In a recent issue, we looked at several therapists treating adults for
issues pertaining to anger. But the sub-niche of angry children might
be even more fertile. Referral sources include schools, physicians,
and other mental health professionals who arenít prepared to treat
this population. Insurance benefits often cover treatment--and even
when they donít, parents are motivated to find a solution to a trying
In this report, we get advice on working in
this niche from four clinicians, from Florida to California. Together,
they offer a set of ideas any therapist can use to get started.
1. When it comes to potential referral
sources, says Tara Moser, "there are almost too many to count."
Although sheís only been in full-time private practice since 2006,
Moserís developed a 25-session-per-week practice with angry children
as a cornerstone. She ticks off seven referral sources sheís used to
good effect: school guidance counselors, school psychologists,
physicians, police departments, clergy, the Association for Play
Therapy (APT), and an organization called "CARE Suicide Prevention,"
where she does talks on child anger.
2. A comprehensive website devoted to kidsí
issues is important, says L.A.ís Charlotte Reznick. About half of her
25-client-per-week practice is devoted to this population. And a
standard therapistís website just wonít attract parentsí attention,
she argues. A banner at the top of Reznickís site,
www.imageryforkids.com, promises: "9 tools to help your child cope."
She also offers a free list of the "top 10 things kids want and need
from their parents."
3. Group therapy is a good match with this
specialty, says Nancy Brooks in Bailey, CO. Her "anger management
group for kids" is held weekly, with just 3-5 kids in each group.
Thereís a different focus at each session, and Brooks keeps the pace
quick to accommodate limited attention spans. She usually starts by
simply defining anger for them. "Kids need to understand," she says.
"The majority of them donít have any idea what people are talking
about when they tell them theyíre behaving in an angry way."
She works with group members using the
trigger response model: what triggers the anger, and what they need to
do to deal with it. They role-play, and discuss anger, working on ways
to keep from getting angry. Brooksí group fee is $45 per 50-minute
session, with an eight-week format.
4. Write a book, or even a short monograph
on the subject, so parents have something to chew on before they send
their kids to see you. Florida clinician Norm Hoffman has the most
eye-catching book title that weíve seen lately: Bad Children Can
Happen to Good Parents: A survival Manual for Parents of Difficult
Children. (Hoffman has a small private practice, spending most of
his time on forensics and child custody.)
Cynthia Reznick wrote a book with a more
upbeat title: The Power of Your Childís Imagination. Sheís also
selling a pair of relaxation CDs she put together herself, titled
"Climbing a Mountain of Success," and "Finding Your Special Place." As
well as serving a marketing function, these products provide what
business professionals call "multiple income streams"--which is a just
fancy way of saying "making money in more than one way."
5. "Get qualified by the school system to
teach teachers," says Norm Hoffman. "Instead of holding seminars in
your office, you need to go where the parents and kids are. Hold
presentations for teachers at the school--and do them for free."
Depending on where you practice, he goes
on, you may have to get school board approval for your teacher
education program. The first step is to draw up a proposal stating the
problems youíre addressing, and the goals youíll meet. "Keep it simple
and straightforward...Then be prepared to wait six to eight months.
You have to keep calling--so be sure to have a contact person." Once
youíve successfully sold a program, Hoffman adds, it gets easier to go
back for more.
(Hoffman also recommends working with
family courts--he has referral relationships with a couple of judges,
and about 12 attorneys. He gives free workshops for the Florida Bar
6. Blogging can actually help in this
specialty. Weíve spoken to plenty of clinicians whoíve tried to get a
blog off the ground. But for the most part, itís an enjoyable hobby,
not a marketing tool. But Charlotte Reznick started doing a blog
through Psychology Today a couple of months ago--and says 600
to 1,000 people have been reading each entry, leading to book sales on
her own site as well as inquiries from potential clients. (Thereís a
link to her blog on her homepage, www.imagreryforkids.com.)
Tara Moser is also blogging, and tells us
it helps promote her practice, although the direct benefits arenít as
obvious as in Reznickís case. See her two blogs at:
www.throughtheeyesoftherapydogs.blogspot.com, and http://dfcbooks.blogspot.com.
7. Donít be locked into the 50-minute hour,
says Nancy Brooks. Once the situation is stable, she tells us, her
patients donít require a full session. Instead, Brooks has them come
in for a weekly "check-in" session of just 30 minutes.
"I ask how things are going at school and
at home, then make suggestions." She reminds them to write in their
journal, and to keep up with other homework sheís assigned to help
them transition out of therapy.
Her standard rate for a 50-minute session
is $100, but half-hour check-ins are just $50. (Obviously, this makes
it easier for parents to go out-of-pocket, or to keep their kids in
Overall, all four clinicians report,
third-party reimbursement for this niche is not a problem. But
Charlotte Reznick in Southern California and Tara Moser in Florida
prefer to run on cash, or out-of-network benefits. Reznick charges
upwards of $190 per session, and Moserís fee is $100. (Moserís clients
pay upfront, she reports, and are able get $60-$80 reimbursed.)
Itís an unhappy reality that child behavior
problems are increasing. Therapists who can help deal with this
reality will be more in demand in the years ahead.
Contacts: 1) Nancy Brooks, Bailey,
CO, (303)838-2283, email: nancybrooks @earthlink.net; 2) Dr.
Norm Hoffman, Ormond Beach, FL, (386)677-3995, www. drnorm.com; 3)
Tara Moser, Cape Coral, FL, (239)540-1155, www.deltafamily
counseling.com; 4) Charlotte Reznick, Los Angeles, CA,
(310)889-7859, www. imageryforkids.com.