Episode 11: Don't Be The Applebee's Of Therapy — You're The Expert!

Show Notes

Choosing your niche is a lot like setting yourself up as the expert in a particular field, population, set of struggles, or way of working.

Last year when I started talking about Impostor Syndrome on FB lives, webinars, etc., I was just talking about my experiences. The more I talked about it, the more I was being viewed as "the impostor syndrome expert." All of a sudden, I was speaking at conferences,  on podcasts, coaching courses, and more!

Too often I hear, "I'm a trauma-informed therapist who works with A, B, C..."

If you don't know who you're marketing your services to, then how could they possibly find you or call you? Why would someone pay you out of pocket if you don't proclaim to be the "expert" in a certain struggle, population, or technique?

When you ask yourself, "do I really need to have a niche," I think the resounding answer is YES!!

If you work in a really saturated area, how do you stand out if you work with "everyone?" 

How often do we see therapists asking the same questions over and over in all of the FB groups?  

• "Why isn't my phone ringing?" 
• "How do I get more self-pay clients?"
• "But, won't I exclude clients if I focus on a "specific population?"

Listen to this episode of the All Things Private Practice Podcast so you can gain clarity on the importance of choosing your niche, and why I think our niche is a version of ourselves.

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Transcript

Season 2, Episode 1 – Don’t Be The Applebees of Therapy - You're The Expert!

PATRICK CASALE: Hey everyone, this is Patrick Casale with the All Things Private Practice Podcast, here in Asheville, North Carolina, coming to you today to talk about choosing your niche. I really hate that word, by the way, but I want to talk about it, because it's a very important topic in private practice ownership and one that a lot of therapists really get wrong, so to speak. When we start to think about starting our private practices, a lot of us are getting out of community mental health jobs, and coming from places where we've worked with a very diverse clientele, all acuity levels, ages presenting concerns. I think that's great because it exposes us to a lot of different things that people are struggling with within the mental health community and substance use world. I really think that that is a good part about community mental health.

I know a lot of you know that I'm not the biggest advocate for CMH. But I certainly get the purpose. We enter private practice without a good understanding about, why do I need an ideal client population or populations? Why do I need to choose a niche? Isn't that excluding other people from accessing my services and my care? I think that feels really counterintuitive when you're coming from a place of you have to see everybody that walks in the door, regardless of whether or not you are the expert, or specialize, or truly even understand the struggle, or concern. I teach coaching courses for private practice startup, and I hear this a lot. There's usually a lot of struggle, emotion, concern, and even resistance that comes up when we start talking about ideal clients. A lot of the concern is, how do I exclude other people from services? They feel guilty or even shameful for saying I have an ideal clientele or a population that I really love working with. 

And this doesn't mean you're a bad therapist, to start thinking this way. This actually means that you're probably going to become a good private practice owner and business person, because you really have to understand your niche and ideal clients, so that your marketing makes sense, that they're speaking to your ideal client’s pain points and experiences, and the reasons that they're seeking therapy out. If we market ourselves without really, truly understanding our intentionality, or the direction that we want to go, or who we're even marketing to, it kind of falls flat. It kind of feels like we're the Applebee's of therapy, right? Like, we're trying to do it all. I don't think that we can do it all, and I definitely don't think that we can do it all well. That's why in another episode, I talk about networking and building win-win relationships so that you have referral lists so that when someone calls you who's not a good fit, you can refer them out appropriately. That's also helping the client, that's also stepping into an abundance mentality where we're supporting each other's businesses to make sure that the client lands on their feet in the most appropriate setting with the most appropriate provider. 

If someone calls me and says, “Hey, I have disordered eating. I'm really struggling with that. I'm 17.” My instinct is to immediately offer referrals, because I don't specialize in teenagers, and I definitely don't specialize in eating disorders. I know that about myself. I'm not trying to take on everyone that comes in the door or calls on the phone. I did that a lot when I first started my practice. I thought I had to take everybody in anybody. I was so desperate to get clients that I was like, “Oh, you're calling with this presenting concern, issue or struggle?” Sure. I'll work with you. “Oh, you're experiencing A, B, and C?” Yeah, of course, I'll help you. And then what I was finding is like the relationship, the report, the fit, it just wasn't there. Maybe somebody was seeking a modality or theoretical approach that I just didn't use or incorporate. 

Someone would say, “I really want a CBT-trained therapist.” I'd be like, “Yeah, I know CBT.” But then I started to think, I'm like, “But I'm not a big believer in it. I know it's evidence-based.” We'll talk about evidence-based treatment down the road in a different podcast episode, but that's just not my style. I'm a very attachment-focused and harm reductionist therapist. I never really meshed well, and those clients would leave after a couple of sessions, and I'd be saying, “What did I do wrong? My imposter syndrome’s flaring up. I'm a bad therapist. I clearly can't help these people.” But in reality, I started to realize that choosing your niche is really tapping into the lived experiences, the pain points, the things that your ideal clients are struggling with, and not only really understanding it, but really enjoying working with those presenting concerns, or those people, or those populations. That doesn't mean you're going to exclude other people from seeking out your services. I get that a lot. 

Like, if I narrow down too much other people aren't going to seek my services. I think you have to ask yourself if I want to be a private pay-only practice, what are the odds that people are just going to find me who have specific concerns, and they're going to call me if I'm not marketing or speaking to those concerns? If I'm a generalist, and I'm not knocking people who are generalists, I get it. I understand why we want to support everyone and anyone. However, if you are a generalist, why would someone call you and pay you 200, 250, whatever your private pay rate is out of pocket if you really don't get their concern or their struggle. People who are paying out of pocket are typically looking for the, “Expert in the community.” So to speak. I struggle with the expert label, because I don't think we can ever truly become experts, because we're always learning in this profession, and we should be. 

However, if someone's seeking out someone who's trained in attachment-focused EMDR, they're more likely going to pay that person out of pocket. If someone's seeking out someone who does internal family systems, they're more likely to pay that person out of pocket. If someone's seeking out a BIPOC clinician who specializes in working with BIPOC women, then they're going to pay that person out of pocket. Again, because these are specialties, these are areas where there's more focus, there's more understanding. For example, for me, I work a lot with high-achieving adults who are perfectionists, entrepreneurs, neurodivergent, never feel good enough, are always moving on to the next thing, and that brings me to a really important point. I think that our ideal clients or our niches are versions of us.

When I first started in this career, it was young adult men who are struggling with substance use and recovery, because I myself struggled with a massive gambling addiction for most of my life. A lot of you have heard that story. I can walk the walk, I can talk the talk, right? I get what it's like to be trapped inside that inner hell of addiction, I get what it's like to manipulate, and lie, and steal, push people away, be consumed with something, be obsessive, be compulsive, taking lots of impulsive risk, and not really considering the consequences. I get that life. I also understand the shamefulness that comes with it, the feelings of loneliness, isolation, and guilt, the suicidality even. So, that's who I was attracting, because that's what I was putting out there in my content creation, and I was becoming well known in the community here as that therapist for a young adult man struggling with addiction and recovery. 

I was full for a very long time, and it was very fulfilling, but my career has evolved as ours do in this profession, and our ideal clients change. Now my ideal client is more coming from the perspective of a coaching intervention. Now, I'm really much more solution-focused, because I'm working with a lot of therapists who are starting their businesses in less than a therapeutic sense. When I'm working with therapists, helping them build their practices, we're focusing on niche, understanding ideal client population, because that allows us to write content that is really authentic, that allows us to really, “Become the expert.” Right? If you want to specialize, what I hear a lot is, “I'm a trauma-informed therapist, I work with addiction, depression, anxiety, and trauma.” It's like, “Great, that's fantastic.” 

However, let's go deeper. For example, I have a colleague and friend of mine who took my first coaching course, and she specializes in eating disorder and athletes. In the course, I ask everyone who's the population that really lights you up, where the clock just like hits the 55-minute mark, and you're like, “Wow, that session was amazing?” The ones that are really energizing for you, the concerns that people bring in the door where you're like, “This is my shit, this is my jam. I get this. I love helping people who struggle with these things.” She gave this short answer, which was, “I specialize in working with adolescents and young adults who struggle with eating disorders and athletic performance.” They go hand in hand. I said, “Let's think deeper about that. That's a great niche. Let's really start to understand the pain points that exist there, right? Why would somebody be picking up the phone or emailing you for services, if those are the presenting concerns and the daily experiences? Let's think about lived experiences from a social perspective, from a professional perspective, family dynamics systems. Let's think about all the things that are impacted when someone is a higher-performing athlete who's struggling with eating disorders.

It might feel like you're never enough, that you're constantly striving for the next achievement. You feel like you have made your body dysmorphia, but you can't put words to it. You look in the mirror and you don't like what you see. That you're binging, purging, that you're restricting that you notice intense rigidity in thinking patterns, that you're obsessive about things. All of these things start to come up, and we want to put wording to that. Because what I hear a lot too is, “I specialize in anxiety.” And then, I say, “Great, but how many clients of ours that aren't mental health clinicians are well-versed in the mental health world even know what anxiety means?” 

Yeah, the term, sure, everyone probably can throw it around. But if you're asked someone to describe what it was like to feel anxious, physically, mentally, emotionally, I think we have to start understanding we have to look beyond the diagnostic label and terminology, because I've had clients before who certainly were very anxious, yet, they would tell you to your face, they’re like, “I don't have anxiety.” But when you start to describe symptoms and how it impacts day-to-day, overthinking, overanalyzing, worrying about worst-case scenario, your gut maybe hurts a lot, you're clenching your teeth, you have tension in your neck and you’re constantly worrying about what could happen, your brain won't turn off. It may lead to panic attacks, which feel like A, B and C, then we start to really describe what it's like for someone to go through their day-to-day with major anxiety disorder. 

I think that once we start to set ourselves up to become the experts in certain populations or struggles, that's when we really start to get self-pay referrals, that's when our businesses really start to take off. What I was doing during COVID, on the onset, was talking about imposter syndrome a lot, whether it was Facebook Lives, Zoom webinars, whatever the case may be. The more I talked about it, the more I felt it, the more I understood it, and I started to become the expert in it. Like, professionals in the field are reaching out to me to come on their podcasts or speak at their conferences about the subject matter. That never happens if you don't start to really immerse yourself in it, embrace it, feel it, write about it, understand what it's like to go through on a day-to-day basis. It's really hard to become the expert in a population or a struggle if you don't really understand how to go deeper. I imagine that most of you do. I want you to sit there and think about it. If I want to be the expert, if I want to choose a niche, and it's really a hard thing for me to do, think about why you would pick up the phone or have picked up the phone before to contact a therapist. Think about the struggles that were going on in your life. 

Now reflect on that. Do you feel like those are the things that really energize you? Because I think a lot of us get into this field to heal versions of ourselves too and I hope that all of you are doing your work. But I think, from all of my experience, both professionally and personally, that our niche, our ideal client populations are versions of us or people that we love and care about, and you know how to support them, and you know how to talk the talk. But your content creation on your websites and your site today profile still sucks. And it still is in first-person language, and it still speaks in general, like diagnostic terminology that most people in our society don't use. I really want to challenge you all to start writing more authentically, your content creation, your websites, your landing pages, really speaking to that client experience. 

And here's how you won't exclude everyone by honing in. If you're honing in, and your expertise, your ideal client population is high-performing athletes. Let's think about all the things that go into the struggle for high-performing athlete, right? We already named some of it, the perfectionism, the rigidity, the compulsion in nature, the inability to disconnect from achievement and self-worth, if you start to write content about that stuff, and really start to show examples of it and understand it, people who read that content, who may not be high performing athletes may also be struggling with some of those things. And they are going to contact you because they're like, “Oh, yeah, I don't identify with everything on the website. But I do identify with A, B, and C, and I think this person could help me.” That's how we kind of cast wider nets too, so that we're not excluding other people. But excluding people isn't a bad thing. I know it may feel that way, at first, when you're getting into practice, and you're like, “How can I exclude people from seeking services if they want to help.”

But if you're not the right fit for them, you're not really helping them, so that's why having a good network and referral list is really important, so that when someone calls you who's not a good fit for you, or you don't feel up to snuff, or really excited to work with them, referring them out is actually doing a service to them and to you. Because if you don't want to work with someone who struggles with A, B, and C, how are you going to show up authentically and do the work with them? How are you going to support them if you look at your calendar every day, and you're like, “I don't want to do this today, this is too challenging, draining, I'm not enjoying this.” You're allowed to say that. I know we struggle with guilt around that saying, “I don't enjoy working with person A, B, and C who struggles with A, B and C.” I get it. We're helpers, we got into the field for a reason. But at the end of the day, you're not helping if you're not enjoying, you're not feeling confident, you're not feeling the rapport is there, you're not feeling like you can actually support the person, refer people out. It's okay to refer people out, you're going into small business ownership, so you need to treat your business like a business. 

Yes, we're still helping. But yes, you also get to say, “I only work with adults struggling with A, B and C.” You get to say, “I only work with women struggling with A, B and C.” You get to say, “I only work from this perspective.” For example, your ideal clientele if you're really struggling with choosing a niche, think about the way that you work. Maybe you work from an attachment focus perspective, so everything is relational and relationship-based. Write content that way, then you're attracting clients who are seeking out services that are speaking from that perspective, right? Like, “Hey, I believe everything is around childhood trauma. This is what childhood trauma experience can do to person A, B and C throughout development, relationships, work, sense of self, enjoyment, satisfaction, how they feel around the holidays.” We can go on and on and on. But then you're going to get people who are looking for that specific sort of therapy. And that, again, is a different way to choose a niche.

We don't have to have a website dedicated to just one population, and if you do great, because you're going to get all of the referrals for that population. You can be a little bit more broad. What I would challenge you to think about is not having it be completely general, not having it use a lot of diagnostic terminology unless it's something very, very specific that is a specialty. I would really try to think about what are my clients struggling with? What are they calling about? Are you working with young adults who feel like they're lost in life? Like, they don't have purpose? They don't know what the next step is. They're concerned about the environment, and COVID, and everything else in the world. Great, then like, let that be your niche. Let it be young adults struggling with life transitions and existential crisis. Are you really enjoying working with moms who are struggling, because they're working, and they don't have time for themselves, and they're filling the maternal role that society kind of places upon them, they don't feel like they have enough time, they can't do self-care, or maybe like you're working with high achieving working moms. There's so many different ways to conceptualize this. 

But I want you to challenge yourself to get a little bit more direct, I want you to be a little more concise, I want you to think more about it in terms of who do I really enjoy supporting, and you can make a list. These are the things, struggles, traits, characteristics, issues, or pain points that I really love working with. On the flip side, on the same list, you can make the list about who do I not enjoy working with? That can help you hone in on it too. Writing content, and we're going to talk about this in the next podcast episode, so that you can write content that feels really authentic, unique, stands out, doesn't feel generic. But we can't do that if we don't know who we're writing content for. We really have to understand that our marketing, our content creation, everything needs to be synchronistic. Everything needs to kind of flow really nicely and be really concise. 

We don't want to just talk about general mental health, and that's okay to do. You can, obviously, blog and write posts about general mental health topics, those are important, but your marketing needs to be more concise. Your marketing needs to be really descriptive. You really need to know who you're writing content for. I have a coaching client who works with chronic illness and people who are really struggling to feel connected, because they've maybe been pushed to the side, because they can't always show up in social situations, or job performance may suffer. But then that person’s able to network with naturopaths, acupuncturists, and just holistic healers, because that's where her ideal client is seeking out services. So then we start to understand how to network, how to market, where our ideal client shows up, how to support them, more specifically, and really getting in touch with their struggle.

For those of you who are still feeling like this resistance is coming up, or I really can't do this, because I can't exclude people, what I would challenge you to do over the next year in your private practice is to just kind of notate in your mind or wherever the case may be, who are the clients that I'm truly, truly, truly enjoying working with. And that's not saying you're not enjoying all of them, but we are human beings. Start to think about that, who are the clients that I am really excited to see, I'm really feeling energized by, when they leave I'm like, “Ooh, that was a great session.” Think about what struggles or concerns they're bringing into the therapy room, and maybe there's a correlation there, maybe there's a connection. Think about your own struggles. We all have them. Think about if you really enjoy those populations. We can really tap into that, we can really create a lot of great content, because we know the struggle. We walk the walk, we talk the talk. That's kind of how we set ourselves up to be the expert. 

If you want to get more self-pay clients, we've got to really have an understanding of how to do this. If you're taking insurance in your practice, and there's nothing wrong with that, you can be more of a generalist, because you're going to get clients who are just calling you because you take Blue Cross, and that's the reality. That is also okay. But for those of you who are, “Why is the phone not ringing? Why am I not getting the self-pay clients I want? I want to build a self-pay practice, and it feels too daunting. We really need to start understanding how to do that and how to do that means really getting in touch with who our marketing is marketing to, who our website is speaking to, who our content creation is speaking to. We have to know that. It cannot be the Appleby's of therapy. I'll wrap that up with that statement. 

Thank you so much for listening, again, to the All Things Private Practice Podcast. You can find more about me, my coaching services. I do individual coaching and course coaching for therapists who want to start their practices. My website is allthingspractice.com. I also run a Facebook group called All Things Private Practice. I hope to hear from you soon. I want to see your content that you're creating, I want to start to challenge you to step more into your ideal authentic practices, because that's why you're starting them. You want to get out of your job, you want to work for yourself, so you may as well make it as enjoyable as possible. With that being said, I'll see you next Monday, and thank you for listening, downloading and subscribing.