Why It’s Important to See a Therapist Who Is Both a Specialist and a Generalist | Seanna Crosbie, LCSW-S Therapist in Austin, Texas & California

Are You Getting the Right Therapy—or Just One Piece of the Puzzle?

You finally take the step to see a therapist. You’re struggling with focus, motivation, and emotional ups and downs. The therapist you choose is a trauma specialist, so they explore your childhood experiences, attachment wounds, and nervous system dysregulation. But something feels off. You mention your struggles with distraction, hyperactivity, and challenges with executive functioning since age 5, and they don’t seem to connect the dots to potential ADHD.

Or maybe you see an ADHD therapist. They immediately focus on executive functioning strategies, medication referrals, and productivity hacks. But the deeper emotional wounds—those moments of fear, shame, and anxiety—aren’t fully explored. They attribute everything to ADHD when in reality, past trauma is playing a major role.

This is why it’s critical to see a therapist who is both a generalist and a specialist—someone who can recognize multiple layers of your experience rather than viewing everything through a single lens.

The Problem With a Narrow Focus in Therapy

Recently, I was talking with a trauma therapist. In passing, I mentioned that about 30% of my clients have ADHD. They paused and said, "I don’t know much about ADHD."

That moment stuck with me. Many clients enter therapy without knowing they have ADHD. If a therapist isn’t familiar with ADHD symptoms, they might misinterpret executive dysfunctioning challeges as avoidance, hyperactivity as anxiety, or emotional dysregulation as trauma responses. When ADHD goes undiagnosed and untreated—either therapeutically or medically—it can create major roadblocks in therapy.

On the flip side, I once spoke with an ADHD therapist who wasn’t trauma-informed. They interpreted a client’s intense emotional responses, fear of abandonment, and self-sabotaging behaviors solely through the lens of ADHD. But those reactions weren’t just about dopamine or executive function—they were deeply rooted in past trauma.

If therapy only addresses one part of the equation, clients don’t get the full support they need.

Why Seeing a Specialist Who is Also a Generalist Matters

A well-rounded therapist balances breadth and depth—understanding a range of mental health concerns while having deep expertise in mutliple key areas. Here’s why this is important:

1. Mental Health Is Complex

No one exists in a vacuum. Trauma, ADHD, anxiety, depression, and relationship issues often overlap. A therapist who can recognize these connections prevents misdiagnosis and ensures you receive the right support.

2. One-Size-Fits-All Therapy Doesn’t Work

If a therapist views everything through a trauma lens, they might overlook biological and neurological factors like ADHD or anxiety disorders. If they only focus on ADHD, they might miss emotional wounds and attachment issues. A balanced approach ensures a more accurate understanding of the whole person.

3. Clients Need Flexibility in Therapy

Therapy isn’t linear. Some weeks you might need to process past trauma. Other times, you might need practical strategies for focus, productivity, and impulse control. A therapist with a broad skill set can adapt to your evolving needs.

4. Misdiagnosis Can Lead to Stagnation

When a therapist only sees part of the picture, progress can stall. Someone with untreated ADHD might feel stuck in trauma work, unable to implement coping skills. Someone with unresolved trauma might struggle with emotional overwhelm, making ADHD strategies ineffective. Addressing both opens the door to real progress.

How to Find a Therapist With the Right Balance

1. Ask About Their Areas of Expertise

A strong therapist should be able to say, “I specialize in trauma and ADHD, and I also work with anxiety, grief, and relationships.” If they only list one area, they may have a narrow focus.

2. Look for Evidence-Based Approaches

A well-rounded therapist is trained in multiple evidence-based modalities, such as:

• Acceptance & Commitment Therapy for improving psychological flexibility & promoting meaningful healing

• CBT (Cognitive Behavioral Therapy) for thought patterns

• Executive Functioning Strategies for ADHD

• Emotion-Focused Therapy for relationship healing

• Exposure & Response Prevention for OCD, helps confront fears and anxieties

• Mindfulness-Based Strategies for emotional regulation

3. Notice How They Respond to Complexity

A good therapist acknowledges when issues overlap. If they say, “This may be a mix ______ and ______ — let’s explore both,” you know they’re considering the full picture.

Therapy Should Be Holistic, Not One-Dimensional

If you’ve ever felt like therapy is missing something—or like your struggles are being oversimplified—you’re not alone. Mental health is complex and interconnected, and therapy should reflect that. Seeing a therapist who is both a generalist and a specialist ensures you get comprehensive, adaptable, and effective support.

About the Author

Seanna Crosbie, LCSW-S is a therapist with 25 years of experience helping adults and children navigate grief, trauma, anxiety, OCD, ADHD, relationships, and parenting challenges. She is a former clinical director and now runs a private practice offering therapy in Austin, Texas, and California. Seanna is committed to providing evidence-based therapy to help clients transform their relationships and heal attachment wounds. For more information, contact her here.

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