How I Found My Private Practice Specialty

My private practice specialty has morphed and changed over the years. Today, I want to share my story about how I landed in my specialty.

Maybe you will find it helpful if you are discerning what niche fits you best. Or maybe you will relate with having to go on a meandering journey to find what you wind up specializing in.

My Therapy Practice Specialty

My current private practice specialty is working with folks who identify as being misunderstood or marginalized by the church. I have a particular emphasis on working with clients who identify both as LBGTQ and Christian, or who come from a Christian background and identify as LBGTQ. And to be clear, I am fully affirming in my views.

👆 A screenshot from the homepage of my therapy practice website

When my Passion For Therapy Began

When I was 14 I developed very severe panic disorder. I wound up going to the library and scouring books to try to figure out what was happening to me. I thought I was going crazy!

Eventually, I decided to implement systematic desensitization on myself. (Thanks library books!) It completely worked! I found it bot incredible and challenging.

I was amazed that I could experience freedom from the gripping fear that panic attacks brought on, all from utilizing therapeutic techniques.

After that, I was all-in on becoming a therapist. I was hooked!

My Initial Specialty: Anxiety

Given my personal experiences, I thought anxiety was going to be my specialty forever.

About ten years later when I graduated from grad school I was still on the anxiety specialty train. I did my postdoc in a private practice setting and I emphasized working with clients dealing with anxiety.

The practice that I was working at was a Chrisitian group practice. So I primarily worked with client who identified as Christian. At the time, I mostly worked with people who were dealing with anxiety disorders, panic disorder, and scrupulous OCD.

I genuinely enjoyed that specialty. And I still do! I love implementing systematic desensitization and other CBT-based interventions for anxiety.

However, there was a pattern that started happening. I started having clients who were coming to see me for anxiety, but as we explored their story we came to realize there was a lot more beneath the surface. As is often the case!

A lot of folks who were church members, leaders, or clergy started coming out to me. As we dug deeper we realized there was a whole story that was fueling their anxiety. Systematic desensitization is only going to take you so far if you have a lot of repressed stuff around your gender or sexuality.

Conservative Christian Upbringing

To give you a bit more context, I grew up in a very conservative evangelical Christian home. I was taught harmful beliefs about how to understand those who identify as LBGTQ.

As a child, I didn’t question these views because that was what I was taught by the authorities in my life.

But, things started to change for me when I was in college. A lot of my friends who I knew from my Christian circles started coming out to me. In response, I’m sure I said and did things that weren’t ideal. Or may have potentially been harmful.

I had a lot of inner turmoil as I was trying to reconcile what I had been taught as a child with who my friends were as people and what their lived experiences were. How could I make sense of this?

Compassion for LGBTQ Experiences

Over the years many different friends and clients came out to me in college, grad school, and the early years of my therapy practice. This experience kept knocking on my door. In response, I felt this intrinsic, organic pull to figure out what I truly believed.

I went on an extensive deep dive which started unraveling my childhood belief system. As time went on, I started to develop a huge heart and passion for folks who were closeted in the church.

I was internally leaning into exploring this topic. I wanted to see if there was a way to support those who lived at this intersection of Christianity and LBGTQ identities. That being said, I wasn’t changing anything outwardly that communicated to the world about my shifting interest in specialty.

I knew that if I changed my marketing materials and website to say that I was an affirming therapist who works with clients who identify as LBGTQ, then I would lose a ton of my referral sources.

A lot of my referrals came from church clergy. If they knew what my specialty was and that I had affirming beliefs then many of them would not continue to refer folks to me.

Cognitive Dissonance

After going about it this way for a couple of years, I had a build-up of cognitive dissonance. How could I feel so passionate about helping people embrace who they are and come out to others around them if I was not willing (as a hetero, cis, married woman) to be known publicly as an affirming therapist?

Now with my current lens looking back, I can have an inner voice that says, “How dare I?”

But, I know that that was part of my process. That’s where I was at, at the time. It just clearly took me a hot minute to get there!

I realized that I had so little to lose by identifying my specialty that I had to change my marketing materials to communicate my affirming stance. This would demonstrate my care for the folks who I wanted to work with.

Officially Changing My Specialty

Around 2017 or 2018 I changed my marketing language on my website. I made it crystal clear that I have very progressive Christian views, I’m LBGTQ-affirming, and I enjoy working with clients who identify as Christian and LGBTQ. I also work with folks who experience other phenomena that arise for folks who are misunderstood or marginalized within the church.

Now looking back, despite all my fears at the time, I can genuinely say that move was the right decision.

Don’t get me wrong: as predicted, I got blacklisted from a bunch of my clergy referral sources.

But, when I niched down into something very specific not only did I enjoy my work more, but my practice had a much easier time staying full. For folks who were looking for my specific specialty, they likely felt comfortable in reaching out once they saw my website.

It’s Okay to Change Your Specialty

One of the reasons I thought this article might be helpful is because I wanted to highlight how possible it is for our specialty to be influenced by our own life experiences.

I hope sharing this story offers you some permission to explore, meander, and choose a specialty that makes the most sense for now. Remember that you can let your private practice specialty grow, evolve, and change as you grow, evolve, and change as a human. You can change your marketing materials accordingly. 🙂 The internet and the world will eventually catch up with you.

I hope you can have the same joy and excitement, as I did, in discovering your specialty.