Episode Summary: Counseling with the Cows – Six Tips for Growing a Rural Private Practice

Podcast: Private Practice Startup
Episode: 140
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Dr. Julie Merriam
Date: June 15, 2019

Overview

In this lively and insightful episode, Dr. Kate Campbell and Katie Lemieux welcome Dr. Julie Merriam—therapist, rancher, professor, and rural practice expert—to explore “Counseling with the Cows: Six Tips for Growing a Rural Private Practice.” Rooted in personal experience from big-city and rural settings, Dr. Merriam offers practical, creative, and sometimes humorous advice for clinicians seeking to build a thriving practice outside urban areas. Her tips focus on visibility, authenticity, community engagement, and cultivating a fearless mindset, showing that a successful private practice is possible—even “in the middle of nowhere Texas.”

Key Discussion Points & Insights

1. The Power of Community Relationships

[05:00–08:40]

• Be involved, be authentic: In rural communities, visibility and genuineness are everything. It isn’t enough to just set up shop—you have to “bring those baked beans to the picnic,” as Dr. Merriam says.
• Attend local events: From fish fries to volunteer firefighter fundraisers, show up at as many community gatherings as possible.
• Know the local culture: Subscribe to the local paper, stay attuned to town happenings, and get your face known.

“You’ve got to be willing to bring those baked beans to the picnic, you’ve got to be seen, you’ve got to be known, and you’ve got to be authentic—really involved with your community, not just, you know, talking about it.”
— Dr. Julie Merriam [05:16]

• Address dual relationships proactively: In small towns, running into clients is unavoidable. Dr. Merriam discusses confidentiality openly with clients, clarifying how she’ll interact in public and deferring to their preferences.

"I discuss it in my disclosure paperwork, and we really have a conversation about confidentiality... I may not speak to them until they speak to me—just so they know I'm not being stuck up."
— Dr. Julie Merriam [07:10]

2. Telemedicine to Expand Your Reach

[09:40–11:18]

• Go beyond physical limits: Online counseling is essential to supplement caseloads in sparsely populated areas.
• Personalize your approach: Dr. Merriam tried virtual counseling herself before offering it, ensuring high-quality service.
• Willingness to travel: To nearby towns—further grows your client base.

"We've got to be willing to do online counseling if you're out here in the boondocks... I really had to dive into that."
— Dr. Julie Merriam [09:43]

3. Niche Marketing—Yes, Even in Rural Areas

[11:10–11:18, 12:02]

• Don’t fear having a specialty: Contrary to the belief you need to “see everyone,” Dr. Merriam built a strong couples niche even in a rural town, using telemedicine and creative outreach.
• Know your community: Tailor your language and offerings to local values and needs.

"I thought that for a while—I was like, 'I'm in the country, I can't niche.' But no, I can, and it works."
— Dr. Julie Merriam [11:12]

4. Creative, Local-Focused Networking

[12:20–14:30]

• Go where the people are: Networking is foundational. Dr. Merriam gets creative—hosting booths at local cook-offs, creating playful relationship quizzes, and even running a “kissing booth” for couples.
• Direct marketing: She delivers baskets—tailored for each business, complete with snacks and brochures—for plumbers, local shops, and more, always following up with handwritten thank-you notes.

“I market to every business in town. We actually have a phone book still that I go through!”
— Dr. Julie Merriam [14:36]

5. Engage Through Speaking and Writing

[14:46–18:48]

• Give back and educate: Offer free talks to churches (premarital counseling), workshops for school staff, mental health training for law enforcement, and activities for the 4H club.
• Embrace local media: Dr. Merriam writes columns for the local paper, submits blurbs for church bulletins, and advertises at the local theater (“It keeps me out in the community all the time”).
• Use grants: She discusses securing a $300,000 grant to provide rural mental health care.

"I posted a Facebook video on self-care... got almost 800 hits... and three bookings. A new intern, two new clients. Nice. It was a good whim!"
— Dr. Julie Merriam [17:52]

6. Fearless, Abundant Mindset

[20:18–21:30]

• Value your services: Even in rural Texas, Dr. Merriam charges $175 for individuals, $225 for couples.
• Maintain boundaries and self-worth: Refer out if you’re not the right fit, and believe in your value.
• Get support: Masterminds, coaching, and podcasts counter the isolation of rural practice and keep you inspired.

"It goes beyond that—if you believe you can, you can; if you believe you can't, you can't. That narrative is so powerful, and I believe I can."
— Dr. Julie Merriam [20:53]

Notable Quotes & Memorable Moments

• On Marketing in Rural Areas:

  “In the country, you’ve got to join Camp Gladiator, you’ve got to be out in the community. I am in the community. I’ve joined all the chains.”
  — Dr. Julie Merriam [06:00]

• On Boundaries:

  "I've had people come up and want to squeeze lemons with me and talk about, you know, how the husband was an ass or whatever that week, and I'm like, can't do this right here."
  — Dr. Julie Merriam [08:26]

• On Giving Back:

  "Offering a two-hour workshop on premarital counseling for free, or mental health first aid to law enforcement—it's about being out there and serving."
  — Dr. Julie Merriam [15:40]

• On Mindset:

  "You have to have that abundant mindset. You get them hooked up with the right person if you’re not it...that leads to number six, the fearless mindset."
  — Dr. Julie Merriam [20:18]

• On Possibility:

  "Take your desire on a date and then romance it and make it into a permanent relationship, which is what I've done with this private practice. It can be done."
  — Dr. Julie Merriam [23:03]

Timestamps for Key Segments

| Timestamp | Segment/Topic | |-----------|------------------------------------------| | 02:25 | Julie’s background & rural life intro | | 04:52 | Tip 1: Build authentic community relationships | | 06:22 | Navigating dual relationships & confidentiality | | 09:40 | Tip 2: Using telemedicine & expanding reach | | 11:10 | Niche marketing in the country | | 12:20 | Tip 3: Creative networking and visibility| | 14:30 | Tip 4: Speaking, giving back, engaging | | 17:52 | Harnessing local media & Facebook | | 18:48 | Writing & community outreach | | 20:18 | Tip 6: Fearless & abundant mindset | | 22:59 | Episode wrap-up—key takeaways | | 24:33 | Final encouragement: “It can be done!” | | 24:51 | Julie’s ebook giveaway |

Final Takeaway

Dr. Julie Merriam demonstrates that with creativity, strategic visibility, and a genuine commitment to community, therapists can build a thriving rural practice. Her six tips—relationship-building, telemedicine, creative networking, public speaking and writing, and most importantly, maintaining a fearless mindset—are all rooted in authentic connection and service.
"Any practitioner can build a practice in rural America. You’ve just got to think outside the box." — Dr. Julie Merriam [24:32]

Resource & Giveaway

• Julie’s eBook: “Ninja Guide to Burnout Proofing Your Life” – available via email (link in show notes).

Recommended for:
Therapists at any stage considering rural practice, or anyone interested in innovative, community-centered marketing.

For more:
Visit privatepracticestartup.com for resources, tips, and future episodes.