Why Sensitive Therapists Shouldn't Work With Everyone
When you think about being a “good therapist”, what qualities come to mind? Perhaps someone who is reliable, empathetic, ethical, a clear communicator, or has strong boundaries. Can you be a good therapist and also be selective about who you work with? Can you be a good therapist and make choices about who you help based on what feels most aligned to your needs, personality, or interests?
Does it matter that being more selective often leads to more effective clinical treatment and personal fulfillment as a sensitive therapist? When you’re more fulfilled and effective, you’re more likely to stay in the field longer, helping more people along the way. Not that helping the most people possible is the only way to be a good therapist!
When I was a pre-licensed therapist, I already knew I wanted to specialize in working with highly sensitive clients. Finding out about the trait and working with a highly sensitive therapist as a client myself was deeply impactful and changed my life immensely. I wanted to help others have the same experience. Thankfully I had supervisors that encouraged and supported my vision, but I still received feedback from licensed therapists that I came across who vehemently told me specializing so early was not okay. In their view, I needed to generalize and work with everyone.
Prioritize Clinical Impact Over Volume
If I was working in community mental health or a similar setting where I was seeing a wide range of clients, I would have agreed, but at that point, I was already on a private practice track. Why did I need to spread myself so thin to help everyone a little instead of helping some people greatly? It just didn’t make sense to me and still doesn’t.
Even working with HSPs across populations - adults, kids, teens, couples, families - felt like a stretch at times. Working with an HSP/non-HSP couple in conflict took a very different clinical skill set than working with an 8-year old HSP struggling with social anxiety. And an even different clinical skill set was needed for supporting a queer HSP teen with panic attacks and self-harming behaviors. I had all of these presentations and more on my caseload pre-licensure, even with an HSP niche. I can’t imagine having to spread myself even thinner.
Over the years, I’ve allowed my clinical focus to narrow more and more. The result? Honestly, at first I felt guilty and worried I wasn’t being a good enough therapist - letting the messages from those naysayers cloud my instincts. Once I gave myself permission to listen to my needs and look at the effects of working in alignment with those needs, the choice was clear. I was happier and so were my clients.
Lean Into Your Assets as an HST
When you’re highly sensitive your brain wants to process at length, it wants to feel prepared, and use all the data it’s accumulated. You’re also very attuned to nuance and non-verbal cues which leads to strong intuition and creative thinking, an incredible asset as a therapist. If you allow yourself to immerse in a clinical specialty, you will not only align with your sensitive system’s need for depth, but you’ll combine your knowledge with your instincts to be an incredibly effective clinician. You will understand your specialty deeply, impacting your clients in profound ways.
I’ve seen this happen again and again. Clients feel seen as soon as they land on my website and then the growth progresses quickly once the therapy starts. This is even true with clients who have seen other therapists for years. Why? Because I know what to look for in highly sensitive clients, what questions to ask, what resources to recommend, what the blindspots usually are, and what often gets missed when therapists aren’t as familiar with the trait.
Be Less Overwhelmed + More Effective
The more you can immerse in your preferred clinical specialty, the more knowledgeable you become in this area, the more the following is possible:
Feeling less overwhelmed by trying to learn a little about everything
Spending less time preparing for sessions and getting consultation/supervision
Finding more fulfillment and meaning in the work you’re doing
Being more effective, more quickly with clients
Putting your sensitive gifts of empathy, intuition, creative thinking, depth of processing, and awareness of subtleties to use in impactful ways
Being able to apply insights from trainings across your whole caseload and honing your clinical skills quickly
For HSTs, there is so much benefit in narrowing your clinical focus to help your clients more effectively while you feel more satisfied as the clinician. This work is often so draining for us, it’s paramount to bolster against burnout in every way you can. You may benefit from one specific niche in one population or have a few, if you’re someone who needs more variety. Whatever you choose, look inward for guidance in deciding what is the best path for you.
More Resources
If you need a little help deciding what clients to welcome into your practice, watch my free workshop: 3 Pillars of a Sustainable Practice. You'll learn the three essential strategies to have a supportive practice with less overwhelm and burnout, better boundaries, and more space to prioritize your needs! Click here to watch immediately.
Includes a workbook with:
a new client screening checklist
sample scripts for referring clients out
worksheets to map out your new schedule to get more downtime and identify what you need to maintain your boundaries to feel more energized
