One path to a thriving mental health practice is to limit your focus to a specific group of people (niche) or to a specific type of problem or treatment (specialty), and to refer other folks out.

It may seem counter-intuitive that turning away referrals can contribute to your success. However, by doing so, you build goodwill with other mental health clinicians, while at the same time you become known as a specialist in your community and beyond. As your reputation grows, colleagues and other professionals will refer patients that match your niche/specialty.

People are often willing to travel farther and to pay more to see a specialist. Thus, you can probably charge at the higher end of the going rate in your area. If you are out of network with insurance, some companies may pay your full fee for a given client, under a single-case agreement.

If you choose to stay in-network with insurance, you may be able to negotiate a higher reimbursement fee in your contract, particularly if there is a demand for your expertise.

Getting started in a niche/specialty

Like most mental health professionals, you probably like to help various types of people with various types of problems. How do you decide which to focus on?

In choosing a niche or specialty, consider your interests and your skills:

  • What types of people do you most enjoy working with?
  • What types of problems do you feel competent in addressing?
  • What training and mentoring would you need in order to ensure that your niche/specialty is within your scope of practice?
  • Do you have unique qualifications or experiences that a certain segment of the population would consider important?

Get new ideas for a niche/specialty at professional conventions and conferences. In addition to attending presentations that pique your interest, you can follow up with the presenters and with audience members who contribute to the discussion.

Consider your community, and what types of services are in demand - or not. For example, if you enjoy working with college students in person, you'll have a better chance of success if your practice is in or near a college town.

How do you know if a given specialty service is in demand?

  • Call around to other mental health professionals who provide the types of services that you might specialize in, and find out how long people have to wait for their first appointment. A long waiting list suggests high demand.
  • Take notice of complaints you hear from clients and others about difficulties in finding help for their problems. Can you develop a specialty in any of those issues?
  • Follow local news stories about community problems related to mental health issues. You may learn about layoffs, domestic violence, problems with access to to treatment, etc. Or you may learn that a local mental health specialist has closed their practice or died. If there is a need in your community and you can fill that need, it's a win-win.
  • Notice opportunities to supplement what other specialists are doing. For example, child custody evaluators often recommend counseling or therapy for family members. Ethically, they cannot provide these services themselves after conducting an evaluation, so you can make yourself available for that role.
  • While networking with current and potential referral sources, find out what they most want for their patients and clients, and their biggest frustrations in seeing that happen.

Keep notes on what people in your community need and want in terms of mental health services. A pattern will eventually emerge that can help you decide on a niche or specialty that will flourish.

Marketing your niche/specialty

In your marketing, focus on the people who are most likely to need, want, and be willing to pay for your expertise. Use keywords and language that resonates with these people.

Be consistent across your writing, speaking, and social media posts, sticking to mental health issues experienced by your target audience. It's OK to be repetitive in your messaging. In fact, repeating similar concepts and advice - early and often - will not only help boost your Google ranking for certain keywords, it will also help brand you as an expert.

If you are in solo practice and want to maintain a general practice in addition to your niche/specialty, consider having separate websites, each with different content and focused on different segments of the population.

If you run a group practice with multiple niches or specialties, list these on the home page, and also prominently in the navigation system of your website. Clinicians with specific expertise should be clearly identified, and they should also regularly give talks and post on social media on their specialty topics.