How to Pivot When Your Therapy Niche Becomes Triggering

As early as undergrad, you knew that grief counseling was your calling.

After enduring your own personal loss as a teen, and having a therapist support you through it, it has been clear to you for a long time: This is what I’m meant to do.

Fast forward to now, and you’re sweating. Literally.

Your years of experience as a therapist specializing in loss still couldn’t have prepared you for how it would feel when your partner abruptly passed away, just three short months ago.

And now, sitting in the therapist seat as your client vividly describes her wife’s funeral, you can feel a familiar panic rising in your body. Shifting nervously, hoping she won’t see the sweat droplets forming on your forehead, you will yourself to stay present.

“I’m supposed to be good at this,” an old-but-familiar voice in your head echoes critically. You take a deep breath.

“No,” you think in response. “I’m only human.”

Your client suddenly stops mid-sentence, sensing that she’s lost you. “Do you know what I mean?” she asks, waiting for your reassurance. Your stomach drops.

“Too well,” you admit.

It’s an honest answer, but it’s at that moment that you finally realize: I can’t do this. At least, not right now.

It’s not just you

For therapists who invest years in building a practice, deepening their expertise and refining their “niche,” it can feel devastating and even shameful to admit that the specialty you’ve chosen has become too painful and too personal to continue with.

Whether it’s a couples therapist navigating their own divorce, or a trauma therapist confronting a recent assault, this challenge is more common than you might think.

So what do you do when the very work that once energized you and gave you purpose now feels overwhelming, triggering, and even intolerable?

If you’re caught in this difficult tension — between the work you love, and your need for emotional self-preservation — there are steps you can take to de-specialize, holding both your clients and, crucially, yourself with compassion and grace.

This question emerged in Alma’s recent webinar for providers on prioritizing fit when building their caseload. To answer it, we've gathered additional insights from our panelists.

When to niche and when to step back

Specializing in a particular area of therapy can be incredibly rewarding. It allows you to hone your skills, attract ideal clients, and make a significant impact in your chosen field.

As Gary Hominick, LPC CSAT, points out, niching can help you speak directly to your clients' needs:

However, life doesn't always cooperate with our professional plans. Personal experiences can suddenly make our chosen niche feel too raw, too close. In these moments, it's crucial to recognize when it's time to create some distance.

Think of your niche as a drawbridge. Most of the time, it's lowered, allowing for a steady flow of clients and shared expertise. But when personal challenges arise, you have the option to raise that bridge temporarily.

This doesn't break your connection to your specialization; rather, it suspends it, allowing you the space to navigate your own journey while ensuring the structural integrity of your practice remains intact.

Remember, taking a step back isn't a failure – it's an act of self-care and professional responsibility.

By acknowledging your limits, you're ensuring that you can continue to provide the best possible care to your clients in the long run, while also protecting your own humanity and healing in the process.

How to de-specialize your caseload

If you find yourself needing to create distance from your niche, following these steps can help you through the process:

1. Acknowledge Your Feelings

Give yourself permission to feel whatever emotions arise. It's normal to experience a mix of guilt, frustration, and even relief.

2. Seek Support

Paul Fitzgerald, LCSW, emphasizes the importance of professional support:

Don't hesitate to lean on your own therapist, supervisor, or trusted colleagues during this time. If you’re an Alma member, you might also utilize the community hub for peer support.

3. Assess Your Capacity

Take an honest inventory of your emotional bandwidth. Which aspects of your work feel manageable, and which are currently too challenging?

If the admin aspects of your practice are too much — like if you notice yourself making “careless mistakes” while billing, or falling hopelessly behind on your notetaking — you might explore adding additional tools to your practice.

If it’s client disclosures or sessions that are flooding you, look for patterns. Is it specific types of sessions or triggers? Is it a certain number of clients per day that pushes you past your capacity? Are you showing signs of burnout?

Consider if you need specific accommodations, like a reduced caseload or a longer buffer between sessions, or if you need to explore alternative approaches or a different niche altogether (more on that below!).

4. Explore Alternative Approaches

With some awareness of what your triggers are, you can explore alternative modalities to reduce the likelihood of those triggers emerging in-session.

For example, if vivid descriptions of trauma are causing you strain, you might explore other approaches or learn a new intervention, like the Safe and Sound Protocol (SSP), that doesn’t require intense self-disclosure from the client.

Consider if there are ways to continue working within your niche while adjusting your approach to better protect your emotional well-being.

5. Give Yourself Permission to Refer Out

If you need to step back from certain types of cases, that is absolutely okay. It’s not a failure on your part, but rather, a self-loving and ethical decision. Referring out honors your humanity and limits, while ensuring your client gets the best possible support.

If you’re not sure how much to disclose to your client(s) about the need to refer, don’t hesitate to get supervision beforehand to ensure that the transition is supportive of everyone involved.

And remember: Be sure to modify your website, professional profiles, and other marketing materials to reflect your current focus, should it change. This helps manage expectations for potential new clients.

6. Embrace the Underlying Opportunity

Of course, it can be incredibly disappointing to step away from a specialty that has been your personal passion and purpose.

That said, there could be a silver lining inherent in this transition — you now have the chance to explore something new, or build on a skillset you don’t often tap into.

Maybe there’s an intervention or specialty that didn’t exist when your career started, and you now have the chance to deepen your knowledge with some continuing education. Maybe you have a few outlier clients who you love working with, and you have the chance to explore what makes that work so rewarding.

Or perhaps this is the chance to try something completely different, delving into podcasts, YouTube videos, or chatting up your colleagues to learn about what’s changing in the field. Where you might not have given yourself permission before, you get to explore and try on different hats.

Get yourself a fresh notebook (or word document!) and start taking notes on different topics, approaches, or theories in the field that catch your attention. You don’t need to analyze why something is sparking your interest just yet — instead, take note and start looking for any connections that start emerging.

7. Set a Timeline For Reevaluation

Whatever changes or adjustments you make in your practice could be permanent, but they won’t be for everyone! Sometimes you need to pause, and sometimes you need to pivot — and it may take time to discern which one applies to you.

Decide when you'll reassess, maybe even scheduling checkpoints in your calendar to ensure things are progressing in a supportive way.

This might be in a few weeks, months, or even longer – there's no universal "right" amount of time.

8. Let Your Cup Fill All the Way

It can be tempting in healing professions to frame our acts of self-care as ultimately being for the benefit of others.

“If I take this time for myself,” you might be thinking, “It’ll make me a better provider! It’s the responsible thing to do.”

But this can backfire, as it often means that as soon as our cups are a little bit full, we’re tempted to start pouring back into others again. We cut our leaves short, convinced our clients need us back as soon as possible; we forgo important accommodations, convinced we can get by on the bare minimum.

When we frame our well-being as a resource for others, it’s hard to prioritize our care and healing as being something for us.

Remember that if you pivot, pause, or step away altogether, your healing matters. Not because it’s for somebody else, but because you are deserving of the time, support, space, and rest required to fill your cup all the way to the brim.

You deserve the same kind of healing you facilitate for others.

Embracing change is growth

Navigating personal challenges while maintaining a therapy practice is no small feat. It requires vulnerability, self-awareness, and often, difficult decisions. But remember – you aren’t alone in this experience, and you deserve to have your whole humanity acknowledged, even and especially as a therapist.

At Alma, we understand the complexities of building and maintaining a thriving private practice. We're here to support you through every phase of your professional journey – including the unexpected detours.

If you're not yet a member of Alma, we invite you to learn more about how we can partner with you to create the practice of your dreams – one that's flexible enough to accommodate life's twists and turns.