How to Choose a Practice Specialty

I know I’m always nagging at you to choose a practice specialty. Now I should probably give you a few tips on HOW to do that. Wouldn’t that be helpful?

Let’s start here:  Who is your ideal client?

But, before I start discussing your  ideal clients, I need to remind you I’m big on building innovative practices.  Innovative as in “new,” “creative,” “not already done.”

What is done now are generalist, pseudo-specialty practices. These are businesses that serve everyone, or say they specialize in working with adults, children, or couples. In my mind, these are not specialties, they are categories and do nothing innovative or exciting.

So, let’s talk about your ideal clients, shall we?

From the outset, I must tell you a hard fact:  You are not good at treating everyone.  In fact, there are some people you have no business treating at all. For me, this is anyone over the age of 50.  Never in all my training did I ever work with someone over the age of 50.  Who should you never work with?

The good news is, there are lots of people out there who you are very qualified to help and I want you to focus on them.

And I  want you to focus so hard, in fact, that you are going to determine a specific group of people you are fabulous at helping.  This will be your specialty. It will grow your practice beyond measure.  Without a specialty you cannot market (well, you can, but it will be a complete waste of time and money) or grow your business.  This is not a scare tactic, it is how small business works in 2010. I don’t have time to go into the reasons for this in detail.  If you want to hear more about it, listen to my “Way of the Biz Savvy Therapist” audio (also free on the blog!).

So, let’s do a little exercise on your ideal clients.

  1. Write down the qualities of the people you have worked with in the past:  men, women, children, ages, diagnoses, etc.
  2. Which of these clients do you feel you were most effective at helping? Who do you help best?
  3. Which clients did you enjoy working with the most?  Which cases allowed you to use your best skills and feel fulfilled?

Now look at your lists. Is there any overlap (I sure hope so)?  Do you see a pattern?  Can you discern a specialty?

But, what exactly is a specialty?

A specialty typically  has 2 main elements:

  1. a specific demographic of people (children, adolescents, women, men, singles, couples, gay men, lesbian women, etc.)
  2. with a specific concern/diagnosis (grief, PTSD, anxiety, chronic pain, obesity, depression, ADHD, autism, high blood pressure, etc.)

Some examples:

Children with ADHD

Women/men with chronic pain

Men of retirement age

Divorcing couples who disagree on parenting arrangements

Singles who are looking for a life partner

Women with fibromylasia

Depressed/anxious teens

Post-partum women

Cancer survivors

Men/Women in recovery from alcohol/drug abuse

Parents of children with special needs

Executives with health concerns related to stress

Parents who have lost a child

Athletes trying to improve performance

Unemployed people looking for work

Artists blocked in the creative process

Make sense? The possibilities are endless.

For those of you afraid of a specialty

I know for many of you, those specialties look too narrow. You want to open your doors to more people because you worry that there will not be enough clients in one specialty area to fill your practice.

But the truth is, there are MORE than enough clients for each specialty. In fact, by specializing you make it easier for people to send you referrals or to choose to call you up and make an appointment. For example, if you just completed treatment for breast cancer, but feel overwhelmed, anxious and scared that it will reoccur, or that your daughter might eventually get diagnosed, would you rather talk to a therapist who seems nice, but is not a specialist in this type of thing, or would you rather talk to someone who works exclusively with cancer survivors?  Given the choice, who would you choose?  Would you travel 10, 20, 40 miles to meet with this person if they really understood you?  Would you be willing to pay out of pocket for such a specialist?

Imagine this scenario for parents of children with special needs, or someone who struggles with chronic pain.  When you specialize, and offer high quality care, people will seek you out. Your practice will be full.

In my own experience, I specialize in working with children with executive dysfunction (most diagnosed with ADHD, autism or learning disabilities) and their families. I have clients drive up to 75 miles to come to my office.  And I have coaching clients all over the US.  Many pay me out of pocket.  Does my specialty seem narrow?  Absolutely!  And it is that narrow specialty that I attribute to my success.

Action step:

Do the ideal client exercise above.  Do some serious thinking about your specialty area.  Try to come to terms with your internal process and emotions about identifying a treatment specialty. If it feels uncomfortable, that is fine, but don’t allow yourself to get scared back to a generalist model because it is comfy and safe.  If this exercise really freaks you out, send me an email or talk this out with a colleague or friend (ideally one who understands business).   The truth is, there is no risk in establishing a specialty. If you try it for a few months and it doesn’t pan out you can always go back to the generalist way of things. But I know you won’t have to go back there.  Try it for awhile and see how it feels.  The truth is you will need to know who your ideal client is before building any more pieces of your business. So take some time with this and let me know if you need help.

And comment below about your specialty area, or what your considering, or where you are stuck. We need some more activity here on the blog! Let’s work together, rather than sit with all this newness alone!

Comments

  1. Tamarisk says:

    I guess the thing I’m struggling with is how to integrate my theoretical framework (I work existentially, by and large) with a specialty. My feeling is something like CBT lends itself more obviously to a specialism.

    Also, what I love about being a therapist is the variety…! Although I committed to giving this exercise a go and seeing what comes up for me. Thanks Susan!

    • Susan says:

      Hi Tamarisk,
      I appreciate your desire to try the exercise. I understand that many of us come to the profession for variety, however it is very hard to distinguish yourself from every other generalist if there is no way for potential clients to clearly understand what you offer. If you want to see someone who does existential-type work in a specialty way, take a look at Havi Brooks blog, http://www.thefluentself.com.

  2. I’m an attorney, not a therapist, but attorneys often struggle with choosing an area of focus. They think that by specializing in one thing they are cutting off a universe of potential clients. But what they don’t see is that they are opening up to a much bigger, better, well connected, and vocal universe.

    The women with fibromyalgia, the parents who have lost a child, the adult children coping with becoming caregivers of their parents they are connected to many other people with those same issues. They become your raving fans. They tell their friends “this therapist (or lawyer) is the one you need to see. She’s the expert in this.” Reporters writing stories on those topics find your blog and think “this is the person I need to talk to about this.” Other therapists (or for me, lawyers) begin to refer to you because they know you are the expert.

    The benefits to specializing cannot be overstated. And I’ve found that there is enough variety in population of clients who need an elder law attorney to keep me quite interested and engaged for a very long time.

  3. Joyce Tirrell says:

    Hi Susan,

    I have been working for 10 years with clients of domestic violence, teen dating violence, and adult survivors of sexual assault. I feel that I don’t want to stay “stuck” with this group but I’m not sure how I would specialize. I of course work with the attendant diagnoses of PTSD, depression, low self-esteem, anxiety, and so forth that go along with the above issues. How do I specialize?

    • Susan says:

      Joyce, great questions. I’m pulling together a program that will allow you and others to closely examine how to transfer your skills into needed and marketable specialties. It can be done, but takes some careful thought and consideration. Thanks for asking.
      ~ Susan

      • Nancy says:

        Hi Susan,
        In a job not part of my private practice I work with people with eating disorders, who also have depression, anxiety, low self-esteem, etc. I would like to start a private practice and am wondering how to take this knowledge and turn into a specialty without stating my specialty as eating disorders.

  4. Louise says:

    I am looking to fuse my creative side with my scientific side. I have been a creative director in apparel, and recently gained credentails as a Lifestyle Educator and Health coach.
    Besides working with clients on living a more healthful life I want to add a better image as part of the package.
    I veiw it as the inside and outside of a person.
    Would love to hear your thoughts.

    • Susan says:

      Hi Louise, Sound like you have a great background to develop a fascinating specialty! Are you registered for my call today on building a specialty practice? Sign up here: http://bit.ly/7SVp9i I’ll be going over lots of details on how to take your background and interest and bring them together into a focused practice that is beneficial to clients and rewarding for you as a therapist. Hope you can join us!

  5. nancy says:

    I am thrilled to have found your website. I have been entertaining the idea of private practice for a year and have been hesitant as I don’t want to have a generic practice. I am comforted your ideas, as it supports my notion of being innovative and embracing what I really want to do. A true breath of fresh air!. Thank you.

  6. Brenda M. Bomgardner says:

    I discovered your blog from Tamara Suttle. I like how you offer step by step guidlines. I will be graduating in May and am poised to start a private practice. I am trying to narrow it down to a speciality. I prefer working with adults, men or women, who are facing challenging life transitions. I want to work at helping people develop their own qualities of resiliency. I am not sure how to package this as a speciality. Is it too broad? Do I need more specific well defined terms for a web site. Life Transitions and Resiliency Counseling is what I am leaning towards. I would love your opinion.

  7. Dianne says:

    I have alot of interests and have for years been a generalist. I used the exercise and found that the majority of my clients have been children and adolescents to include their families. I found that I have served alcohol and drug abuse/dependent men and women, and DUI offenders. I additionally have a criminal justice back ground working with DJJ and within the court system quite extensively. I work with foster care children and families. I also found that I utilized the marketing element and found that the community was in need of a domestic violence provider, which is where I started and subsequently have provided individual treatment. Haven said this, I still find that it is alot. It did decrease from a page full to these. Now what? Are these my specialty areas are do I need to reduce further? Such as “Specializing in Children and Families whom are affected by alcohol and drugs” or “Specializing in Individuals, Children and Families who have been affected by alcohol and drugs, domestic violence, and the court system”

  8. CGS says:

    Having worked as a generalist with a previous private care company I used to work with, I have found that I am succesful working with those patients who are struggling with depression, biplor affective disorder snd addressing issues that deal with life’s challenges. Is that too big a niche?

    • Susan says:

      Not necessarily. You would need to find a way to define that so the lay person can identify themselves as a good fit for your services. Many people with specific diagnoses don’t know what ails them, so we need to use words they would use to describe their symptoms. So, you might market around people who feel stress, worry and mood swings.

  9. Jeffrey Jarrett says:

    I am just about to start a private practice and most of my experience is in working with children in the school systems regarding social and behavioral issues in school. In order to broaden this to the general public and still specialize, I’m looking at “Children from divorced homes”, “Children who have suffered abuse or loss”, “Children with separation anxiety”. I also enjoy working with college-age men and women about the life adjustments at that age. Am I in the right ballpark, or is this still too vague?

  10. Ann says:

    For my niche, I have come up with Men, women and female teens that experienced trauma and depression. Is this too big?

  11. Hi Susan,

    What are your thoughts about having two niches?

    I have loved working with both young adults and couples. I have felt a lot of fulfillment and success with both populations. I have more experience working with adolescents and college students. However, my dissertation was on the topic of Conscious Intimate Relationship.

    I have a lot of content and information to offer clients around the topic of Conscious Intimate Relationship. However, I live in a college town and have had many college students seek services and become clients (without even my marketing to them).

    A recommendation that I received from a marketing person was to have a website that has three distinct sections for potential clients to choose from.

    If you have the time, I would greatly appreciate your feedback. Thank you very much.

    Warmly,
    Jessica

  12. I always chuckle when I hear the emphasis on specializing and the ideal client–not because I think it’s bunk for most clinicians, but because it doesn’t and cannot apply to me.

    Why? Because all my work is home- or community-based. There are few of us (at least in my area) and, therefore, I must be a generalist. Referral sources appreciate it, as well.

    So, I guess you could say my specialty is being a psychologist who makes house calls!

  13. Lita Perna says:

    I know linking up with physicians is a great referal source. I want to work with 45+ year old women with weight, depression and anxiety issues. Is this too broad? I can not find many therapists who focun on counseling for weight loss or middle age women’s issues.

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