Does your practice have a specialty niche? If not, don’t worry, most therapists do not specialize and its a darn shame.

However, this is one of the biggest fears I hear when I talk to coaching clients about building their practice. The fear sounds like this…

“I’ll be bored if I specialize.”

“What if I’m not good enough in the specialty area?”

“How many people have this problem?”

“What if I don’t want to work with that group forever?”

“But I’m able to help lots of different people with different presenting concerns. Shouldn’t I help as many people as I can?”

I hear you. It is scary to be forced to choose one path and stick with it. When confronted with the idea that specialization builds your practice and actually allows you to help more people, you understand this intellectually, but there is fear and the emotion stops you from making a decision.

What is the fear about? I think it is related to a mindset of scarcity.  We fear there are just not enough clients to go around, so we want to be open to anyone and everyone who might be interested in therapy.

But, using logic again, is that true?  How many people out there need help managing ADHD, divorce, grief, postpartum depression, OCD, phobias of flying? LOTS, right? Just pick one of those specialty areas and you will have more business than you can handle.

But we also have fear of boredom or lack of flexibility.  Many people I talk to pursue a mental health career, and private practice, because they heard it allows for a great deal of flexibility and career freedom. Yes, it does. But no successful business can fling open their doors and say, “We sell everything, do everything and are open when it is convenient for us! Come on in and stay awhile!”  It sounds silly, but that is what you will be doing if you hang on to a generalist model.

There is also a fear of limiting our future options. What if we specialize in working with women coping with an empty  nest at home and after a few years we don’t want to work with them anymore?

These questions are all legitimate and choosing a specialty requires careful consideration.  And the truth is there are boring days. This is a job, after all.  It is not all going to be exciting and dramatic, fulfilling and meaningful.  But there is no job like that, is there?

And those fears about being good enough or limiting your options? Luckily, we are all trained to be good students and we know how to find and learn new information so we can improve our skills or change paths later on if need be.

The mindset that allows you to make choices is that none of this is static. It can be fluid and change over time. After 5 years of working with people in substance abuse recovery, maybe you want to work wtih their spouses or children.  Maybe you decide to write a book about treating those in recovery, or start an online support group.

Fear can stop your career growth or inform it. Make a list of your worries and hesitations and try to decern what is really holding you back.  Try to bridge the gap between your heart (where you are anxious and unsure) to your head (that knows a speciality is necessary to build a great practice.) Be patient with yourself, but don’t ponder this forever. At some point you need to take a path and see where it takes you.