How Developing Niche Can Improve Clinical Outcomes

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Think for a second about the people in the psychology and psychotherapy field that you most admire. The pioneers, the groundbreakers, the transformers... what do they all have in common? 

They all have a clear mission to transform people's live using therapy. 

During my first semester of my Master's in counseling psychology I started working at a domestic violence center. I didn't realize at the time how this position, would in some ways, have more of an impact on my future clinical practice than my graduate degree

Immediately, I received 70 hours of intensive trauma training.  They trained me to start implementing what I learned immediately doing face to face work with domestic violence and sexual assault victims as a paraprofessional. 

As I completed coursework, this initial training gave me a unique lens with which to view and apply the material. And, when I asked a professor how the couple's research we were reading applied to domestic violence cases- she said "you won't see much of that," I began to see the great divide between people doing the day to day work, and those doing the research. 

The people who are changing the world are the ones who are delving deep into their work with real clients. 

Therapists just like you are changing the world. 

Marsha Linehan started out as a clinician in 1974, working in a variety of settings- including with homeless women. She didn't start out as the developer of the gold standard for treating Borderline Personality Disorder. She started out as someone, just like you, who was looking to deeply help people.

Even before that, she started out as a person who was hurting herself and trying to find a way out of her own pain. She had been treated by well meaning medical professionals whose treatments didn't work, subjected to years of seclusion, electroshock therapy, and psychoanalysis which did not develop the skills she needed to survive successfully. She had to stumble through the process of healing on her own, and heal she did. 

What takes therapist from good to great? 

Marsha was deeply passionate about helping people who were in the most intense pain, people who others weren't sure how to help. So she committed herself to developing processes and strategies that really worked for a specific population.

She decided who she most wanted to heal, and made herself an expert in the field. I don't think it was about marketing, or ego, or money. It was about wanting to do something great in the world, wanting to help people who desperately needed someone who was willing to do what it took to find a process that worked. 

You can't be awesome at everything. 

Therapists need a wide variety of skills. We need to be a jack of all trades. We need to be able to understand, diagnose, and treat every issue under the sun. Our clients don't often present as cookie cutter representations of DSM diagnoses.

And yet, can we be awesome at everything? Can we keep up on the advanced training it would take to delve into the cutting edge research in treating each and every issue clients are presented with? 

What if you choose one thing to be awesome at? 

I talk to therapists daily who are tired and burned out. They often won't even realize that is how they feel. They might share that they are unsure, a bit confused, a bit uninspired.

I take them through a process to tap into their passion, and develop a plan to reach out and help the people they are most inspired to heal. During this process, I feel honored to hear the way voices change, giggles emerge, tears fall as therapists connect back in with the real reason they do this work- to deeply transform people's lives. 

What would be different if you specialized? 

How would that change the trainings you took? How would that change the books you read? How would that change the trainings you gave to your community? The supervisor or consultants you work with? The clients you referred out? The way clients see you? The way your colleagues view you? How would it change the way you viewed yourself? Would this impact your clinical outcomes? Would you get better at working with a specific population more quickly? Would your clients get a more inspired, excited therapist? 

If you try to speak to everybody you speak to nobody. 

Jack of all trades, master of none. 

Therapists: Be a jack of all trades but truly, deeply, master one. 

Continue to be a great generalist. Know all of the variable issues that your clients can bring in the door. However, allow yourself to be truly great, truly outstanding in one particular area. Allow the world to know about it. Allow yourself to explore it deeply. 

You never know, you might be the next clinician to make an advance in the profession that changes the lives of people around the world. Be the next Gottman, be the next Sue Johnson, be the next Francine Shapiro.

While each of these people have degrees, research, and a body of work- all of that didn't just happen by accident. They chose their path. They chose to allow themselves to fulfill a deep passion and purpose in one particular area and to become great. 

Have you chosen your path? Share below the path you have chosen to becoming outstanding, awesome, and change the world. Disagree? Let's hear about it! 

Intensive stuff: Business School Bootcamp for Therapists