Career path/advice for current LMHC

[T_S_B]

Hey folks, long time lurker first time poster.

I obtained my MA in mental health counseling in 2011. Between 2011 and 2013, I had a smattering of work experience (worked in an agency doing domestic violence perpetrator groups, working with kids who had severe developmental delays, working with adults who had severe developmental delays, etc).

At the end of 2013, I started working in the crisis field, mainly doing mobile crisis outreach for the county I was living in. Outside of some of the internal political bs, I felt like I was starting to find my area I wanted to focus my career in. In 2015, I was given an opportunity to work in a partial hospitalization program and do per diem work with the crisis team. I took that option, did a bare bones crash course on DBT, and worked in the PHP program for 5 months. Frankly I hated it, it was a lot of running groups...and I discovered that my disdain for group work. I bounced back to mobile crisis full time.

I then moved to a different state, and started work doing evaluations for involuntary psychiatric hospitalization (2016 to now) and also doing per diem work in a local emergency department doing mental health evaluations. I obtained my LMHC at the end of 2016.

I like crisis work, I'm good at it, and in a perfect world I'd probably stay where I'm at because it pays a decent wage and it's job security. However, it's not a perfect world.

Due to some life situations, I'm looking at transitioning to outpatient counseling and focusing on telehealth (I may need the flexibility of telehealth to be able to travel back and forth between places). The last time I did actual counseling type stuff was back in the PHP program 5 years ago. Being able to build rapport, attending to the client, assessment, and stuff that comes with crisis intervention I can do well, but if I'm going to be seeing folks on a weekly basis, those skills can only take me so far. I'm also feel like the skills I currently have is geared towards being a generalist, and the impression that I get is that to be a successful therapist, being able to have a focus or nitch is needed.

So I guess, after that long winded narrative, is what is the best way to sharpen up on the outpatient counseling skills and how did you discover your focus or nitch? If you've made a similar transition, I'd love to hear what that looked like for you.

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[foreverbull]

To sharpen your skills, you might seek consultation, supervision, or additional training. Those are probably the best options, but require a financial investment. On the cheap, you can join or start a weekly case consultation group with other therapists for free.

As far as a specialty, this is hard to say. You sort of fall into it at times by getting a job working with a certain population, and other times you naturally gravitate toward a certain issue/group and expand that interest through training and clinical work. If you are interested in a certain training modality as your specialty, you just need the training. Some folks choose a specialty in an area that they’ve personally experienced in the past but successfully navigated and developed a genuine interest in working with it (Postpartum depression, grief & loss, infidelity, chronic pain, etc.) or identify as part of that population (I.e. ethnic minority, LGBT, etc.), and some just by chance happened to work with a group or issue and found that they enjoyed it (PTSD/vets, older adults, children, adolescents, ADHD, eating disorders, psychotic disorders, personality disorders, etc.). No one else can answer what that will be for you, but training is important if you gravitate toward an issue or population you haven’t worked with much.