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Private Practice Kickstart
with Miranda Palmer, LMFT
& Kelly Higdon, LMFT

Niche & Specialization: Ethics or Business?

Last week we presented at the Therapy Reimagined Conference in Los Angeles to a room of passionate clinicians in private practice. We spent 90 minutes digging into the ethics of niche and specialization and how it impacts client experiences and outcomes from the first contact to termination. In many ways it really came down to the question:
Niche & Specialization: Is it a business decision or an ethical decision?
The truth is, our businesses are based on the legal parameters of our license and the ethical obligations of working within our scope of practice. In other words, our businesses cannot survive if we step outside of our legal and ethical obligations. Even if something is GREAT for business, we can’t do that thing if it will risk our business or our license- because everything hinges on that.
The Client First
Our businesses are ultimately about the need of the clients. If what we do or offer doesn’t help people, why would people continue working with us? If people don’t feel a deep change, why would they refer our friends? And, in this age of online reviews and Yelp pages- can we survive if clients consistently don’t find our services to be outstanding?
What Did Graduate School Teach Us?
In graduate school, we first learned about niche and specialization. Actually, many of us initially learned about having a “theoretical orientation” in grad school. Just a decade ago, your niche was more focused on the WAY you practiced than WHO you practiced with. And yet, what were you taught about assessment and treatment planning? One of your first obligations was to determine what the issue was and whether you were the best person to help them. There was a huge focus on referring out to specialized providers.
What Did Internships Teach Us?
We got to our internships and practicum placements bright-eyed and ready to do what we’d been taught- connect, assess, refer when needed, treat… and then what did we learn? Refer? Refer to who? There isn’t anyone who can help these clients. Just do your best. Your best is good enough- even if it really wasn’t. We learned to push down that voice that told us that something was out of scope and scramble to get information on everything we could. We learned to be Jack of All Trades, Master of None…
Enter in the Business Coaches and Marketing Gurus
And then the business coaches and marketing gurus started shouting about niches and specialization from the rooftops. This is what you need to do well in business. This is what you need to get clients. This is what you need to be found in search engines. And while that is absolutely true… it really isn’t the point…
Niche and Specialization Are In EVERYONE’s Best Interest!
Ultimately, niche or specialization is good for your clients, and THAT is good for business. Ultimately, a niche and specializations are ethically grounded, and what you were taught from the beginning!
You are already a jack of all trades… but you can only be a master of one or two… we need to get honest about what we do best, who we work with best, and let people step into what they are really great at so clients get better services. Psychotherapy as a service is declining, and not because it doesn’t work. But, because we aren’t allowing ourselves to be seen and do our best work!
Niche & Specialization: Ethics or Business?

Miranda Palmer, LMFT

Miranda Palmer, LMFT is passionate about empowering therapists to be extraordinary. Palmer trains therapists how to develop private practices that not only thrive financially, but that provide excellence in clinical care through free private practice marketing trainings, the Business School Bootcamp for therapists, and free study group for licensing exams for pre-licensed therapists.


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APA Reference
Palmer, M. (2019). Niche & Specialization: Ethics or Business?. Psych Central. Retrieved on October 29, 2020, from