory.

Both organisations have spent many years lobbying the Australian Government in an effort to get Medicare rebates for counsellors, to no avail.

I don’t see Medicare rebates for counsellors and therapists happening any time soon. I predict that the Better Access Scheme will be rolled back over time to reduce the number of rebatable sessions and remove the amount of practitioners eligible to offer these services. The cost has blown out and is unsustainable in the long run.

Many counsellors believe without Medicare rebates they can’t build a full practice 

After speaking and working with therapists for more than seven years since the Better Access Scheme was introduced, there are some common beliefs I hear from mental health professionals who can’t offer the rebates.

The beliefs I often hear from therapists in Australia include:

  • You can’t get enough clients to build a profitable private practice unless you can offer rebates through the Better Access Scheme.
  • Clients don’t want to pay your full fee “out of pocket” for counselling or psychotherapy sessions.
  • You need to lower your fees to get clients so they match the gap people are paying Psychologists and Social Workers after the rebate.
  • Most clients with depression and/or anxiety will only see a provider under the Better Access Scheme.

I don’t doubt that these are genuine issues and concerns for many counsellors in Australia, but I don’t buy that it’s only because of the Better Access Scheme.

The problem is not rebates. The problem if you’re not effectively marketing your counselling business.

I think focusing on the lack of rebates for counsellors is a red herring.

It’s too easy to say your private practice is not flourishing because because you can’t offer Medicare rebates.

The truth is, about 5 years ago I went back to university to start studying psychology for the sole intention of being able to offer Medicare rebates to my clients.

Despite the fact I had completed 6 years of intensive study in psychotherapy, I also believed I couldn’t create a profitable private practice without being able to offer Medicare rebates.

After surviving and passing my first year of psychology, I was looking down the barrel of another 6 years of study before I would be a Registered Psychologist.

Thankfully I saw the error of my ways and decided to end my study and instead focused on building my counselling business and marketing towards the people I wanted to work with.

I took some of the money that was to be spent on university fees and worked with a marketing coach to create a cohesive business and marketing plan that would allow me to work full time in private practice.

Here are 5 lessons I learned along the way about how to create a profitable private practice:

1. You need to choose a niche for marketing purposes and have a solid marketing plan


When I started working on my counselling business, I was completely clueless. The fact is, I didn’t have any idea about how to market my services effectively. I didn’t know what worked and what didn’t work.

As I learned more about marketing, I discovered that choosing a niche for marketing purposes and having a marketing plan I could implement would be essential for the success of my business.

I needed an offline marketing plan- strategies for networking and building relationships in the real world. And I needed an online marketing plan- strategies for building an online presence.

I also needed to narrow my focus for marketing a defined niche. I realised that marketing myself as a generalist was no longer effective in today’s climate. Clients are savvy and they too are looking for specialists in the field.

Although it was scary at the time, choosing a niche and marketing to that niche was the best thing I ever did for my business.

The reason a marketing plan is so important is it’s something you come back to again and again. You refine it over time to improve it and add to it.

Most importantly, you refer to it to decide what actions you need to take next.

2. Creating a profitable private practice is hard work. Really hard.


I believe that many therapists aren’t actually cut out to be in private practice. And that’s OK. There’s no shame in working for someone else.

Creating and sustaining a successful private practice takes an incredible amount of work and perseverance, and it’s not for the faint of heart.

No longer can you just love doing your craft and working with clients, while relying on a Yellow Pages advert to send you a steady stream of referrals.

The landscape of marketing a counselling practice has radically changed in the last 10 years. If you don’t get up to speed with what you need to do to market your business effectively, there are just too many other therapists out there that will be getting clients ahead of you because they are doing marketing.

If you think you’re not cut out to learn about accounting and managing your finances, online marketing, networking, social media, and effective website design and copy, then you’re unlikely to be able to create a profitable psychotherapy practice.

The process of being in business means you have to constantly educate yourself and up skill in many different areas.

3. You must take consistent action every single week to make progress


This is one of the biggest issues I see therapists struggle with.

They often know what they need to do to market their business, but they’re not taking action and doing what they need to do.

For example, I started a blogging challenge this year on Australia Counselling, after many requests from therapists wanting more support for learning content marketing.

After more than 50 therapists have since signed up to the challenge and I have published three challenges, there have been less than ten blogs submitted.

If every therapist who signed up had completed the challenges to this point, there would be over 150 blog posts so far.

Interesting statistic, isn’t it?

If you’re not willing to take consistent action in your business, then you need to seriously consider whether private practice is for you.

The reality is it’s the therapists that are taking action on their marketing plan that will get the clients time and time again.

4. You must invest in your counselling business to make money


This one has always puzzled me, but the majority of therapists are not willing to invest in their businesses in order to grow them.

If you ran a restaurant, do you think you could create a profitable business if you didn’t invest in it?

You would need to buy furniture, kitchen appliances, design advice, graphic design of menus and promotional materials, advertising, and the list goes on.

One of the biggest lessons I learned was I needed to constantly invest money into my counselling practice in order for it to grow and generate more money in the long term.

Some of the expenses you need to consider when running a counselling business include:

  • investing in a professional website desig
  • investing in professional copywriting for your website
  • coaching and consulting fees for marketing training
  • investing in professional accounting and bookkeeping
  • graphic design of cards, stationery, and brochures
  • printing of business cards, brochures and stationery
  • investing in advertising on Google Adwords
  • investing in training and courses to learn about effective marketing

Are you getting the idea here?

5. Marketing is not a one-time event- it’s for the life of your business


This is one of the most important lessons I learned.

It’s essential to change your mindset to the point of view that marketing your business is something you need to do for the life of your business.

When I was growing my business, I spent 15-20 hours a week on marketing. Are you prepared to invest that kind of time and energy in your counselling business?

Again, if you think of any other type of small business, you’ll realise that marketing is something that all small business owners are constantly doing. It’s not a ‘set and forget’ process.

Just because you work in a helping profession does not change this.

There is now so much competition in a market saturated with therapists that if you’re not marketing on a regular basis, the therapists that are will be getting the clients.

Medicare is not the reason your business is not successful

I think the challenge that is offered by the Better Access Scheme is a positive one.

The truth is, we have all had clients who have done their 5 sessions of Medicare rebated sessions and have either not been happy with the outcomes, or realise that they need to do longer-term work to get the results they want.

If you’re willing to take up the challenge of private practice and develop a solid marketing plan, choose a niche, take consistent action,  and work hard in educating yourself in important small business skills,  there’s no reason why you can’t build a profitable private practice.

The truth is, there are more than enough clients out there for every counsellor.

What’s missing is the clients don’t realise that you’re the perfect person to help them with their issues and resolve their problems- and that’s what effective marketing is about.

Do you need help with the marketing and promotion of your psychotherapy practice?

If so, why not join Australia Counselling? For less than the cost of a professional development workshop, you get 12 month’s membership with Australia Counselling, Australia’s leading online counselling directory. Click here to read about the benefits of membership.