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Could niching down actually help your practice grow? Does specializing allow you to make a bigger impact, not a smaller one? Does it work out financially? And how can you know when it’s the right time to become a specialty practice?
In this podcast takeover episode, Melissa Schneider discusses the question, “Should you niche down to a specialty practice?” with Kelsey Blahnik, LCSW-S.
Podcast Sponsor: Valant
Something I hear over and over again from practice owners in this community: “The one class I was never taught in graduate school was how to run my business.”
And honestly? That’s not a personal failing; that’s a gap in how we train clinicians. You built something real. But nobody handed you the playbook for intake, billing, team management, or what it actually takes to scale past a handful of clinicians.
That’s what Valant is built for.
Valant is the EHR designed exclusively for behavioral health group practices. With two decades of experience, 13 million patients engaging in their EMR and 28,000 providers using their platform, Valant offers the tools that close the gaps in your documentation, billing, and operations — including AI that handles the admin work so your team can stay focused on patients.
Valant created a free interactive resource specifically for group practice owners like you. It’s called the Breaking Through the Growth Ceiling and in literally five minutes, it pinpoints your biggest bottleneck right now, with a 90-day playbook to fix it.
Meet Kelsey Blahnik, LCSW-S
Kelsey Blahnik, LCSW-S, is the founder of The And Way Therapy, an insurance-based group practice specializing in OCD and trauma across Texas and Florida. She is the author of The And Way: Assertive Peacemaking in a Divided World, an ASWB-approved CEU trainer, and a clinical supervisor who believes gold-standard care should be accessible, not exclusive.
Visit The And Way and connect on Instagram. See also The And Way Therapy Instagram.
FREEBIE: 10 Questions to Foster Dignity in the Therapy Room
In This Podcast
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A bit about Kelsey’s journey
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What is psychological flexibility?
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Building a niche practice
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Why specialization matters for OCD and trauma
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Shifts after switching from generalist to specialty
A bit about Kelsey’s journey
Kelsey started her private practice in 2018 as a solo practitioner in Florida, the same year after the Parkland shooting.
I was feeling [committed] to try and create accessible mental healthcare because there was a lot of talk about gun reform and mental health reform, and I wanted both. (Kelsey Blahnik)
It was important to Kelsey to offer mental healthcare that was both profitable for the practice and simultaneously accessible to the community, which is why she offered both private pay and insurance.
Throughout these years, Kelsey was working on her book, but to get it finished and published, she decided to hire clinicians for her practice to keep it running, allowing her to dedicate more time to publication.
[Hiring clinicians] also allows me to have that ripple effect of teaching psychology flexibility to all my supervisees and all my team members, and they can keep seeing clients. I still see some clients, just less than I used to. (Kelsey Blahnik)
What is psychological flexibility?
At the core of psychological flexibility is the act of stepping away from “either, or” thinking, and embracing nuance.
We don’t have to get stuck in one camp or the other as red or blue, black or white, all or nothing. I was working a lot with eating disorders and disordered eating behaviors as they overlapped with OCD, and that psychological flexibility was constantly coming up because of our need to not look at food as just about nutrition or pleasure. It can be both! (Kelsey Blahnik)
Psychological flexibility is also about understanding that everything in between the extremes also counts. A person’s opinions or actions don’t have to be in their extreme form for them to be valuable.
So much of life exists in the nuance, and it takes effort to sit there precisely because it’s not an “easy” extreme answer.
Building a niche practice
Kelsey transitioned her private practice from being generalist to having an OCD-specialist focus.
The thing that really prompted me was when I had to create a website and narrow down for myself, “What do the clients that I most enjoy working with tend to see in our work together or tend to benefit the most from?” … When I had to get down to the nitty-gritty of that marketing mindset … I realized that there is something really specific that I get excited about when I work with clients. (Kelsey Blahnik)
The change came about when she realized there was a connection between the clients she most enjoyed working with and the transformation they experienced from working with her. Once she pinpointed that it was around OCD, she shifted the practice from generalist to specialty.
Why specialization matters for OCD and trauma
When OCD and anxiety are treated the same, and we use a lot of effective methods for anxiety, like traditional talk therapy and CBT, that can unfortunately exacerbate OCD symptoms.
This looks like:
- Overanalyzing, with talk therapy
- Replaying, with EMDR
If OCD is treated like anxiety in therapy, the counselling room risks becoming what the client needs to function well, rather than something that they can learn from and then exit, with sessions reducing over time.
It can allow for therapy to feel like a short-term relief in the OCD cycle, and then clients are craving and relying on the therapy 50-minute [sessions] … that’s now their way of getting reassurance, and then feel more reliant and dependent on it instead of it becoming a thing where they’re reducing frequency and becoming more and more independent. (Kelsey Blahnik)
Therefore, if you work with OCD as a specialty in your practice, it is crucial to treat it as its own bracket rather than combining it with anxiety, especially in the treatment approach.
Now, Kelsey’s practice does refer out clients to their referral network if they don’t fall into the specialty, but they have more than enough interest from clients who do need help with their OCD to keep the doors open.
Shifts after switching from generalist to specialty
Two years ago, there were four clinicians at Kelsey’s practice, and last year there were 10! And as of 2026, Kelsey has 12 clinicians on her team.
So, one thing’s for sure: the decision to change the practice from generalist to specialist has significantly grown her practice.
However, only niche down once you’ve done the research into whether or not your practice offering overlaps with the needs of your clients.
I would recommend specializing if someone is really passionate about their specialty, and there is truly a need for that specialty in their community. Otherwise, I think niching down just for the sake of niching is not necessarily what I’d recommend. (Kelsey Blahnik)
Books mentioned in this episode:
Kelsey Blahnik – The And Way: Assertive Peacemaking in a Divided World
Sponsors Mentioned in this Episode:
Valant created a free interactive resource specifically for group practice owners like you. It’s called the Breaking Through the Growth Ceiling and in literally five minutes, it pinpoints your biggest bottleneck right now, with a 90-day playbook to fix it.
Discover your best-fit membership group to join to help you reach your next level!
Resources mentioned in this episode:
Visit The And Way and connect on Instagram. See also The And Way Therapy Instagram.
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Check out these additional resources:
- Is DEI Dead? with Melinda Briana Epler | POP 1399
- Practice of the Practice Network
- Group Practice Launch
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- PoP Group Practice Owners Facebook Group
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Meet Melissa Schneider
