To specialize or generalize is a common question asked by those entering private practice. Part of the answer to this question lies in geography. If you live in a rural area specialization will end your practice; generalization is the route to take. There just aren’t enough people (e.g., potential customers) in rural areas to support a specialized practice.

On the other hand if you are in a city or suburban area, specialization in the key to make you stand out amongst the “huddled masses” of licensed mental health professionals in private practice. When I moved to Atlanta I rented space in a town house office park built around a little duck pond. One day after lunch I walked around the pond and counted the names of 40 psychotherapists. So how does one stand out from the huddled masses? By have specialty areas for which you become known.

Choose at least two practice niches and then become the “go-to person” in your community for treatment of these problem areas. “Brand yourself” by doing talks in the community, blogging on your website, presenting for local community groups, presenting for professional groups both within your discipline and other professional groups that are potential referral partners (e.g., do CE presentations for physicians or attorneys), writing for magazines or local newspapers or national professional publications. If you choose a niche then your name should roll off people’s tongues when someone asks them, “Do you know someone who is good at treating _______?”

Choose two niches instead of one. It will help prevent boredom/burnout. It will also insulate your income if economic forces or social policy changes decrease the need/demand for one of the specialty areas.

Generalized referrals will come even though one specializes in one or two areas. If you demonstrate competence in your work it will instill confidence in your referral partners and clients to believe that you may also be skilled in treating other problems. These other referrals will then flow to you.


Steven Walfish, Ph.D. is a Licensed Psychologist in Atlanta and a Partner at The Practice Institute (TPI). For more information on TPI go to Join our mailing list to learn more about activities and products to enhance both the clinical and business health of your practice. To enhance your reputation and increase your volume of referrals check out our “Ethical Marketing” Home Study Course at