What Is Geek Therapy?

Geek Therapy uses clients’ passions (whether it’s anime, sci-fi, comics or gaming) as a bridge to explore mental health. By weaving familiar stories, characters, and worlds into therapy, it creates a shared language that feels natural and accessible. This approach can make it easier to open up about emotions, build coping skills, and engage more fully in the therapeutic process.

In our recent podcast episode, Kailah Tuttle, LPC, an Ellie clinic director and a certified Geek Therapist, shared that Geek Therapy “is a language and skill set that helps deepen my connection with clients. When you understand what they’re passionate about, you can spark insights and make the work more meaningful.”

Using Dungeons & Dragons in Therapy

Think of Geek Therapy as play therapy, but for all ages. It often incorporates role-playing tabletop games, geek culture, and scenarios where clients can explore their feelings through fictional characters. For example, in D&D-based therapy, the therapist may take on the role of a Therapeutic Dungeon Master (TDM), guiding clients through imaginative quests that foster emotional regulation, problem-solving, and teamwork. This format allows clients to practice real-life skills in a safe, fictional environment, making difficult topics easier to approach.

In the podcast interview above, Kailah talks about how she brings a unique twist to her therapeutic practice by incorporating Dungeons and Dragons (D&D). As a Dungeon Master, she creatively uses tabletop role-playing games to help her clients engage with therapy in an interactive and fun way. Currently, Kailah is working on writing and creating a brand-new D&D campaign designed specifically for group therapy. She believes that D&D provides an immersive and imaginative way for clients to process emotions, practice interpersonal skills, and explore difficult topics (plus make new friends and connections!). By stepping into different roles and characters, clients can express themselves, navigate conflicts, and work through challenges, all while remaining engaged and motivated by the game’s structure and storytelling elements.

Geek + Art Therapy = Creative Self-Discovery

Geek Therapy easily intersects with art therapy. Clients might design their own superhero origin stories to reflect their personal strengths or create visual representations of their internal struggles. Seeing yourself as the hero of your own narrative can be incredibly empowering, especially when working through challenges.

I recently worked with a kid in therapy who’s really into video games and different fandoms. To connect with him, we did an art therapy activity where we each created a video game character that represented ourselves. We talked about the strengths and areas for growth in our characters, exploring how they were similar to or different from our own experiences. This approach helped us blend solution-focused skills and narrative skills with Geek Therapy, making the session both engaging and therapeutic.

Intersection of Geek Therapy and Internal Family Systems (IFS)

This approach supports the development of emotional flexibility, communication skills, and self-awareness. In the interview, Kailah talks about how techniques from models like Internal Family Systems (IFS) are sometimes integrated, helping clients explore their inner “parts” through the lens of different fictional characters or avatars. By engaging with beloved stories, clients can gain fresh insights into their own internal worlds.

Geek Therapy Meets You Where You Are

Geek Therapy isn’t just for teens or self-identified geeks—it’s for anyone who connects with storytelling and creative play. Whether through gaming, movies, books, or comics, this approach makes therapy feel less clinical and more like a shared adventure.

Research and Evidence Behind Geek Therapy

You might be wondering if geek therapy is an evidenced-based therapy, and good news– there has been research done on various parts of it!

Recent studies have shown that role-playing tabletop games (including therapeutic Dungeons & Dragons) showed increased confidence, empathy, and a decrease in anxiety, especially social anxiety. The collaborative, imaginative nature of tabletop role-playing games (TTRPGs) provided a safe space to practice interpersonal skills, making it a tool for building real-world confidence. They hypothesize that by facing fictional challenges that might mirror real-life fears, clients practice emotional regulation and problem-solving in a low-pressure, fun setting. More studies can be found at this list.

Unsurprisingly, cosplaying itself has therapeutic benefits. A qualitative study revealed that cosplaying helped individuals express and explore parts of their identity, reduce social anxiety, and build confidence. By stepping into a character’s shoes, participants were able to experiment with self-expression and embrace new social roles.

Who Can Benefit from Geek Therapy?

Geek Therapy can benefit a wide range of individuals, including:

• Gamers and pop culture enthusiasts who like expressing themselves through fictional characters.
• People who struggle with traditional talk therapy. Talk therapy isn’t for everyone: a lot of people can benefit from types of therapy that are more creative and play based.
• Individuals with social anxiety or depression who find comfort in role-playing or creative outlets.  Geek therapy can be offered in groups, and this can be an excellent way to connect with others that share your passions and interests!
• Neurodivergent clients (e.g., those with autism or ADHD) who benefit from structured but imaginative environments. A lot of the research was targeted specifically for autistic clients and the progress they made though this therapy modality.

DIY Geek Therapy Techniques to Try at Home

Not quite ready to jump into geek therapy? Here are some ideas for geek mental health activities to do at home.

Character Journaling

Character journaling is a creative way to bring geek therapy home! It involves writing a journal entry from the perspective of a fictional character, whether from a book, movie, TV show, or even a character you’ve made up. By stepping into their shoes, you can explore emotions, motivations, and experiences in a creative and perhaps more comfortable way. People like this tool, because writing as a character creates a level of separation, making it easier to express vulnerable emotions that might feel too raw when written in your own voice. Plus it’s an imaginative outlet that can reduce stress and encourage flow-state writing.

How to do it:

1. Choose a character whose experiences or emotions you want to explore. This could be someone you admire or relate to.
2. Imagine a specific situation the character is facing (it can be from their fictional world or a new scenario you create).
3. Use their language, tone, and inner dialogue style. Capture their thoughts, emotions, and reactions authentically.
4. Dig into their feelings. Are they angry? Conflicted? Hopeful? Let them express it fully.

Example as a sci-fi character: “Stardate 5923.4. The loneliness out here is suffocating. My only friend is the blinking red light on the console, reminding me I’m still alive. Barely.”

“In Control, Out of my Control” Video Game Activity

Helping kids understand what they can and can’t control can be tricky, but connecting it to something familiar or concrete (like video games) makes it more engaging. A simple way that Kailah recommends to do this is by creating a video game controller worksheet.

How to do it at home (or in sessions, if you’re a therapist):

1. Draw or Print a Controller: Design your own or use a template.
2. Label the Buttons – On one side, they write things they can control (like how they react when upset). On the other, things they can’t control (like their parents arguing).
3. Add “Wish Buttons” – If they say, “I wish I could press a button and disappear when my parents fight,” use that to explore real coping strategies.
4. Reframe & Reflect – Discuss how focusing on what they can control helps them feel more empowered.
5. Use It as a Coping Tool – They can keep their controller as a reminder to focus on their own choices, even in tough situations.

D&D-inspired Goal Setting

Another way that I found you can incorporate Geek Therapy into everyday life is by using Dungeons & Dragons (D&D) mechanics as a framework for goal setting. This can make the process more engaging, creative, and motivating. This approach gamifies personal growth by turning goals into quests, milestones into challenges, and rewards into loot or experience points. Here’s how to bring this concept to life:

Instead of writing a standard goal like, “Exercise three times a week”, transform it into an adventure-style quest, like: “Strengthen your body and fortify your stamina by conquering three physical trials each week.”

Here’s another example, plus ways to break down your larger goal into “mini-quests:”

Goal: Strengthen your mental resilience and emotional well-being by completing three mindfulness-based mini-quests each week.

• Mini-Quest 1: The Breath of Clarity → Practice a 5-minute deep breathing or grounding exercise
• Mini-Quest 2: The Scroll of Reflection → Journal for 10 minutes about your thoughts, feelings, or experiences
• Mini-Quest 3: The Shield of Stillness → Complete a 10-minute guided meditation or body scan

Reward: Consistently completing the quest for a month earns the title “Master of Serenity” and grants a reward, such as a mental health day or a special experience of your choice.

As a therapist, I know that many of my clients benefit from “gamifying” their mental health goals, plus this breaks down larger goals into smaller, more manageable steps.

Considering Geek Therapy?

If this style of therapy sounds like a fit for your (or maybe you’re a parent and you think your kid would connect with this), we can help you find a clinician trained in Geek Therapy. They can help you in a therapeutic journey that feels less like traditional talk therapy and more like an adventure of self-discovery, filled with the stories and characters you already love.

Listen to the podcast interview about geek therapy here, or read the transcript below:

Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda, and we’re here with Kailah. Kailah, thank you so much for joining again. I’m excited to talk to you about this topic and have you back.

Kailah: Yeah, I’m so excited to be here. Hello, fellow Therapy Nerds!

Miranda: I love it. Today, we’re going to talk about geek therapy, which I feel like I know nothing about, so I’m excited to dive in. Kailah and I were just chatting beforehand about birthday plans and all sorts of things before we started recording. I started to ask a question and thought, “You know what? Let’s just start recording and make this authentic.”

So, geek therapy—what is it?

Kailah: Geek therapy encompasses a lot. Essentially, it’s about finding people’s passions and fandoms—things like anime, role-playing games, video games, comics, manga—and using those as a lens for talk therapy and mental health concepts. It’s about creating a common language with clients by using references they understand and relate to.

Miranda: I love that. You just named so many different interests. It seems like geek therapy covers a wide range of topics. Since so many things are considered geeky, this therapy approach must be pretty broad. It sounds like it’s really about meeting clients where they are, through their interests. It almost feels like play therapy in a sense. You’re nodding—did I get that right?

Kailah: Yes! There’s actually a whole field of geek therapy now, with more research emerging. I did a training last summer in 2024 called Therapeutic Dungeon Master training. You learn how to be a Dungeon Master and run therapy groups using mental health topics. It’s essentially play therapy because it’s so adventure-based. You lead people through a quest while integrating skills like mindfulness.

For example, you might have clients embody their character and describe their surroundings, take a deep breath, and access their “internal guide” or wisdom. You can create entire worlds while teaching regulation skills.

Miranda: That makes so much sense. With play therapy, you can be either directive or non-directive, depending on your style and the client’s needs. The way you’re describing geek therapy feels similar—meeting clients where they are and using their preferred language to help them process.

When I think of kids, they naturally process through play. For example, my daughter knows we’re about to move, and now her Barbie family is constantly moving houses in her dollhouse. It’s all they talk about during play. It helps her make sense of the transition. It sounds like geek therapy taps into a similar concept, but for all ages—using interests like games or fandoms as a form of processing.

I’m curious, though—does geek therapy have formal certifications? Like with play therapy, you can use play-based techniques without being a Registered Play Therapist, but there are also certifications that require specific training. Is it the same for geek therapy?

Kailah: Yes, exactly. You can be competent in geek therapy without being formally certified. Geek Therapeutics is the organization I’m part of. I went through their training five or six years ago, and I’m now a certified geek therapist. They offer a bootcamp of classes, and they also host monthly CEU trainings on specific skill sets and new media trends.

Miranda: That makes sense—you’d have to stay current with pop culture, video games, and movies since new content is always coming out.

Kailah: Exactly. What’s cool is that you don’t have to be a therapist to take the training. They offer competency classes for teachers, youth workers, and people in other fields. It’s really versatile.

Miranda: So, when you did the bootcamp, was there an exam or supervised practice required, like with other therapy modalities?

Kailah: Yes, it’s similar. You take an exam, complete 30 to 50 courses, and do supervision. They offer supervision for both geek therapy and therapeutic DMing (Dungeon Mastering), so you can specialize in either area.

Miranda: That’s so interesting. What does geek therapy look like in your practice?

Kailah: Sometimes it’s as simple as identifying a client’s favorite characters or fandoms and using those to explore mental health concepts. For example, if a client relates to an anime character or a superhero, I might use that character to help them understand their own experiences.

I also use Internal Family Systems (IFS) a lot, so I’ll have clients assign parts of themselves to fictional characters. They might have a “Batman part” that’s a loner or a vigilante, and we’ll explore how that part approaches situations in their life. It creates a safe way to discuss internal conflicts.

On a larger scale, I’m developing a therapeutic Dungeons & Dragons group that will run for 10 weeks. Participants will create characters, level up, and go on an adventure together, while working on skills like regulation and problem-solving.

Miranda: That’s so cool! Is it a closed group, with the same participants throughout? I don’t know much about Dungeons & Dragons, but I do know being a Dungeon Master requires a ton of creativity and planning. It sounds like a lot of work to combine it with therapy.

Kailah: It is! You’ll notice I said I’m “working on” the group—it hasn’t started yet because it’s so time-intensive. I’m a therapist, a mom, and a clinic director for three clinics, so it’s a passion project that’s slowly coming together. Even if you use a pre-existing campaign, you still have to adapt it with therapeutic elements, run character-creation sessions, and teach the basics of tabletop role-playing. It’s a lot of prep work, but once it’s done, I’ll have a reusable framework.

Miranda: That makes sense—it’s like group therapy. It sounds like it has psychoeducation elements where you’re teaching skills, but is there also a processing component? Do clients share personal experiences during the campaign?

Kailah: It depends on how you structure the group. Typically, we start with check-in questions. For example, we might ask how a client and their character would respond to a current event. Speaking through a character often makes it easier for people to be vulnerable.

Characters can represent idealized versions of clients, more reserved or more expressive than they are in real life. Through their characters, clients reveal insights into their own emotional world. It creates distance, which helps some clients express emotions they might otherwise avoid.

Miranda: I can see how helpful this would be. As you’re describing it, I’m like, this makes so much sense. Especially when you’re talking about character creation. Other modalities do that too, where they’ll have you talk about a preferred future or your safe space. IFS makes a lot of sense—you have your manager parts—and it makes sense how you can use character building to explore how a person might be similar or different from the character they’ve created. This is fascinating.

Okay. First off, I don’t know much about Dungeons and Dragons, but can’t a single session last for hours? How would you contain this to a short group?

Kailah: Yeah, it depends. We would probably do a long campaign with different modules or scenes. If you think about it like a play or a movie, there are different acts. Sometimes you have to get really creative, and that takes some flexibility. There’s a lot of improv involved in role-playing settings. Sometimes you need to say, “This is a good time to pause,” and maybe fill the last 20 minutes with something else. Or you have to stop at an awkward point and pick back up later.

It takes a lot of note-taking and being mindful of where everyone’s at. It doesn’t always fit neatly into a time period, so ideally there’s some flexibility.

Miranda: I’m just thinking about how you would bill insurance and write your progress notes. You’d have to be creative about it. You’d probably say something like, “Client processed X, Y, and Z through therapeutic play” or something like that. Or tweak the notes to frame it as a therapeutic intervention. I’m just envisioning how you would write down some of the different things.

Kailah: Yeah. You typically just focus on the skill, like you would with anything else. You’d write, “Learned how to ground using breathing techniques” or whatever it is you’re targeting in the group setting.

Miranda: You wouldn’t write, “Miranda went on this adventure, encountered a dragon, and stole all of their loot.”

Kailah: No, but that would be so much more interesting to read.

Miranda: It would! I would much rather write a note like that. But… insurance.

Kailah: Yeah, insurance.

Miranda: That’s so funny. Okay, so Dungeons and Dragons—I can’t wait to hear more when you actually run this campaign. This is super cool. But in order to do this, did you call it Therapeutic Dungeons and Dragons?

Kailah: Yeah, so I am technically a Therapeutic Game Master after completing this training.

Miranda: Game Master, okay. What did that training look like? Did you have to do additional training after your Geek Therapeutics certification?

Kailah: Yeah, this was a whole separate program. It was structured in a similar way. I had a cohort of other therapists across the U.S. It was all virtual, and we had our own therapeutic dungeon master. It was both learning and process-oriented.

It was two hours every week for about 10 weeks. The first hour was theory—game and character creation, adventure planning, and technical Dungeons and Dragons skills. The second half was focused on blending it with therapy. We also facilitated our own group. We acted as characters and role-played to get a sense of the process.

For our final project, we each had to take turns being the DM (dungeon master) and lead a scene. We created our own content—called “homebrew”—and walked people through it. We outlined the skills we wanted the group to practice throughout the process.

Miranda: I remember a couple of years ago when we first started this podcast, we had one of my colleagues, Tamara, on. She talked about how therapists find their niche. She was someone who, right out of grad school, knew she wanted to work with elderly or geriatric clients. That was her niche.

But for a lot of us, it takes longer to figure out what type of client we love working with. By the time this comes out, we’ll have another episode with Karna, who talked about how her niche became all trauma. But seeing trauma clients for five to eight hours a day caused her to experience secondary traumatic stress.

When we talk about finding our niche, sometimes it takes experimenting with different clients and realizing, “Actually, I really like working with this group.” From that old episode, I remember Tamara said it’s all about the clients where you feel in flow—the ones where it doesn’t feel like work. Everything just flows naturally.

I can see how, for a lot of people who identify as geeks, this would be such a cool modality. They probably feel like you do—it’s fun. You can see how it helps people, and it also helps you. This modality seems like a lot of fun, especially for people who are really into games, role-play, or geek culture.

Kailah: Yeah. It’s really fun, and it makes it easier to talk about hard topics through this lens. And not just individually, but also with the group behind it.

One of my favorite things to do is go to Comic-Con. When you’re there, you find your community—your people. It’s the same for anything, whether it’s going to a football game or whatever your thing is. You meet people who resonate with the same stuff.

Through characters, people process their own content. A lot of geek culture and media is based on Jungian theory—archetypes and the collective unconscious. You see these repeated themes throughout humanity—stories, fables, and characters that show up again and again. There’s a reason they resonate so deeply—they reflect the human experience.

Miranda: What are some other things you like to do with clients that fall under this realm?

Kailah: I do art therapy as well. Art therapy and geek therapy blend together really beautifully.

Miranda: Ooh, how?

Kailah: There’s so much you can do with narrative therapy. If you think about it through the “hero of your own story” lens, I’ve had clients write their origin story—similar to a superhero’s backstory.

Most superheroes have gone through trauma. Batman, Superman—most of them have some sort of traumatic past that shaped them. What better lens to view humanity and the therapeutic process through? It allows clients to reflect on their strengths and how they’ve grown.

Miranda: Interesting. So when you do art therapy, would you ever have people create a comic book? For some reason, that’s the first thing that comes to mind. What other types of activities would you have them do?

Kailah: It really depends on what the client is into. I’ve definitely done comic books, especially with younger clients. I mostly see adults now, with some teens. I still see kids, but my schedule makes it harder to take on as many.

At Comic-Con events, I run therapy resource rooms and usually include some sort of art activity. We’ve done journal origin stories and comic book-style projects. We’ve also done mask-making—creating an alter ego superhero mask.

Another fun activity is making trading cards, especially for clients who like Pokémon. They design cards based on their strengths or values. You can get creative with it—this is my deck, and I can collect attributes, trade them out, or give them to others. You can use it however you want, but it becomes a tangible representation of their qualities.

Miranda: Oh, that’s so cool. I remember a couple of years ago, we had Neil Peterson on—shoutout to Neil! He was actually the one who first told me about geek therapy. I learned about this topic because of him.

He’s a play therapist and a clinic director here in Minnesota. In his episode, he talked about his big closet full of games. As part of his geek therapy, he uses really specific, awesome board games with clients.

When I first heard about geek therapy, I thought it was just about playing board games like Dominion or other geeky games. But it seems like it can also just be talk therapy, using shared language or this lens. What does that look like?

Kailah: I think you have to have one foot in both worlds—steeped in geek culture and aware of what’s out there. Even if it’s something I don’t necessarily watch, you just learn how to talk the language and understand the basic components. But then also, of course, mental health is the primary focus.

Sometimes it’s about crafting metaphors to walk alongside people on their journey. I use the Hero’s Journey a lot in therapy—thinking about where people are. Most people don’t come to therapy because things are awesome. They come because they’re in a really hard season of life. So, if you can mirror that with another character or experience they resonate with—whether they’re having the same struggles or they see strengths in that character they haven’t found in themselves yet—they can draw on that for wisdom or support. It’s almost like they have their own little Yoda guiding them.

Miranda: So, if you were starting out with a new client, would you have them identify characters they admire or relate to? How would you begin to tease that out?

Kailah: I don’t usually ask directly, “Which geeky characters do you identify with?” during an intake—unless they’re obviously super nerdy. Instead, I ask about hobbies, interests, or just walk through their day. If they mention playing video games, I’ll ask, “Ooh, what games?” Or if they say they play board games with friends, I’ll get curious about which ones. That gives me a sense of shared commonality and helps me understand their world. Books, movies, shows—anything they engage with can be a doorway into that connection.

Miranda: Man, you really have to be on top of everything! Geek culture is so broad—it covers movies, board games, video games, and more. I admire you for keeping up with it all. Are there parts of geek culture you gravitate more toward? You mentioned Dungeons & Dragons, but if someone is super into Marvel or superheroes, do you lean into that?

Kailah: Definitely. There are certain areas where I can speak the language more fluently. I’m by no means a D&D expert—I’m still learning a lot—but I know enough to engage with it. Harry Potter is a big one for me. I’m a huge fan—I actually had a Harry Potter/Lord of the Rings-themed wedding!

Miranda: Oh my gosh, I love that!

Kailah: Yeah, so naturally, I draw from those worlds a lot. There’s so much built-in magic, facing fears, and overcoming traumatic backstories. Because I consume that content so frequently, it’s easy to reference it in therapy—like comparing a client’s journey to Harry facing his fears or Frodo carrying his burden.

Miranda: That makes so much sense. It’s funny—about a year or two ago, I was seeing a 14-year-old client who was super into Harry Potter. At the end of each session, she would bring me Harry Potter trivia questions.

Kailah: That’s adorable.

Miranda: It was so fun, but also humbling because I was terrible at the trivia! I’ve read the books, but she knew it inside and out. She’d be like, “Who did this?” and I’d guess, “Hermione?” and she’d go, “No, of course not—it was blah, blah, blah.” She beat me every single time.

It’s funny, though—if I had known about geek therapy back then, I probably would’ve thought, “I should refer her to a geek therapist. She would thrive in that setting!”

Would you actually consider geek therapy its own modality? How would you describe it?

Kailah: I think of it more as a lens rather than a standalone modality. It’s typically paired with other evidence-based approaches. There are people with doctorate degrees doing research on geek therapy, and there are conferences and books dedicated to it. But it’s usually integrated with something else—like art therapy, narrative therapy, or CBT. For example, you can use characters to build psychological flexibility or explore personal values.

For me, it’s more of a language and skill set that helps deepen my connection with clients. When you understand what they’re passionate about, you can spark insights and make the work more meaningful.

Miranda: Yeah, I can see how it would be a powerful tool for building rapport and finding common ground.

Are there any other parts of geek therapy you feel we haven’t covered?

Kailah: There are so many different aspects to it. Geek Therapeutics sends out a weekly newsletter that’s a great resource—even if you’re just mildly interested. You can sign up for free at geektherapeutics.com. They share tips like, “How to explore strengths and values through Pokémon” or other creative interventions. It’s a great way to get new ideas.

Miranda: That’s a fantastic resource.

If a therapist wanted to start incorporating geek therapy with a client, are there any specific interventions or activities you recommend? I loved your idea of making trading cards or comic book characters. Do you have other go-to strategies?

Kailah: Yeah, a few come to mind. One simple activity is creating a video game controller worksheet—especially for kids. You have them draw buttons that represent things they can and can’t control in their life. For example, they might say, “I wish I could hit a button and disappear when my parents argue.” It’s a creative way to talk about control and coping.

Another one is working with ideal vs. current self. Around the new year, people naturally reflect on their goals, but you can gamify it. I sometimes have clients create a D&D-style character sheet with their current stats—things like strength, charisma, wisdom—and then make an ideal version. We talk about what it would take to bridge the gap. Do they want to be stronger? More confident? What skills or experiences would help them level up?

Miranda: Those are brilliant. I’m not a geek myself, but I could definitely see using these activities with clients—especially adolescents. So many of them are into manga, video games, or other geek culture.

Kailah: Absolutely! It’s such a fun and meaningful way to connect with them. Miranda, I wanna learn more about your fandom. Like, if you were working with a geek therapist and they asked, “Miranda, what are we gonna use?”—what would be your thing?

Miranda: Oh my gosh, that’s such a good question. Hmm… maybe superheroes? I’ve never been super into superhero movies, but when I was little, I would write stories about superheroes all the time. I think there’s just something about imagining what my superpower would be or what I’d want to be able to do.

And honestly, there’s still a part of me—the inner kid—that totally loves that kind of stuff. It’s just fun. Oh! I’m also a Disney nerd. My husband and I are actually taking our kids to Disney next month, and, Kailah, I am obsessed. I live and breathe everything about our trip.

Right before I jumped on here, I texted my sister a screenshot and was like, “This is where we meet Mickey, and we have to be there at 2:00 PM.” I’d been looking at historical data and figured out that’s when the line is shortest. I don’t know, I just… maybe I geek out about Disney logistics.

Kailah: No, that’s so good! I love it. And you’re bringing up something really important—staying connected to your inner child. I’m such a big believer in keeping that sense of wonder alive.

Miranda: Yes!

Kailah: Play, imagination, love—all those things we tend to lose sight of as adults. Our world gets so hectic and busy that it takes conscious effort to tap back into that childlike joy. And play is one of the most powerful ways to do it.

Miranda: I totally agree. I feel like I’ve never felt more connected to my inner child than I have since becoming a parent. Having a 4-year-old and seeing the world through her sense of wonder, excitement, and pure magic—it’s just so much fun. It’s brought a lot of that back for me, too. It’s like I get to experience things through her eyes.

Okay, wait—what’s your main fandom? What’s your thing?

Kailah: Oh, probably Harry Potter. But I’m also a big fan of Buffy the Vampire Slayer.

Miranda: I’ve never seen it!

Kailah: Oh my gosh. You’re missing out!

Miranda: I know, I’m a bad millennial.

Kailah: Haha! It’s so good. I love vampire lore in general—it’s always really fun. Anything with vampires or witchy magic vibes, I’m into it.

Miranda: I like it.

Thank you so much for joining me today—this has been such a fun conversation. It was really helpful to learn more about geek therapy and how you incorporate it into your work. I’ll be sure to include some of the resources you mentioned in the episode description so people can check them out.

Oh! And are you currently accepting clients, or are you way too busy?

Kailah: I’m pretty busy! I oversee about 20 therapists, and most of them are accepting clients. I’ll probably be running groups in the future, once I get everything rolling, so people can stay tuned for that.

Miranda: Awesome. Well, I can’t wait to hear about your D&D groups—I bet they’re gonna be amazing. Thanks again for joining, and thanks to everyone for listening. We’ll see you next week!

The post Geek Therapy: How Video Games, D&D, and Fandom Can Support Mental Health appeared first on Ellie Mental Health, PLLP.

As you step into the next phase of life, navigating post-college challenges and overcoming graduation anxiety requires not only practical skills but also emotional resilience. Understanding the post-college transition, managing anxiety, and building a strong foundation for success are critical components of this journey.

This article explores strategies to cope with post-graduation anxiety and offers advice on embracing personal growth while maintaining work-life balance.

The Post-College Transition

The emotional and psychological impact of graduating college can be profound. After spending years in an academic environment, suddenly stepping into the unknown world of adulthood can feel disorienting. The transition from a structured, routine-driven life to one filled with uncertain outcomes and personal responsibility is a major shift. Many new graduates find themselves asking, “What now?” or even feeling scared to graduate college.

The excitement of earning a degree can quickly fade as the reality of financial independence, career decisions, and personal growth sets in. During this transition, it’s common to experience:

• Sadness or a sense of loss
• Confusion about the future
• Feeling scared or worried
• Pressure to quickly secure a job or prove oneself
• Questioning if you’re doing the right thing

You may miss the camaraderie of campus life, the predictable schedule, and the feeling of being part of a community. External expectations can lead to a sense of inadequacy, leaving many wondering if they are on the right path.

The reality is that this period is one of self-discovery, growth, and trial and error. It’s essential to acknowledge that not having everything figured out immediately is perfectly normal. The transition can be smoother when approached with patience, self-compassion, and a willingness to embrace uncertainty.

Understanding Post-Graduation Anxiety: Quarter-Life Crisis and Common Stressors

A significant psychological hurdle many recent graduates face is the quarter-life crisis, which is a period of doubt, confusion, and self-questioning typically occurring in the mid-20s. This often emerges as graduates feel unprepared to meet the expectations placed on them by society, family, or themselves.

Common stressors after college graduation include:

• Job uncertainty: Finding a job can be a difficult task– especially in a competitive market. Whether you have one lined up or are still job hunting, the pressure to secure employment is a major source of anxiety.
• Financial pressure: Paying off student loans, managing living expenses, and adjusting to a new financial reality are all significant challenges. Learning how to manage money effectively is a crucial step in easing post-graduation anxiety.
• Social comparison: Social media can make it seem like everyone else has it figured out. This can heighten feelings of inadequacy, especially as you are seeing peers achieving what appears to be success, whether it’s securing an impressive job, traveling the world, or starting a family.
• Identity and purpose: Transitioning from “students” to “college graduates” and then to “professionals” often requires deep introspection and a reevaluation of personal and career goals.

Recognizing that these experiences are normal (and that many others are going through the same thing) can help ease the pressure. There is no set timeline for success; everyone’s path is different.

Strategies to Manage Post-College Anxiety

While the post-graduation period can feel overwhelming, there are several strategies that can help ease anxiety and provide a sense of control and direction.

Set Realistic Career Goals

Setting realistic career goals is essential for navigating the job market. It’s easy to feel overwhelmed by the pressure to land your dream job right out of college but remember that career paths are rarely linear. Instead of focusing solely on the destination, create small, manageable goals to help you build your skills and gain experience.

How to Set Career Goals After College

Set both short-term and long-term objectives that are specific, measurable, and attainable. This approach will allow you to track progress and feel a sense of accomplishment, which is crucial for reducing anxiety.

Build a Support Network

Developing a support network of family, friends, mentors, and colleagues is crucial in overcoming post-graduation anxiety. Lean on your loved ones for emotional support and encouragement, and seek out mentors who can provide career advice and guidance.

Networking for Recent College Graduates

Networking is also a powerful tool for both professional growth and reducing anxiety. Doing this through events, alumni groups, or LinkedIn can also open doors and increase confidence while opening doors to job opportunities.

Develop Financial Literacy

Financial stress is common (especially with the looming burden of student loan debt), but learning to manage your money can help reduce anxiety. Start by:

• Creating a budget
• Tracking expenses
• Setting financial goals

Financial advisors or financial therapists can be an important post-college support system. They can give financial planning tips for new graduates and help to build good money habits early on.

Check out our other tips for dealing with financial stress out of college in this blog post.

Embracing Personal Growth and Adaptability

The post-college years are an excellent time to embrace continuous learning. Your education doesn’t have to end with your degree. Take advantage of continuing education after college through online courses, workshops, or certifications that can help you develop new skills and enhance your professional profile. Skill development for graduates not only improves your job prospects but also boosts your confidence, making it easier to navigate post-graduation challenges.

Working on Resilience and Adaptability

Life after graduation is rarely predictable, so it’s important to cultivate resilience and adaptability. Being open to change and learning from setbacks will help you overcome obstacles and adapt to new situations. Resilience allows you to bounce back from disappointments and keep moving forward. Try to reframe challenges as opportunities for growth, rather than as failures. This mindset shift can significantly improve your emotional well-being and reduce the impact of anxiety. Check out our blog post about coping skills for more ideas for dealing with this anxious time.

Balancing Professional and Personal Life after Graduating College

Establish Work-Life Balance

Achieving work-life balance is an ongoing challenge, especially in the early stages of your career. As a new graduate, you may feel compelled to work long hours to prove yourself or gain experience. However, neglecting your personal life and well-being can lead to burnout and increased stress. Set boundaries to ensure that you can maintain a healthy balance between work, social activities, and relaxation. Make time for hobbies, exercise, and spending time with loved ones. Prioritize self-care to maintain your mental and physical health.

Prioritize Mental and Physical Health

Taking care of your mental and physical health is essential for overcoming post-graduation anxiety. Make sure to:

• Exercise regularly
• Get enough sleep
• Eat balanced meals
• Practice mindfulness or journaling

Don’t be afraid to seek professional help if you’re struggling with anxiety or other mental health challenges. Therapy or counseling can provide valuable tools for coping with stress and transitioning into post-college life.

Conclusion

Life after graduation can feel overwhelming, but by recognizing the challenges, building resilience, and implementing strategies for personal and professional growth, you can navigate this post-college transition with confidence. Embrace uncertainty, continue learning, and lean on your support system.

Remember: You’re not alone, and your post-college journey doesn’t have to be perfect to be meaningful. By taking proactive steps, you can create a fulfilling and successful life after college.

The post Life After College: Overcoming Post-Graduation Anxiety appeared first on Ellie Mental Health, PLLP.

Spring cleaning is typically a time of thoroughly cleaning our homes, ridding them of any items you do not want to take into the new season. This may look like reorganizing your closet, deep cleaning, or selling old items. Have you ever considered mentally spring cleaning? Mental spring cleaning is a beneficial way to get a fresh start on regaining control of your overall well-being. This is an opportunity for one to shift and reorganize your thoughts, emotions, and patterns that you find are no longer serving you, and there’s no better time than the springtime!

As you evolve, you may notice negative patterns or bad habits that you have carried with you throughout various seasons of your life and often struggle to figure out how to clear your head. Some of these habits may have positive effects, while others can leave a negative impact on your relationship with yourself and others. When looking to mentally spring clean, it comes with recognizing these habits and acknowledging the ways in which they have played a role in personal development.

Research shows that it can take anywhere between 18 to 254 days to break a habit. But don’t worry! Breaking a habit or reshaping behaviors requires a level of self-compassion, grace, and understanding that you aren’t on any specific timeline. Often times, we begin to compare ourselves and lose sight of our own journeys which can create barriers for us when attempting to break a negative habit. But, it’s not impossible. All you have to do is start!

As you enter the spring season, take some time to consider some habits or patterns that you want to throw away.

3 Habits to Let Go of This Season:

1. Holding on to Past Relationships

Many times, we hold on to relationships that no longer serve us, out of fear of starting over and the history of the relationship. This can be reflective of the difficulty of setting and maintaining healthy boundaries for ourselves, and others, which can hinder our progression and growth. Consider ways in which you would like to reestablish healthy and meaningful relationships by setting expectations and boundaries, as well as reflecting on areas of self-improvement.

2. Being Self-Critical

Have you heard the saying “You’re your own worst critic”? There is no denying it. While being self-reflective and aware can be beneficial to your growth, being excessively critical of yourself can have a negative impact on your mental health. This can increase your chances of anxiety and depression, as well as alter your self-esteem.

Here is a useful resource to further explain the psychology behind self-criticism, and ways it impacts our overall mental health.

 Implementing positive daily affirmations to reframe negative self-talk can be a prominent way to improve your sense of self, and work toward more positive self-talk. This article shares why repeating affirmations is helpful in reprogramming our subconscious and shifting the perspective we may have on our stressors and worldviews.

3. Procrastination

When procrastinating, we tend to push off important tasks and become increasingly stressed due to the overwhelming load of the task. Sometimes, just the thought of a task feels so heavy that we find it difficult to even begin. This can lead to missed deadlines, increased workload, and intensified anxiety rooted in fear of failure. Some helpful tools to reduce the chances of procrastination include setting measurable goals for the day, using timers, eliminating distractions, and rewarding yourself. We all have unique methods that may be beneficial to us in order to achieve tasks and goals. Don’t give up when one method doesn’t work. Continue implementing new ideas until you find the one just for you.

How to Build Healthier Habits this Season

Journaling in the Fresh Air

• Write it out: Choose an outside space to journal and simultaneously soak in Vitamin D. This can boost serotonin levels, which boosts our mood. This can be useful as you release and navigate your thoughts and emotions on paper. Take a few minutes each day to write down what’s on your mind, and let it flow freely without judgment. This can clear mental space, as well as promote a longer attention span.

• Identify mental clutter: Think about the recurring thoughts, worries, or stresses that keep popping up. The more aware you become of these patterns of thoughts, the easier it can become to manage them. Write down these patterns and thoughts and reflect on where you have seen them show up in your interpersonal relationships. This can help you not only take more accountability for your behaviors but also take the front seat in establishing alternative behaviors and reframing negative thoughts.

Fight Against Procrastination

• Set Timers: Set a timer ranging from 5-15 minutes to allow yourself increments of time to complete tasks. This can reduce the chances of feeling overwhelmed and not being inclined to accomplish goals, which then results in less procrastination.

• Create a To Do List: Create a to do list in efforts to organize and prioritize your day-to-day responsibilities. This can be on your phone, or a tangible list that you place on your refrigerator, desk, or any area that is easily accessible. To-do lists are helpful ways to keep up with anything you need to get done, but also a way to decrease the pressure of accomplishing larger tasks, opposed to smaller and minimal ones.  

Declutter Your Social Media

• Limit Anxiety Inducing Content: Remove or unfollow social media platforms that create an algorithm of content that are likely to increase the chances of experiencing anxiety. This can be news outlets, gossip blogs, or content creators whose pages highlight current events and daily alerts regarding disparaging news.

• Fasting: Take a deliberate break from social media for a specific amount of time. To get the most out of fasting, find additional hobbies or activities that can productively fill the time typically dedicated to social media.

Improve Sleep Quality

• Establish Bedtime Routine: Giving yourself an intentional cutoff to begin your bedtime routine can increase discipline and consistency in improving your sleep quality. This routine can include a bubble bath, reading, journaling, or any activity that involves you settling your mind and body.

• Limit Doom Scrolling: Scrolling excessively on our telephones and limit the amount of quality sleep we are able to receive. By limiting the amount of time we spend scrolling before bed, we are training our brains to recognize that we are winding down, and this can also allow us to develop healthier bedtime routines.

Practicing Gratitude

• Create a Weekly Gratitude Ritual: End your week with a form of ritual that involves identifying at least three positive things that occurred during your week. These things can be both personal and career driven but are used to balance potential negative interactions that can distract us from being grateful.

• Celebrate Small Wins: Acknowledge and celebrate your progress, no matter how big or small. This can aid in boosting your self-confidence as well as assist you in measuring your progress and staying present.

Spring is not the only season where mental decluttering can be useful. These tools can be used throughout the year as needed and become daily habits with consistency and persistence. Give yourself a moment to inhale and allow yourself to take the leap to forming better habits. While it can be challenging initially, soon you’ll see the positive impact that spring cleaning provides. Challenge yourself to one week of implementing at least one of the tips provided above. After you’ve done this, increase the number of tips you choose to implement. Eventually, you will find that slowly adding these tools to your regime will become more manageable and a consistent habit.

The post Spring Cleaning for Your Mental Health: 3 Habits to Let Go of This Season appeared first on Ellie Mental Health, PLLP.

The Need for Effective Stress Management

Stress affects every aspect of our lives, from our physical health to our relationships and daily routines. When left unchecked, stress can spiral into overwhelming feelings of anxiety, fatigue, and frustration. Understanding how stress affects daily life is the first step toward realizing the importance of stress management.

Why Managing Stress is Crucial for Your Health

When stress becomes chronic, it can have serious health consequences. High levels of stress are linked to a variety of physical ailments, such as heart disease, digestive issues, and weakened immunity. It can also lead to emotional problems, like anxiety and depression. By learning how to manage stress effectively, you can protect your long-term health and improve your quality of life.

Some of the immediate effects of unmanaged stress include headaches, tension, difficulty concentrating, and irritability. It can also lead to sleep disturbances, increased blood pressure, and even weight gain or loss. Therefore, stress relief is not just about feeling better in the moment—it’s about maintaining a balanced, healthy lifestyle.

Looking for more concrete resources for managing stress? Check out our stress management tools here.

Understanding Stress: What It Is and How It Impacts You

Before you can address your stress, it’s important to understand what is stress and how does it affect you. Stress is the body’s natural response to any demand or challenge, whether it’s external (e.g., work or family pressures) or internal (e.g., self-imposed expectations). While stress is a normal reaction, prolonged exposure to stress can cause serious emotional and physical health issues.

Physical and Emotional Symptoms of Stress

When you’re stressed, your body releases hormones like cortisol and adrenaline. This “fight or flight” response can cause rapid heart rate, shallow breathing, tense muscles, and heightened alertness. While these symptoms are meant to help you face a threat, they can become problematic when they occur too frequently or for too long.

Common Causes of Stress

The common causes of stress vary from person to person but tend to stem from a few common sources:

• Work pressures: Deadlines, workload, and interpersonal conflicts at the workplace can be significant stressors.
• Financial worries: Concerns over money, job stability, or debt can create chronic stress.
• Relationship challenges: Family dynamics, romantic relationships, or issues with friends can be major sources of stress. Recognizing these daily stress factors is crucial to begin managing them more effectively. By identifying your stress triggers, you can take steps to reduce their impact on your life.

Find a therapist for stress management here.

Practical Daily Techniques to Reduce Stress

Learning to manage stress in your daily life doesn’t require drastic changes. Simple, practical techniques can help you feel more in control and less overwhelmed. Below are a few daily stress management tips for busy people that can fit into almost any routine:

Quick Stress Relief Tips

1. Deep Breathing: In moments of stress, deep breathing exercises can calm your nervous system and provide instant relief. Try inhaling for a count of four, holding for four, and exhaling for four. Repeat this several times.
2. Progressive Muscle Relaxation: This technique involves tensing and relaxing each muscle group in your body. It helps release physical tension and promotes a sense of calm.
3. Short Walks: A quick walk outdoors can refresh your mind, reduce tension, and provide a mental break.

Mindfulness for Stress

Mindfulness is the practice of being fully present in the moment, without judgment. It allows you to focus on the here and now, rather than worrying about the past or future. Practicing mindfulness can significantly reduce stress by shifting your attention away from anxiety-inducing thoughts.

Meditation for Stress Relief

Meditation is another powerful tool for stress management. It involves focusing your attention and eliminating the stream of thoughts that may crowd your mind. Studies have shown that meditation

can lower stress hormones, reduce anxiety, and improve emotional well-being. Whether it’s guided meditation or a simple practice of sitting in silence, taking a few minutes each day to meditate can help reset your mental state.

Lifestyle Changes for Long-Term Stress Management

While short-term solutions are important, lasting stress management requires sustainable lifestyle changes. Making adjustments to your daily habits and routines can help you better manage stress over time.

Setting Boundaries

One of the most effective ways to manage stress is by setting clear boundaries. Learn how to say no to requests that overburden you, and make time for activities that promote relaxation and self- care. Creating boundaries with work, family, and friends helps prevent burnout and allows you to focus on your own needs.

Balancing Professional and Personal Life

Achieving a healthy work-life balance is essential for stress reduction. Prioritize your personal time just as much as your work responsibilities. This means scheduling time for hobbies, relaxation, and quality moments with loved ones. Making space for these activities can prevent work from overtaking your personal life and reduce stress.

The Role of Nutrition, Exercise, and Sleep in Stress Management

Physical health plays a significant role in how well you handle stress. Eating a balanced diet, exercising regularly, and getting enough sleep are all crucial for stress reduction.

• Nutrition: Eating whole, nutrient-dense foods can help stabilize your mood and energy levels, preventing stress from becoming overwhelming.
• Exercise: Regular physical activity releases endorphins, which are the body’s natural mood lifters. Whether it’s yoga, jogging, or a dance class, movement is a powerful stress reliever.
• Sleep: Chronic stress often disrupts sleep, and lack of sleep, in turn, increases stress. Aim for 7-9 hours of quality sleep each night to give your body the rest it needs to recover.

Resources for Stress Management

If you find that managing stress on your own is difficult or overwhelming, there are numerous resources available to help. Seeking professional stress management support can provide you with additional tools and strategies for coping with stress in a healthy way.

Best Stress Management Apps for Everyday Use

There are several apps designed to help with stress relief. Some of the top-rated apps include:

• Calm: Offers guided meditation, breathing exercises, and sleep stories to help manage stress.
• Headspace: Focuses on mindfulness and meditation techniques for reducing stress.
• MyLife Meditation: Provides personalized meditation and relaxation exercises. These apps can be great tools to use throughout your day to reduce stress and improve mental clarity.

When to Seek Help for Stress

It’s important to recognize when stress becomes overwhelming. If you find that your stress is affecting your ability to function, impacting your relationships, or leading to physical symptoms (such as headaches, fatigue, or stomach problems), it may be time to seek professional help. Therapy can provide you with personalized tools for stress management and help address the root causes of your stress. In therapy, you’ll learn to explore stress management techniques, set healthy boundaries, and develop strategies for coping with the pressures of life.

Final Thoughts

Stress is a natural part of life, but it doesn’t have to control your health or happiness. By understanding what stress is, recognizing its impact on your body and mind, and implementing practical techniques for stress relief, you can regain control and foster a calmer, healthier lifestyle. Remember, effective stress management is an ongoing process, and it’s okay to seek support when needed. Whether it’s through meditation, lifestyle changes, or therapy, the tools are available to help you live a more balanced life.

The post The Ultimate Stress Management Guide: Proven Techniques for a Calmer, Healthier Life appeared first on Ellie Mental Health, PLLP.

Perinatal mental health (mental health during pregnancy and the postpartum period) is a critical yet often overlooked topic. Many parents-to-be face challenges like anxiety, depression, and intrusive thoughts, yet stigma and lack of awareness often prevent them from seeking support. It’s understandable since they’re likely not sleeping well, hormones are probably all over the place, there are physical changes going on… I could go on and on.

In this blog post, I’ll share some of my personal experiences, along with insights into the common struggles many expectant and new parents face from a podcast episode I recorded with Amanda (a therapist) and Twilight Florido Burgad (a psychiatric nurse practitioner)—both providers specialize in this crucial period. Whether you’re currently pregnant, navigating postpartum, or supporting someone who is, this post is here to remind you that you’re not alone—and that there’s help and hope.

Let’s explore what perinatal mental health is, how it can show up, and what steps you can take to prioritize your well-being.

Here’s the podcast interview with Amanda and Twilight about perinatal and postpartum mental health:

What Is Perinatal Mental Health?

The perinatal period pregnancy covers pregnancy all through the first year of your baby’s life. This is a vulnerable and transformative time for parents, fundamentally altering their life and often their mental and physical health too. It makes sense that people struggle during this time!

Signs of Postpartum Depression and Anxiety

Postpartum depression or anxiety looks a lot like normal depression or anxiety, although its onset is during that perinatal period. Symptoms of postpartum depression usually include:

• Feeling sad or feeling like you’re not a good parent (especially if these feelings persist beyond the two-week baby blues period)
• A sense of overwhelming guilt,
• Feeling unable to cope with emotions
• Feeling disconnected from themselves
• Feeling tired or unable to get out of bed (although, this is a hard one to decipher because you’re probably not sleeping a ton)
• Lack of appetite or eating more than usual (again, this might be a tough one because lactating can cause some new eating habits)

Symptoms of Perinatal or Postpartum Anxiety

There is an increased risk of clinically significant anxiety during the perinatal period, with symptoms like racing thoughts, worrying about the baby’s safety, or having intrusive thoughts that might be distressing and lead to behaviors like not wanting to go down stairs for fear of dropping the baby.

In the initial weeks after I gave birth, I experienced intense anxiety around whether my baby was breathing while he was sleeping or if my cat or a blanket might suffocate him. While this is a common fear, I did find some relief as time went on (and especially after I started sleeping a little more). When I was struggling with these intrusive thoughts it helped me to verbalize them with close friends who were also parents—it made me feel like I wasn’t alone and their reassurance was what I needed at the time.

Common Mental Health Challenges During Pregnancy

Perinatal anxiety is the most common type of mental health issue during this time. Personally when I was pregnant, I experienced a lot of anxiety. Many of my friends had gone through miscarriages, physical health issues, and even stillbirths, so in the early days of my pregnancy, these thoughts consumed me. I found some relief after the very first doctor’s appointment where I heard the heartbeat, but I continued to have waves of anxiety that I needed to find new ways to cope through.

Tips for self-care during pregnancy:

1. Listening to pregnancy or non-pregnancy meditations.
2. Staying active by doing yoga, walking, or swimming (as long as it’s ok with your doctor).
3. Connecting with others in similar life stages or that are becoming parents through Facebook groups or prenatal classes.
4. Writing or reciting encouraging mantras, like “One day at a time,” “I can do this,” or “My body is amazing.”
5. Visualizing encouraging things, like your partner holding a baby at the end of the pregnancy, your children meeting the baby for the first time, or a peaceful birth.
6. Saying no to things that tire you or that don’t contribute to your peace.
7. Seeking therapy if you’re noticing that it’s difficult to control your worry or if you’re feeling more down and hopeless or extended periods of time. There are lots of therapists that specialize in pregnancy and perinatal mental health at Ellie Mental Health!

Beyond Postpartum Depression

Most of us have heard of postpartum depression, but it is just one of several perinatal mood disorders. There are other conditions like postpartum psychosis that are crucial to recognize and address. warns, must be treated as a psychiatric emergency due to its potential risks.

Symptoms of Postpartum Psychosis

The following are the most common symptoms of postpartum psychosis—but keep in mind that this diagnosis is fairly rare. They typically develop within two weeks of giving birth, but they could come on later.

• Delusions: Believing things that are true, when they’re not
  • Example: Believing that your baby was swapped with a different baby
• Hallucinations: Hearing, seeing or feeling things that aren’t actually there
  • Example: Hallucinating that someone is telling you to harm your baby
• Rapid mood swings
  • Example: Feeling euphoric or really happy and switching to hopelessness or depression
• Difficulty focusing or make sense of your words
• Paranoia: Feeling suspicious of others
  • Example: Believing that your mother is going to kidnap your baby
• Risk taking and impulsivity that is out of the ordinary
• Difficulty sleeping
• Thoughts of harming yourself, your baby, or suicidal ideation

If you or someone you love is experiencing these symptoms, please don’t ignore it. Postpartum psychosis is serious and should be treated right away by contacting your doctor or going to an emergency room. Typical treatment is a combination of medication and therapy.

Can Men Get Postpartum Depression?

Absolutely! In fact, research indicates that approximately 10% of new fathers encounter postpartum depression, with symptoms often peaking between 3 to 6 months after childbirth. For dads, this can look like irritability, fatigue, changes in sleep and appetite, difficulty bonding with the baby, and feelings of inadequacy

Can Adoptive Parents Experience Postpartum Depression?

Yes! Adoptive parents may experience a form of postpartum depression often referred to as post-adoptive depression, which shares many symptoms with PPD, including:

• Emotional changes: Feeling overwhelmed, anxious, or emotionally distant from the child. A lot of adoptive parents I work with share that the time following placement often just feels like “babysitting” because there’s not a lot of attachment there yet.
• Fatigue and sleep disturbances: You’re pooped. All of the time. Sleep issues are a very common issue in adopted kids—regardless if they’re infants or not. An adoptive family I worked with years ago shared that she had to sleep on the floor of her daughter’s room for a whole year before the kid felt comfortable falling asleep on her own. There can also be nightmares or night terrors because of trauma. 
• Feelings of inadequacy: Adoptive parents have to go through an enormous amount of trainings, background checks, and the entire homestudy process to “prove” that they are fit to be parents. You often feel like you’re under a microscope and every choice you make will be judged. Combine that with the secondary grief and separation that the birth parent and child may be experiencing, and it’s easy to feel like you’re not enough.
• Isolation: It’s a new dynamic and it can be lonely. Adoptive parents don’t always receive the same support biological parents do. While baby showers and meal trains are becoming more common for adoptive parents, it is unfortunately not always a given for every parent. 
• Unrealistic expectations leading to disappointment: As an adoptive parent, you’ve spent years preparing to be a parent and proving that you’ll be a great one… what happens when you struggle? In my experience, adoptive parents are less likely to speak up when things feel off or when they’re not measuring up to the rosy picture we had in our heads out of fear or pressure.
• Fear and anxiety: Depending on your state and program, there may be a period of time after the child is placed with you where the birth parent, agency or state can take the child back. This might be due to a birth parent changing their mind and deciding to parent, the birthparent getting legal custody through court after an involuntary removal of the child, or if a different placement option comes up that fulfills the rules of the Indian Child Welfare Act or the Sibling Bill of Rights. There can be a lot of unknowns until it is legally finalized.

If you’re interested in learning more about Post Adoption Depression, I highly recommend checking out Karen J. Foli’s research and book.

Normalizing the Postpartum Experience

It’s very common to experience the “baby blues” while you’re adjusting to parenthood, and counseling for new parents can be very helpful. The “baby blues” is when you’re feeling anxiety, overwhelm, sadness, irritability, crying, reduced appetite, and inability to sleep. It typically starts after delivery and can last up to two weeks.

We need to normalize the difficult emotions and experiences parents may face during this time period, while also highlighting what to do when things are feeling more serious. As Twilight emphasizes, it is essential for parents and clinicians to understand that having “scary thoughts” can often be a part of adjusting to parenthood. Amanda further adds that acknowledging and normalizing these experiences can prevent isolation and help new parents seek necessary support.

The Importance of Social Support

Social support is paramount during the perinatal period. Twilight advocates for building a strong support network well before the baby arrives, underscoring the importance of leaning on family, friends, and community resources. Programs like those offered by Postpartum Support International (PSI) provide valuable support and education for new parents.

Amanda Davis Scott shared: “Talk about what can happen, how common these things are, perinatal mood and anxiety disorders, what you can do to protect yourself, protect your sleep, utilize your resources and support around you so that you don’t run into the problem of expecting too much out of yourself or extending yourself too thin.”

Twilight added: “Not everybody is going to need medication. Not everybody is going to need therapy, but social support is the one essential that everybody needs during that time.”

No-one gets a parenting instruction manual, but that’s okay. The team of experts from Ellie Mental Health can guide you in your postpartum mental health journey. Find a perinatal therapist near you today.

Parent Self-Care and How to Support New Parents

Both Amanda and Twilight stressed the importance of parental self-care in the podcast episode. This includes eating healthy food, sleeping when you can, and mental health support. They encourage parents to shed societal pressures of perfection and to seek help without guilt.

When you become a new parent or you add another kid to your family, it can sometimes feel like you’re drowning and take some time to adjust. This adjustment period can feel even harder when you’re struggling with your own mental health too. Self-care looked different in those early days for me—it needed to be quick, require less energy, or just be simpler. It looked like:

• Sleeping or lounging around in cozy pajamas
• Going for a quick coffee run all by myself
• Dancing with my baby
• Going for a short walk (with or without the baby in the stroller)
• Using meal kids and grocery delivery instead of needing to run errands
• Rewatching favorite shows during the endless hours of feeding (Friends and Mr. Monk were my go-tos in the early postpartum days)
• Taking lots of warm baths
• Facetimes with other moms that I knew would get it
• Getting a new water bottle since I was suddenly thirsty all. the. time.
• Taking my older daughter on our own little dates

In the whirlwind of new parenthood, self-care can get pushed to the backburner (which is understandable—you’re suddenly caring for a whole new little person), but it’s important to prioritize even the smallest things for your mental health.

Think about some things that help you feel a little bit more like yourself (maybe it’s going for a walk with a friend or trying all of the Costco samples on a Sunday afternoon) and then don’t be afraid to ask your support system for help to make it happen.

If you, dear reader, are a support person to a new parent, be proactive! Buy the new parent comfy pajama pants, bring over dinner one night (pro tip: bring paper plates or offer to do the dishes afterwards), or offer to watch the kids while they catch up on some sleep.

In another blog post about how to support a new parent, therapist Anna King recommends asking questions like, “I’m running by Starbucks, can I pick something up for you?” or “I really struggled adjusting to parenthood at first. How do you feel like you’re doing?” Be direct and pro-active, rather than just waiting for the new parent to ask for help.

Final Thoughts

Parenthood is a life-changing experience, but it’s not always the picture-perfect journey we see on social media. If you’re struggling with your mental health during pregnancy or postpartum, I want you to hear this loud and clear: you’re not alone, and it’s not your fault.

As a therapist (and a mom) I’ve been there. Those overwhelming feelings, the anxiety, the intrusive thoughts… they can make you feel like you’re the only one going through it. But trust me, so many parents face these challenges, even if we don’t always talk about it.

The good news? You don’t have to navigate it alone. Whether it’s finding a therapist who specializes in perinatal mental health or even just sharing your feelings with a friend or partner, there’s help out there.

If you’re a support person, don’t underestimate how much simple acts of kindness matter, like offering to pick up coffee or holding the baby while they nap.

You’re doing better than you think, and it’s okay to ask for help. Parenthood is tough, but you don’t have to go through it on your own. There’s so much support and hope waiting for you.

The post Let’s Talk About Perinatal Mental Health: You’re Not Alone appeared first on Ellie Mental Health, PLLP.

That being said, when complex psychological concepts weave their way into mainstream culture, their original meaning can get lost in the hullabaloo, and “triggers” are no exception. As our society becomes more comfortable talking about trauma, I think it’s important to understand what triggers are, how and why we get them, and what we can do to manage them when they show up.

Want to learn more? Contact Ellie Mental Health and get connected with a therapist who matches your needs today.

What Are Triggers?

Triggers are anything (a sound, a smell, a place, or even a situation) that brings up a strong emotional reaction tied to past experiences. For people who have experienced trauma, triggers can make it feel like the past is happening all over again, leading to anxiety, panic, or shutting down. Learning to recognize triggers is an important part of healing because it helps people build awareness, develop coping strategies, and regain a sense of control over their emotions.

What Does It Mean to Be Triggered?

When we are triggered, we lose our capacity for rational thought. Our prefrontal cortex (the thinking part of the brain) gets hijacked by our limbic system (the reacting part of the brain) and blocks our ability to effectively problem-solve, listen, advocate for change, or carry on a productive conversation (note: if you are in actual danger, you haven’t been triggered; your limbic system is simply doing its job, which is to keep you safe.)

The Relationship Between Trauma and Triggers

Triggers do not exist in the absence of trauma. So, to understand triggers, you first need to know a little bit about trauma.

For better or for worse, trauma happens to all of us at some point. Not only is trauma inevitable, but it also teaches us how to survive, which is probably why we are wired to react more strongly to the bad stuff that happens to us than we are to the good stuff.

Broadly speaking, here’s how trauma impacts us most of the time: The bad thing (i.e., traumatic event) happens, we have a big negative emotional response, and then once that bad thing is over, the brain processes the experience, gleans the lessons that can be learned from it, and then files it away into our long-term memory. This is what I call Wisdom. It’s why your thrice-divorced grandma is able to give you excellent relationship advice.

Sometimes, however, a bad thing happens to us, we react, the bad thing ends…but we are prevented from processing the experience and learning from it. This can happen for a variety of reasons, some more complex than others. For now, suffice it to say that the bad thing and the big negative emotional response sorta get frozen in time and stored together in the limbic system, becoming unprocessed trauma, or what I call Baggage. Baggage is why my grandma, who was a child during the Great Depression, would furtively stuff leftover pork chops into her purse when we went out to eat, despite having a fully stocked pantry at home.

The Fallout from Unprocessed Trauma

 Ok, so here you are today, with your Wisdom and your Baggage. Sometimes, negative things happen to you, and while you may have some lingering feelings about it, you are able to reach back into your storehouse of wisdom, grab the lessons you have learned from similar experiences in your past, and make your next move accordingly.

Once in a while, however, you may encounter a situation that falls into the Baggage category, and it sends you into an emotional tailspin. In fact, you feel just like you did the very first time something similarly awful happened to you. You may even be aware that your response is totally outsized, given the actual situation, but it doesn’t stop you from freaking out anyway. The reason for this? You have been triggered.

In other words, your triggers are located inside your Baggage.

Types of Triggers

Triggers are deeply personal and can vary widely from person to person based on their experiences and sensitivities. Some triggers are external, like a specific smell, a loud noise, or a familiar location, while others are internal, such as certain thoughts, emotions, or physical sensations. What feels neutral to one person might be overwhelming to another, making it important to recognize individual patterns. Understanding these differences helps people develop personalized coping strategies and regain control over their responses.

Examples of Internal Triggers

Internal triggers come from within, and they are often linked to thoughts or emotions that unconsciously activate unresolved trauma. Since these triggers are internal, they can be harder to identify and may seem to come out of nowhere.

For example, someone who experienced a past abusive relationship might feel an unexpected wave of panic after experiencing a moment of self-doubt or criticism. Even if nothing in their environment is threatening, the familiar feeling of inadequacy may unconsciously resurface memories of past emotional harm. Without recognizing the trigger, they may spiral into distress, reinforcing the emotional pattern. Learning to identify and address internal triggers:

• Fear
• Anxiety
• Stress
• Physical or emotional pain 
• Intrusive thoughts
• Loneliness 
• Abandonment

Examples of External Triggers

External triggers come from the outside world and can include specific sights, sounds, smells, places, or even people that unconsciously activate unresolved trauma. These triggers are often tied to past experiences, making the brain react as if the original event is happening again. Because they’re connected to the environment, external triggers can feel sudden and overwhelming, sometimes catching a person off guard.

For example, someone who was in a car accident might feel a surge of panic when hearing screeching tires, even if they are safe in a parking lot. Their body instinctively reacts to the sound, triggering memories of the crash and the fear they felt in that moment. Without realizing they’ve been triggered, they may experience a racing heart, shallow breathing, or an urge to escape. Recognizing external triggers can help you develop strategies to manage your responses and regain a sense of control.

• Sights
• Sounds
• Smells
• Anniversaries
• News stories
• Music
• Situations

How to Identify Triggers

So how do you know if you’ve been triggered, or if you’re just upset? First and foremost, you need to determine if your emotional response was disproportionate to the situation. For example, it is perfectly reasonable to get upset at someone for making fun of your shoes. But if you take your shoes off and hurtle them at the person’s head, along with every offensive word you can think of, I think we can agree that is a disproportionate emotional response, and it could be a sign that somewhere in the past you have some unprocessed trauma.

To be very clear: getting super upset does not, in and of itself, mean you have been triggered. For example, if you are a woman or person of color, no doubt you’ve been told more than once you are overreacting to a situation simply because you had a stronger reaction than the people around you. It should go without saying that a person of color would probably have a bigger emotional response to a racist remark than a white person would. A woman may have a more negative reaction to a misogynist joke than the men in the room. That does not mean they have been triggered. But if the woman responded to the misogynist joke by setting fire to the joke-teller’s car, that’s your clue she may have been triggered.

How to Deal with Triggers From Trauma

The bottom line is that while you are not responsible for the trauma that happened to you, you are the only one who can do anything about it.

Now for the good news: You can do something about your triggers! You are not at the whim of the people around you! Huzzah! 

One way to help manage your trauma-related triggers is through mood tracking or journaling. There are also several widely used therapeutic interventions to help manage trauma triggers, all of which have a sizable body of research supporting their effectiveness. EMDR, Adaptive Internal Relational Network (AIR) Therapy, Brainspotting, and Trauma-Focused CBT are a few of the most widely used interventions that have a sizable body of research supporting their effectiveness. These tools and therapies can help to get to the root of the issue and get you to feel some relief.

Want to learn more? Contact Ellie Mental Health and get connected with a therapist trained in any of the above modalities.

The post How to Recognize and Manage Trauma Triggers appeared first on Ellie Mental Health, PLLP.

Through years of training and practice, I’ve learned that Dance/Movement Therapy (DMT) is much more than just dancing to feel good. It is a powerful, evidence-based psychotherapy approach that integrates movement to promote emotional, social, cognitive, and physical well-being.

Before diving into what DMT is, let’s start with what it isn’t.

What Dance/Movement Therapy Is NOT

Many misconceptions surround Dance/Movement Therapy. Let’s clear some up:

• Not a Dance Class: Clients do not need to know how to dance or be “good” at dancing to benefit from DMT. It is not about learning dance techniques or choreography.
• Not a Form of Physical Therapy: Although movement is a core element of DMT, its primary focus is psychological and emotional healing, rather than rehabilitation for physical injuries.
• Not Just for Women: There may be a misconception that DMT is only for those who identify as female. However, it is a therapy for all individuals, regardless of gender.
• Not for Everyone: Like any therapeutic approach, DMT may not be the right fit for every client. The best therapy is the one that aligns with a person’s needs and comfort level.

Check out our recent interview with a Dance/Movement Therapist here:

The History and Definition of Dance/Movement Therapy

Dance has been used for healing purposes in cultures around the world for thousands of years. However, modern Dance/Movement Therapy as a psychotherapeutic practice developed in the 20th century.

The Origins of Dance/Movement Therapy

One of the pioneers of DMT, Marian Chace, began using dance as a therapeutic modality in the 1940s and 1950s at St. Elizabeth’s Hospital in Washington, D.C. She later co-founded the American Dance Therapy Association (ADTA) in 1966, helping establish DMT as a recognized field.

According to the American Dance Therapy Association (ADTA), Dance/Movement Therapy is:

“The psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration of the individual.”

ADTA members have expanded this definition to include:

“The intentional use of dance, creative movement, body awareness, and embodied and spoken communication, facilitated through the therapeutic relationship, to foster healing and wellness for individuals, families, and communities.”

What Can Dance/Movement Therapy Treat?

Simply put, DMT can be utilized to treat anything and everything. Examples include:

• Aging and Dementia
• Autism Spectrum Disorders and Intellectual Disabilities
• Learning Disabilities
• Psychiatric, Emotional and Behavioral Disorders in children
• Stress
• Anxiety
• Mood disorders
• Eating disorders
• Low self-esteem
• Relationship concerns
• Trauma
• OCD

…and so much more! A Dance/Movement Therapist will work with you to determine the best approach for your treatment area and goals.

How Does Dance/Movement Therapy Help with Trauma?

Sometimes it can be difficult to articulate trauma experience through words. The body holds memories. When faced with certain stress triggers, we may experience reactions such as shortness of breath, clenched fists, or the flight/flight/freeze response. DMT offers clients a safe space to express their emotions and process their experiences in an embodied way. Over time, this can help individuals to release these held memories and emotions and gain a sense of control, safety and sense of empowerment in their bodies.

Find an Ellie Dance/Movement Therapist near you.

Where Is Dance/Movement Therapy Used?

Dance/Movement Therapy is used in a variety of settings, including:

• Mental health facilities
• Rehabilitation centers
• Medical settings
• Educational institutions
• Forensic settings
• Nursing homes
• Disease prevention and health promotion programs
• Private practice

DMT can be practiced with people of all ages, backgrounds, and in various formats, including individual, couples, family, and group therapy.

How Does Dance/Movement Therapy Work?

Dance/movement therapists help clients improve self-esteem, body image, communication, relationships, and coping skills. By observing and analyzing movement patterns, therapists can help clients gain deeper insight into their behaviors and emotions.

What Happens in a DMT Session?

A Dance/Movement Therapy session can include:

• Expressive movement with props (scarves, stretch bands, balloons)
• Seated or standing movement activities
• The use of different types of music
• Guided imagery and visualization
• Breathing and meditative relaxation exercises
• The use of metaphor, play, and storytelling
• Individual movement, partner work, or group interactions

The goal is not to perform but to use movement as a tool for self-expression, healing, and personal growth.

The Mind-Body Connection in Dance/Movement Therapy

DMT recognizes that we are not just our minds and not just our bodies, but a combination of the two. What impacts one, affects the other.

By engaging in movement-based therapy, individuals can work through emotions, build resilience, and foster a greater sense of self-awareness.

Is Dance/Movement Therapy Effective?

In a word, Yes. Research in the field has demonstrated that DMT can be effective at decreasing depression, decreasing blood pressure, improving psychological and physical outcomes in cancer patients, addressing trauma, improving balance and communication in older adults, and so much more. To learn more, check out these research articles from ADTA or this article found on the National Institute of Health’s site:

Effects of Dance Movement Therapy and Dance on Health-Related Psychological Outcomes. A Meta-Analysis Update – PMC

Do You Need Dance Experience for Dance/Movement Therapy?

No, you do not need any dance experience to participate in a DMT session. Your therapist will guide you in various forms of moving, that may include movement warmups, use of imagery in movement, and use of props such as scarves or stretch bands, to help you express your emotions and address your treatment goals with focus on the mind-body connection. They will meet you where you are in your therapeutic journey and never push you to engage in a way in which you are not comfortable or physically able to do.

How Does One Become a Dance/Movement Therapist?

There are master’s level programs at select schools throughout the country, as well as alternate route training available. After graduating, therapists can apply for their R-DMT (Registered DMT) or go on to pursue their Board Certification and become a BC-DMT. Continuing Education credits are required every five years. In addition to webinar courses, the ADTA holds a Virtual Spring Summit as well as an annual conference in the Fall, held at different regions of the country each year. This year the ADTA will be holding its 60^th annual conference in Raleigh, N.C. In addition, there are numerous opportunities to become involved through local chapters and national committees. For more information, visit www.adta.org .

Ready to Experience Dance/Movement Therapy?

If you ever have the opportunity to try a Dance/Movement Therapy session, I hope this breakdown has given you a better understanding of what it is—and isn’t. I’ll leave you with a quote from American dancer and choreographer Agnes de Mille:

“The truest expression of a people is in its dances and its music. Bodies never lie.”

To learn about other “non-traditional” forms of therapy, check out these other blogs from Ellie Mental Health:

Art Therapy Techniques, Benefits, and Applications | Ellie Mental Health, PLLP

What is Psychedelic Therapy? | Ellie Mental Health, PLLP

VR Therapy and its Mental Health Benefits | Ellie Mental Health PLLP

Listed to Ellie’s podcast episode about Dance/Movement Therapy on Spotify. Read the transcript below:

Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda. I am a licensed clinical social worker, and I’m here with Shelby. Shelby, do you want to introduce yourself?

Shelby: Hi, I’m Shelby. I’m here at the Ellie Mental Health Clinic in St. Petersburg, Florida. I am a registered intern mental health counselor, but I’m also a registered dance movement therapist. It’s interesting to have both fields and bring that to the table for people.

Miranda: So, with dance movement therapy, is that a specific degree you pursued, or is it training you received after earning your mental health or master’s degree?

Shelby: It’s interesting—the school I attended actually offers a psychology minor. I completed that along with everything else. The full title of my degree is Clinical Mental Health Counseling with a Specialization in Dance Movement Therapy. The school is Lesley University in Cambridge, Massachusetts, and their program combines psychotherapy and dance movement therapy at the master’s level.

It’s a two- or three-year degree, and once you finish, you’re eligible to become a registered dance movement therapist. You just submit your application, log your hours, and then meet your state’s licensure requirements—whether that’s becoming an LMFT, licensed mental health counselor, licensed clinical social worker, or whatever fits your state’s obligations.

Miranda: Which of those programs did you complete, or which licensure are you pursuing at this point?

Shelby: So, I have my license in dance movement therapy. You can either be a registered dance movement therapist (R-DMT) or a board-certified dance movement therapist (BC-DMT). You have to be registered first to move up to board-certified status, which requires more experience.

As a registered dance movement therapist, you can do everything a board-certified therapist can, except for things like conducting official research studies. You can still provide therapy, work with clients, and collaborate in the field. But becoming board-certified is a great next step—it just opens more opportunities.

The track for that is pretty straightforward. If you’ve done enough work within your program, you’ll continue building on that. There are always conventions and networking opportunities happening. I stay connected with my cohort, too—we all grew really close during the program. Now, we’re spread out, each bringing different viewpoints on how to apply this approach to both dance and therapy.

Miranda: That is so cool. I appreciate you walking me through that because, in my mind, it’s similar to art therapy. You can infuse creative techniques into your practice, but unless you’ve completed the specific training, you’re not a registered art therapist.

Similarly, as a licensed clinical social worker, I could incorporate some movement techniques with my clients, but that doesn’t make me a dance movement therapist. That distinction makes sense. How did you get started with this? It sounds amazing.

Shelby: It’s a long story—one with a lot of emotion and depth.

I started dancing when I was a freshman in high school and immediately fell in love with it. I always knew I wanted to combine dance with helping people. For the longest time, I thought that meant working with individuals with physical disabilities. I was especially driven to do that because I have a physical disability myself—I’m hearing impaired.

That was my focus for years. But then, in 2015, I got devastating news—my boyfriend had passed away. It was incredibly difficult. I struggled to verbalize what I was feeling. I was so young, and at the time, I was working on a dance project for class. I couldn’t bring myself to continue with the original focus, so I asked my dance professor if I could change it to help me process my grief. She said yes.

I ended up creating a video that was both a celebration of my boyfriend and our story, but it also portrayed the stages of grief. That project was a turning point for me. Something clicked. I realized there was a profound connection between physical movement and emotional healing, and I knew I wanted to explore it further.

I started researching mind-body connections but couldn’t quite find what I was looking for. Then, one day, dance movement therapy randomly popped up on my Facebook feed. I started diving into it and instantly knew, this is it. This is what I’m meant to do.

From there, I researched schools, programs, and what I needed to make this a career. I went all in. Dance movement therapy became my passion—combining mental health with creative expression. I still have the option to work with individuals with physical disabilities if I want, but the mental health aspect really resonated with me. Using movement to help people heal is so creative and fulfilling—it sparks so much inspiration in me as a therapist.

Miranda: Oh, thank you so much for sharing that. That’s incredible. I love how you recognized the healing power of movement before you even fully understood the therapeutic connection. You were processing your loss through dance without realizing how impactful it was, and now you get to help others do the same. I have chills—that’s so cool.

So, what exactly is dance movement therapy? What does it look like in practice?

Shelby: That’s a great question. When people hear “dance movement therapy,” they often think, Am I signing up for a dance class? But no—it’s not a dance class.

The foundation of dance movement therapy is the belief that movement is our first language. We don’t come out of the womb talking—we move. Even in the womb, there’s movement. It’s how we first communicate our needs.

Dance movement therapy taps into that innate language. It’s not about formal dance styles like ballet or hip-hop. Instead, it’s about exploring each person’s natural movement. What feels authentic to them? When they’re angry, how does their body express it? When they’re sad, how do they physically carry that emotion?

As therapists, we help clients reprocess and reframe emotions through movement. It’s a psychological approach that integrates physical expression into social, cognitive, and emotional healing—just like other forms of psychotherapy, but using the body as a key tool for expression and processing.

Shelby:
It’s just in a nonverbal way, but we also recognize the importance of verbalization. To be able to have that too, because once it processes in the body, they can be like, “Oh, okay, now I can verbalize this a little better.”

There are some dance movement therapists—I like to do this too—who practice a “let’s move, let’s talk, let’s move, let’s talk” approach. Then I have some people who are strictly like, “Hey, I don’t want to do verbal,” and I’m like, “Okay.” We’re just going to do movement for the whole session. It’s about bringing in those dance movement therapy skills and helping them on a therapeutic level during those times.

Miranda:
I have so many questions. This is so cool. Okay, what does your office look like? Do you have space to move?

Shelby:
In my office, I have space for me and one other person. If it goes beyond that, or if the person wants more room, I’ll move us over to the group room so they have more space.

I can also do dance movement therapy via telehealth. It doesn’t have to be in person. If any of my clients are interested in virtual sessions, I just want them to have space where they don’t feel constricted.

Also, dance movement therapy doesn’t have to be done standing. It can be done sitting, lying down, or in any way that makes the client feel comfortable—especially in the beginning when it can feel really vulnerable. Being okay with that can be hard, so I let them take the lead with some guidance. Then, we work on building up rapport and confidence in movement.

It’s fun. It’s interesting. I always do it at the client’s comfort level.

Miranda:
Do most of your clients seek you out specifically for dance movement therapy? Or do they tend to have a background in dance?

Shelby:
I have some clients who reach out specifically for dance movement therapy. They’re like, “We want this. We want a holistic approach,” because essentially, that’s what dance movement therapy is—even though we’re applying psychotherapy skills in the session without people realizing it.

Some people see me for just dance movement therapy. Others want both—they’ll say, “Hey, I want dance movement therapy, but I also want talk therapy.”

Miranda:
Sure.

Shelby:
So, I always have two plans in my head for those clients. If they’re doing talk therapy that day and need to process something, I have a plan for that. If they’re wanting dance movement therapy, I have an ideal movement plan ready.

Some people also reach out to me specifically because they want a body-positive therapist. They trust that, as a dance movement therapist, I’ll be body-positive and affirming. I’m not going to shut anything down or dismiss their experiences, which they may have faced elsewhere.

I help them build self-esteem and become more comfortable in their bodies. It’s about fostering body positivity for themselves.

Miranda:
Oh, that’s so cool. When you’re doing dance movement therapy, I think I know the answer to this, but it’s not like you’re saying, “Alright, we’re going to process your grief now, so these are the movements you do for grief,” right? It’s not that structured—it’s more client-led, with whatever movements feel right for them?

Shelby:
Definitely. It’s based on movements that feel comfortable for them, but as the therapist, I’ll gently challenge them to push further when appropriate.

I create treatment plans with my clients. With dance movement therapy, I’ll ask, “What do you want to focus on? Grief? Trauma? Anxiety? Depression?” Then, we set goals and priorities.

For example, if someone comes to me for trauma, I might have them draw something out. Then I’ll say, “Okay, now let’s move with this. How does this move you?” It gets their creativity flowing and helps them explore what their experience looks and feels like through movement.

It’s their story. It’s like they’re becoming the narrator of their story through movement—expressing what their trauma felt like or what they actually experienced.

I have some clients who’ve suffered from domestic violence. If they were choked or held down, they might show those movements. I know the areas of the body where they’ve suffered, and we can work on processing those experiences through movement.

As the therapist, I’m observing and assessing in the moment—while also helping them process. It’s very client-led, but it can also be structured if they feel more comfortable with that. I always check in and say, “This is your body. This is your movement. How your body moves is different from how mine moves. What does this look like for you?”

Miranda:
I would imagine it’s very different from a dance class. It’s not like you’re teaching them specific dance moves. It’s more about showing how their body processes emotions, right? Asking, “What does that movement look like for you?”

Shelby:
Exactly. I’ll also bring in props if I notice someone is struggling.

If I sense they feel “stuck,” I’ll bring out a bunch of props and say, “What do you gravitate toward?” It helps them express their feelings tactically.

A lot of people choose my dancing scarves—these see-through, colored fabrics. The colors can represent emotions. For example, some people pick orange or yellow for anxiety. It’s interesting to see the connections they make.

As they work with the prop, I’ll ask, “How does this feel for you?” Then, I’ll guide them to incorporate it into their body movements. “Where do you feel this in your body?” It helps with the transition into deeper movement exploration.

Miranda:
That’s awesome. A couple of weeks ago, we did an episode on self-care with a therapist (shoutout to Taylor!) who talked about how she processes stress by dancing after work.

I was so inspired by that. Dance is such a great way to release feelings and move your body—especially for therapists who sit all day. Even just being silly or shaking off stress can be so helpful.

I’m curious, what role does music play? Do you choose the music, or do clients choose their own?

Shelby:
It’s different for all ages. With kids, music is huge, of course.

The type of music matters. For example, if we’re working on grief but the music is really upbeat, the client might shift away from processing and just match the music’s energy. As the therapist, I have to assess: “Have they processed enough and now they need this change, or do we need to refocus and switch the music?”

I have several dance movement therapy playlists. Some people get overwhelmed choosing music, so I’ll offer playlists with different moods. I have grounding music—more mellow, meditative tracks—and more intense emotional music that still includes some grounding elements.

If clients bring their own songs or playlists, I fully support that. I just ask that we’re mindful of explicit lyrics since we share office space with other therapists and clients of all ages.

Miranda:
That makes sense.

Shelby:
If a client’s music has explicit content, I’ll ask them to find a clean version. That way, they still feel validated by their music choice while maintaining a therapeutic environment.

Miranda:
Are clients ever choreographing routines, or is it more free-flowing? Like, do they say, “I’m going to dance to this song next week,” or is it different each time?

Shelby:
It can be either way—there’s so much creativity in dance movement therapy.

I’ll ask clients, “Do you want this to be free-flowing, or do you want it choreographed?” Some want something special and structured, like what I did in my own video. Since I was a dancer, mine was choreographed.

If a client wants to choreograph, I’ll honor that. It can be challenging, so I’ll support them through it. But if they want free-flowing movement, I’ll honor that too. It’s entirely based on their comfort level.

Miranda:
That’s great. I’m assuming you’re moving with them—you’re not just sitting and watching, right?

Shelby:
Exactly. Most of the time, I’m moving with them unless they tell me otherwise. I don’t want them to feel alone or like I’m critiquing them. Moving together helps create connection, and I can still observe and assess while participating alongside them.

I’ll mirror exactly what they’re doing—nice and easy—whatever they feel comfortable with. If they say, “Hey, I’m done,” then we’ll close it out. And I’ll ask, “How did that feel for you? What did you notice, especially with the trauma story?”

When they’re doing that mirroring, it can be really liberating for them to finally have someone who’s reflecting their movements. It’s like saying, “I understand what you’re feeling. I hear your narrative. I’m validating your feelings and moving through this process with you.”

I actually did my dance movement therapy thesis on trauma and how to apply these techniques for different trauma situations. It’s fascinating to use dance movement therapy techniques to help someone rewrite their narrative through movement.

Miranda: Mirroring is such a cool concept. I can see how helpful that would be for people. What are some other techniques you often use with clients that are similar?

Shelby: My go-to technique is something I call a body map.

The body map can be whatever the client wants it to be, but it helps both of us see what’s happening in their body. I don’t typically introduce it in the first or second session. I usually wait until there’s more rapport built. When we do it, they create a body map.

There are two ways to do this, depending on their comfort level. They can either trace their body on a large poster board or use a smaller, printed outline of a human figure. On the map, they label emotions they feel in certain areas or identify triggers, like words or music, that evoke specific sensations.

For example, if they feel anxiety in their hands and I notice their hands shaking during a session, I’ll say, “We talked about this during the body map. This is a trigger. You’re feeling anxious right now. Let’s pause and ground.”

Often, people place sensations in their stomach. I’ll notice that they start slouching or cowering inward, almost as if they’re protecting their stomach. That body language tells me a lot, and the map helps me recognize and respond to it.

I always do another body map when they’re ready for discharge. It gives us a visual representation of any changes. We can look at it together and say, “This is how dance movement therapy helped you.” It’s a tangible way for them to see their progress.

Miranda: That’s such a cool tool. I often have Gina on the podcast—she was my clinical supervisor—and she does EMDR, mostly with kids. She talks about using body maps a lot to help kids identify feelings and where they experience them physically. I love that you incorporate this into dance movement therapy too.

Do you mostly work with kids, or do you see adults as well? What ages do you typically work with?

Shelby: It’s all ages. Dance movement therapy has no restrictions. We can adapt it to fit anyone’s needs.

If I have elderly clients, I tailor the movements for their abilities. I also see younger women, and sometimes younger boys. As they get older, boys are often more hesitant due to the stigma around doing something artistic. But I have worked with some older boys who are willing to challenge that stigma.

Overall, dance movement therapy is completely adaptable. There are no restrictions on mental health diagnoses, age, or physical abilities.

Miranda: That’s so important—and so cool—because I can imagine some people might wonder, “Can I do this if I have mobility restrictions?” It’s great to hear how flexible and inclusive it is.

Do you have certain diagnoses or presenting issues that are your niche or that you prefer to work with?

Shelby: I’m pretty open, but I do tend to see a lot of clients with trauma. This includes sexual assault, physical assault, and childhood trauma.

Everyone knows the book The Body Keeps the Score, but it’s true—your body really does hold onto trauma. I often work with people who feel like they’ve cognitively processed their trauma through talk therapy, but they’re still experiencing lingering physical symptoms. That’s where dance movement therapy helps bridge the gap by connecting the mind and body.

I also work with people processing grief. Grief can make you feel physically weighed down, like you can’t even walk. Through movement, we practice releasing some of those heavy, chained feelings.

I see a lot of clients with anxiety as well. Many of them recognize that their anxiety shows up in their body before it registers in their mind. So, they come to me wanting to learn how to regulate their physical symptoms first, knowing that the cognitive response will follow.

Dance movement therapy is also helpful for people with autism, ADHD, and other neurodevelopmental disorders. When I worked in a facility, I saw a wide range of diagnoses. It really just comes down to whether the person is open to the experience. If they’re hesitant, we explore why. Are they afraid something might surface? Or do they simply feel it’s not their thing? It’s fascinating to see how different people respond.

When I was at the facility, I often ran dance movement therapy groups. People would ask, “Are you doing individual dance movement therapy sessions?” and I’d say, “Yes, but only a few per week.” The group format was more common. We’d choose a topic and work through it together using movement.

Miranda: A dance movement therapy group is such a cool idea—I hadn’t even thought about that! Do you choose the music and topic each week, or how does that work?

Shelby: I always choose the music. When you have a large group, it’s hard to cater to everyone’s preferences. That’s where my playlists come in handy—I have a variety to fit different moods and themes.

I do ask them for topic suggestions, though. Boundaries is a big one that comes up a lot. We work on identifying physical boundaries and building the strength to say “no.”

Anxiety and stress management are also frequent topics, along with depression. Sometimes, the group gets super specific, but I try to keep things broad and relatable so no one feels left out. I want everyone to feel they belong, no matter their experiences.

Miranda: When you choose the music, do you typically go for instrumental or with lyrics?

Shelby: It depends. Sometimes I’ll ask, “Do you prefer lyrics or instrumental?” and go with a majority vote. I remind them they’ll get through the group either way, and to just breathe through it.

Other times, I’ll choose the music myself and have it playing softly before they even enter. It helps set the tone and creates a welcoming atmosphere.

Some dance movement therapists always have music playing beforehand, while others don’t. Personally, I like giving the group the chance to experience some quiet before we start—it gives them more agency. When they get to participate in those little choices, I notice their eyes light up.

I always make sure the lyrics are clean, of course. Lyrics can be powerful. People often resonate with specific verses or chords. That emotional connection adds another layer of processing. It’s not just about the movement—it’s about making meaningful connections between mind and body.

For me, it’s all about being flexible. Everyone has their own preferences, and I want to make sure the group feels accessible and effective for all.

Miranda:
For a therapist who’s listening to this, who might be thinking, I didn’t go to school for dance movement therapy, but I have a client who would probably really benefit from doing some dancing in sessions, how would you recommend they approach that?

Maybe it’s a good opportunity for grounding, or maybe it’s a chance to help release some anxiety. What recommendations would you have for a therapist who just wants to dip their toes into it and help their clients?

Shelby:
Grounding is the easiest one for me. When I was starting in the dance movement therapy world, it was easier for me to grasp. There are so many ways you can help someone ground through movement—whether that’s small or big.

In dance movement therapy, breath is huge. We want to make sure we’re breathing while we’re moving. But also, if you notice someone starting to hyperventilate, it’s important to take that moment to be there with them.

I like to add an extra layer to breathwork. I don’t just say, “Okay, listen to my voice and breathe in and breathe out.” I want clients to feel their breath. So, I’ll have them place their hands where they’re comfortable. If they’re stomach breathers, I’ll have them place their hands on their stomach to feel the rising and falling. If they breathe more through their ribs, I’ll have them place their hands on the sides of their ribs or on the front and back, so they can really feel the breath happening.

Tapping is another great one. It’s not hugely well-known, but guiding clients through tapping on their wrist, temples, or center of their chest can signal the body that it’s okay. It creates a new sensation to focus on, helping them get grounded.

I also use progressive muscle relaxation—tensing and releasing different muscle groups. When people get anxious, their bodies often tense up, especially in the shoulders and neck. Leading them through some gentle stretching or progressive muscle relaxation can help release that tension.

Another technique I use for grounding is guided visualization. I have clients visualize their safe or peaceful place, walking them through the path to get there. Once they’re there, I have them take a few breaths and then start incorporating movement. I’ll guide them to imagine moving in their peaceful place and begin mirroring that movement in their body.

So, while they’re mentally in their safe place, their physical body is also moving, keeping them present. It’s often a lot of flowing arm movements, especially if they’re sitting down. You’ll see gentle, wave-like motions because they’re regulating themselves.

To bring them back, I’ll say something like, “Okay, let’s bring your hands together. Take a deep breath in, let your arms circle out, and then come back into the present moment.” I’ll ask, “How was it to be in the present moment and grounded at the same time?” And clients are often like, “Whoa, what was that?”

For kids, I’ll do something playful, like patty-cake, to shift their focus and bring in some fun. Sometimes, I’ll use a coping and grounding skill sheet with random body movements and have clients try them out. It gets creative and spontaneous, which can be really effective.

One piece of advice I always share: try it on yourself first. If you have an idea for a grounding technique but aren’t sure how it will feel, practice it yourself before doing it with a client. That way, you have a sense of how it might land and feel more comfortable guiding them through it.

Miranda:
Okay, you’ve given so much good advice—this has been such an awesome episode. I really appreciate you coming on and sharing your personal connection to this work, as well as giving such practical tips for how therapists can start incorporating movement into their sessions.

Any last thoughts or anything you feel we’ve missed about dance movement therapy?

Shelby:
It’s an ever-evolving field. Therapy as a whole is always changing—there’s constant research happening. Dance movement therapy has been around for a long time, but it wasn’t always recognized as evidence-based. Now, we’re seeing more and more research proving its effectiveness.

There are dance movement therapists currently working on applying cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) techniques to dance movement therapy sessions. That way, it can be more easily billable through insurance and provide clients with even greater benefits.

Trauma work has always been a big focus for dance movement therapy, but seeing these additional modalities incorporated is exciting. It makes me think, “Ooh, what does this do for the field moving forward?”

Miranda:
Thank you so much again for joining me, Shelby. This has been such an insightful episode, and I really appreciate you sharing your expertise.

And thank you to everyone listening! I hope this conversation was helpful and inspiring. See you next week!

The post What Is Dance/Movement Therapy? Benefits, Myths, and How It Works appeared first on Ellie Mental Health, PLLP.

What does it actually mean to regulate your nervous system? For a long time, I thought that my nervous system would be regulated whenever I stopped feeling hard emotions. I’ve learned through years of personal and professional work that my belief was wrong. Hard emotions don’t just stop happening.

Nervous system regulation doesn’t exist in the absence of emotions. To experience nervous system regulation means to experience adaptive responses to emotions. When I can feel my emotions, experience, and move through them, without feeling totally overwhelmed and out of control, I know that I am regulated.

Dr. Dan Siegel identified a concept called the window of tolerance. He identified that when individuals are existing within the “optimal zone,” we are able to effectively cope with emotions that arise. Within this window, we are regulated. Our window of tolerance is flexible. It may shrink when we’re experiencing trauma or emotional overload. It can also grow as we develop and use regulation skills and build emotional resilience. When we are operating outside of this window of tolerance, we may be on one of two sides – hyperarousal or hypo arousal.

Hyperarousal vs. Hypo Arousal

If we think of nervous system regulation as a spectrum, then hyperarousal and hypo arousal lie at opposite ends. Different emotions, behaviors, and thinking patterns can indicate which state we might find ourselves experiencing, which can help us better understand ourselves and our needs.

When you think of the word hyper, you may imagine a little kid with a lot of energy. That is also true for the nervous system. When in hyperarousal, the body has a lot of energy and wants to do something. This is why someone experiencing hyperarousal might unexpectedly hit something or snap at a friend.

Symptoms of Hyperarousal

• Emotions like worry, panic, or anger
• Hypervigilance
• Irritability
• Racing heart
• Feeling hot/sweating

Hypoarousal is just the opposite. Think about a cell phone that you’ve set to low power mode. To conserve energy, the phone limits certain functions. Hypo arousal functions very similarly, although it operates subconsciously. When in hypo arousal, the body is attempting to conserve energy for the tasks the body deems most important. This is why a person experiencing hypo arousal might find themselves staring at their phone for hours, unable to start a task.

Symptoms of Hypo Arousal

• Immobilized, feeling stuck
• Fatigue
• Brain fog
• Boredom, indifference, apathy
• Dissociation

Tips for How to Regulate: Nervous System

Nervous system dysregulation can be tough to deal with. Once we realize that we are experiencing hyperarousal or hypo arousal, what do we do to shift back towards regulation? I’m going to share two emotional regulation techniques to help – mindfulness and radical acceptance.

Mindfulness: A Key to Emotional Regulation

Noticing where we are emotionally at any given moment is half the battle – and it can be a hard one!  Mindfulness isn’t about fixing or stopping emotions. It’s about simply noticing; allowing ourselves to witness our emotions with curiosity and non-judgment.

Mindfulness has a rich history, stemming from Eastern religions and spiritual institutions, such as Buddhism. After Jon Kabat-Zinn brought mindfulness to Western society in the 1970s, its popularity has risen throughout the decades to follow. Meditation is one very common form of mindfulness, but it’s not for everyone. That’s okay! There are several other options for those interested in practicing mindfulness – mindful movement, mindful creativity, even mindful eating. The goal of mindfulness is to build self-awareness, which can happen in a variety of contexts.

Mindfulness isn’t necessarily about what we’re doing, it’s about how we’re doing it. When practicing mindfulness, I decide that I’m going to spend time present with myself, not judging whatever emotions, thoughts, and sensations might come up for me.

Radical Acceptance: The Power of Letting Go

One of the ways I practice non-judgment towards myself is by practicing radical acceptance. The term radical acceptance was coined by Marsha Linehan. She describes complete and total acceptance of our reality. If I can be honest here, I struggled with this concept for a long time. It changed for me when I realized that acceptance is not synonymous with like. I can accept that I may be feeling anger, jealousy, anxiety, or any other emotion. That doesn’t mean that I have to like it, and that doesn’t mean that I have to sit in it either.

Linehan said, “You only have to accept the moment you’re in, but you can try to change the next moment.” Radical acceptance does not mean staying stuck. Radical acceptance allows us to embrace our current reality so that we can make the best choices we can moving forward. Pain cannot be avoided, and rejecting or resisting that pain doesn’t help. From my personal experience, acceptance provides a sense of clarity that allows me to work towards a potential solution.

Radical acceptance is a key part of DBT and ACT. A therapist that specializes in ACT or DBT might be a good place to start.

Final Reminder + a Sprinkle of Self-Compassion

Think back to the hypo arousal example. This person is using their phone, unable to start a task. Mindfulness can allow this person to bring their attention to the present moment and their current experience. Being careful not to slip into self-judgment, the person can practice radical acceptance – “I accept that I feel stuck right now. What can I do to feel slightly less stuck in the next moment?” Even the most regulated individuals may slip into hyperarousal or hypo arousal occasionally – it’s all part of the human experience. Regulation is all about our responses and our ability to mindfully shift into adaptive coping strategies.

One of my personal core beliefs is that we are all trying our best at any given moment. And our best often looks different moment to moment and day to day. Sometimes, we have so much space, capacity, and time and on other days, we just don’t. I’ve recently started to slow down and remember that I do my best. It’s okay that my best today might not be as good as my best yesterday. And it’s okay if that’s true for you too. Growth isn’t a straight path.

Frequently Asked Questions

What is Nervous System Regulation?

Nervous system regulation refers to the ability to respond to emotions in an adaptive way, rather than becoming overwhelmed by them. It’s all about being able to calm ourselves down when things are overwhelming.

What is the Difference Between Mindfulness and Meditation?

Mindfulness is a state of awareness and non-judgement, exploring one’s thoughts, emotions, and bodily sensations. To be mindful is to allow thoughts, emotions, and sensations to come up naturally, simply observing and noticing. Meditation is one form of mindfulness, and tends to be a more structured, formal process in which the meditator often focuses on something specific, such as an object, mantra, or the breath.

How Can I Practice Radical Acceptance in Everyday Life?

First, we must notice any resistance we are feeling. Sometimes emotions are not fun to feel, and we resist them. That’s a normal response! That resistance can act as a reminder, telling us to pause, notice, acknowledge, and accept what we are experiencing and feeling.

Let’s use an example. Many of us have found ourselves late to an appointment and stuck in traffic. Often, our response to this might look something like, “I can’t believe this! I’m already so late, I can’t deal with this.” To practice radical acceptance, we can first pause. Then, we can notice the emotions that are coming up, maybe anger, frustration, anxiety, boredom, etc. Once we notice it, we can acknowledge it by saying, “I accept that I’m stuck in traffic. I accept that I feel super frustrated about this situation.”

Okay, I’ve Practiced Mindfulness and Radical Acceptance – Now What?

These are great steps to take, but sometimes they may not feel like enough. Now that you’re feeling a bit more regulated, it’s a good time to focus on self-care. This article provides a great list of self-care activities you may find helpful.

The post Two Simple Ways to Regulate Your Nervous System for Better Mental Health appeared first on Ellie Mental Health, PLLP.

What Self-Care Is (and What it Isn’t)

Self-care is often mistaken for the occasional indulgence—a massage, a long bath, a big vacation, or a special treat. While those things can be nice, true self-care for therapists is about consistency. It’s about creating habits that support our emotional, mental, and physical well-being. This could mean setting clear work-life boundaries, engaging in activities that bring joy (like dance workouts or journaling), or simply being mindful of self-talk. Small, intentional acts make a big difference over time.

Listen to our interview with therapists about how they manage stress and burn-out:

How to Know if You’re Burned Out as a Therapist

Therapist burnout doesn’t happen overnight… it builds up over time from work stress for therapists. A little bit of stress is normal and can even be motivating. But if you’re noticing some of the following signs, it’s probably time to make some changes:

• Feeling emotionally drained after most sessions
• Increased irritability, cynicism, or feeling detached from clients
• Decreased empathy or feeling numb to clients’ experiences
• Difficulty concentrating or making decisions
• Questioning your effectiveness as a therapist (“Am I even helping anyone?”)
• Chronic fatigue, even after a full night’s sleep
• Frequent headaches, muscle tension, or stomach issues
• Trouble sleeping (either too much or too little)
• Procrastinating on case notes, emails, or session prep
• Avoiding certain clients or feeling dread before sessions
• Increased self-isolation or withdrawing from colleagues
• Difficulty “turning off” work thoughts, even after hours
• Noticing a drop in job satisfaction (feeling stuck, unmotivated, or indifferent)
• Finding it hard to be present with clients or feeling “checked out” in sessions
• Thinking about leaving your job more often than usual

One of the most impactful books I have read in my career was “Trauma Stewardship” by Laura van Dernoot Lipsky. This book discusses the physical, mental, and emotional toll of working with trauma or in helping professions. It helped me to recognize my own “warning signs” and how to do this work well without sacrificing my own mental health.

Checking In With Yourself

Regular self-assessments can help prevent burnout from creeping up unnoticed. Tools like the Professional Quality of Life (ProQol) scale can offer insight into stress levels, compassion fatigue, and overall well-being. It’s easy to keep pushing forward without stopping to check in, but a little self-reflection can go a long way in maintaining a sustainable career. In our podcast episode, Shelby shares that this is an assessment she regularly gives to the clinicians at her clinic.

Let’s face it: It’s easy to get so caught up in taking care of others that we forget to check in with ourselves. If you’re feeling stretched thin, overwhelmed, or just off, these questions can help you assess where you’re at and what might need to change. Feel free to just think on these questions, journal about them, or use them with your clinical teams:

• Am I practicing what I encourage my clients to do for self-care?
• Do I feel guilty when I take breaks or set boundaries?
• Am I dreading sessions, procrastinating, or zoning out more than usual?
• Do I feel like I can actually keep up with my workload?
• How often do I check emails or think about work after hours?
• Do I have a solid routine to decompress after work, or do I carry everything home with me?
• Do I still find meaning in this work, or does it just feel like a burden?
• Does my workplace support my well-being, or is it a major source of stress?
• Does my workplace align with my values, or do I feel disconnected from its mission?
• If a friend told me they were this stressed at work, what advice would I give them?

Effective Self-Care Strategies for Therapists (Tips from Our Therapists)

From small resets between sessions to after-work rituals that help create a clear boundary between work and personal life, these strategies can make a real difference in managing stress and preventing burnout. Let’s talk through some tips from our therapists.

The Power of After-Work Rituals

Having a clear transition from therapist mode to personal life can make a huge difference. Whether it’s listening to music on the drive home, taking a walk, or changing into comfy clothes, these rituals help signal to your brain that the workday is over. Without them, it’s easy to let the emotional weight of the job bleed into personal time, leaving little space for rest and recovery.

In the podcast interview, Taylor talks about having a moment on her way home where she stops thinking about work:

“I’ve learned something from other therapists—they find a specific place on their drive home where they mentally stop working. For me, when I lived in Lee’s Summit, there was a ‘Welcome to Lee’s Summit’ sign. It’s kind of weird, but every time I saw it, I started telling myself, Alright, no more work. That sign became my boundary. Just like in EMDR, where we talk about containers, I imagined leaving all the stress, frustrations—even the victories of the day—right there. That was my mental shift: I’m home now, it’s time to focus on my personal life.”

Practical self-care practices for mental health professionals during the work day

Self-care doesn’t have to wait until after work. Small moments throughout the day, like stretching between sessions, taking deep breaths, and stepping outside for a few minutes can help maintain energy and focus. Even something as simple as having a mindful moment between clients can reset your nervous system, keeping you present and engaged.

I know, it’s easy to resort to doomscrolling on your phone, but when was the last time you finished that and felt better? Here are some alternate ideas for workplace self-care strategies:

1. Deep breathing exercises – Try box breathing (inhale for 4, hold for 4, exhale for 4, hold for 4).
2. Progressive muscle relaxation – Tense and relax different muscle groups to release tension.
3. Grounding techniques – Use the 5-4-3-2-1 method to refocus on the present moment.
4. Desk stretches – Stretch your neck, shoulders, and wrists to release tension.
5. Take a short walk – Even a quick lap around the office or outside can help reset your mind.
6. Watch a short funny video or share a joke with a coworker. (I am totally guilty of watching a Nate Bargatze stand up show in between sessions before when in need of a “palate cleanser”)
7. Organize your workspace – A clutter-free desk helps reduce mental clutter.
8. Prioritize tasks – Use the Eisenhower Matrix (urgent vs. important) to reduce overwhelm.
9. Take a nap—I’m convinced that at some point every therapist has taken a nap on their couch.

During the podcast episode, Taylor added:

“Sometimes we overcomplicate self-care. At its core, it’s about basic human needs—eating meals, sleeping, drinking water, moving your body. These things feel like givens, so we devalue them, but they’re essential. During my day, I make sure I have snacks, I drink water, and I pay attention to what I need between sessions. If I feel social, I chat with coworkers. If I need to decompress, I stretch or meditate.”

When Self-Care Means Quitting your Job

Not all burnout is personal—sometimes, it’s the environment.

Signs it’s time to leave your job as an act of self care.

 If a workplace demands endless emotional labor without proper support, no amount of self-care will be enough. In some cases, the best self-care decision may be to seek a setting that truly values and supports your well-being.

Work-Life Balance and Setting Boundaries for Therapists

When I was younger, work-life balance to me meant working long hours, hustling to make enough money for big trips and taking PTO whenever I could. It felt like self-care in those moments was a one-off event, something that was planned in big bursts, like a vacation or a weekend getaway.

Now, as a parent, work-life balance has taken on a whole new meaning. It’s about scheduling my time around my daughter’s soccer games or my son’s daycare breaks. It’s no longer about sprinting to make a big event happen but finding a rhythm that works day to day. It’s more like a marathon now,  sustaining a better pace so that I can show up for my family while still doing what I love professionally. Work-life balance and setting boundaries in my own therapy practice looks like:

• Having firm boundaries on when I’m done with work (not feeling pressured to work until 8pm at night or come in on my day off)
• Keeping work calls and emails to business hours, and not feeling like I need to answer on weekends or when I’m on PTO)
• Not giving my personal contact information out to clients
• Being intentional and choosy about the clients that I see (sticking to my niche)
• Having coworkers I know that I can reach out to for consultation or venting
• Having the flexibility to adjust my work hours or session times to better fit with my life.
• Feeling supported by my boss and my employer to do these things.

Leaning on Support Systems

We preach the importance of support to our clients, but let’s not forget that we need it just as much. Having a therapist, peer consultation group, or trusted colleagues to debrief with can make all the difference when experiencing work stress and burn-out. Processing our own stressors in a safe space allows us to return to our work with clarity, perspective, and renewed energy. This is one of the things I love about being a group supervisor—getting to create a supportive space where we can lean on one another.

Conclusion

Taking care of yourself isn’t just about feeling better—it directly impacts the quality of care you provide. By making self-care and work-life balance a priority, we model healthy habits for our clients and create a career that is sustainable, fulfilling, and grounded in well-being.

Bottomline: therapy is a part of what you do, but it is not your entire identity. Be sure to dedicate time to things that you enjoy and bring you more balance.

Ready to dive in deeper? Listen to the whole podcast here.

Podcast Transcript:

Miranda: Welcome to the Therapist Thrival Guide! My name is Miranda. I’m a licensed clinical social worker, and I’m here with Shelby and Taylor. Today, we are talking all about self-care.

This might be a topic where you’re thinking, I’ve already learned about self-care, but we have so much great information for you—so many tips, so many warning signs—all the things. We’re going to jump right in, but first, I want Shelby and Taylor to introduce themselves. Shelby, do you want to go first?

Shelby: Sure! My name is Shelby Finley. I’m a licensed professional counselor in Missouri and a licensed clinical professional counselor in Kansas. I’m the clinic director for the Kansas City locations for Ellie. We have three locations in this area.

Part of the reason I joined Ellie was to take better care of therapists. I’m really excited to talk about self-care because, as a company, I kept wondering how we can truly pour into therapists. From there, it became about encouraging therapists to take care of themselves, which is why I brought Taylor on—to talk more about what self-care looks like for a therapist.

Taylor: My name is Taylor Magruder. I’m a provisionally licensed professional counselor in Missouri, and I’m a therapist at the Kansas City Stateline location. I work with adults (18 and up) on issues like anxiety, depression, ADHD, PTSD—all those kinds of things.

Miranda: Awesome. This topic is so important, especially this time of year. We just went through a lot of election stress with clients, and now we’re moving into seasonal affective disorder season.

As helpers, we go through our own struggles, but we’re also expected to show up for clients. Sometimes, we neglect ourselves and try to continually pour from a cup that isn’t being refilled. I’m so excited to talk about this because even if you’re listening and thinking, Don’t worry, I take bubble baths when I’m stressed or I go for a run after a hard day—great! But there’s always room for improvement when it comes to self-care, not just for ourselves, but for our families, our clients, and our employees. It’s absolutely crucial.

So, where do you want to start, Taylor? Do you want to dive into how to recognize when you need self-care? What are the warning signs of burnout?

Taylor: First off, I think it’s so funny that you mentioned self-care isn’t just bubble baths. That was literally one of the first things I wrote down when I was thinking about this! What self-care is not.

Bubble baths and face masks can be part of physical self-care, but it’s not limited to that. For me, when I’m approaching burnout or not taking care of myself as well as I should, my texts and emails start to pile up. I become a little avoidant. My to-do list gets longer, and I start feeling overwhelmed and resentful—kind of a woe is me mentality.

At some point, I have to stop and ask myself, What role am I playing in this feeling? Where am I not setting boundaries? Because even though I become avoidant, I’m also lacking boundaries and not being mindful about what I can realistically take on.

Miranda: When you say lacking boundaries, what do you mean?

Taylor: A lot of it is about saying no—to social invitations if I don’t have the energy, to clients who want to schedule more often than I have availability, or to requests that stretch me too thin.

I was telling Shelby that my own therapist has a pretty limited schedule, and in the past, it’s been tempting to schedule my clients during that time instead of prioritizing my own sessions. Eventually, I had to realize, This isn’t sustainable. If I keep making space for others but not for myself, something is off.

Miranda: That’s such a good point. When we talk about boundaries as therapists, I often think about how we tend to overextend ourselves for clients. I was talking to a supervisee recently, and he mentioned giving out his personal phone number to clients.

I get that he cares deeply and wants to be there for them, but I also want to make sure he’s protecting his own boundaries. One of the fastest ways to burn out is getting texts from clients at 10 or 11 p.m. saying they’re in crisis. Of course, we want to show up for our clients, but we also need to acknowledge that if we’re constantly on call, we’re going to end up exhausted, resentful, and unable to be effective.

Shelby: Exactly. There are two big reasons why holding that boundary is important. First, you’re taking care of yourself. Second, as therapists, we’re not supposed to create dependency in our clients.

If a client can only turn to you at 10 or 11 p.m., that’s a sign they need to build a stronger support system. Who else can they turn to? What natural resources do they have? They need to start growing their network, because as much as we care, we can’t be that one person forever. And like you said, Miranda, even on days off, if you get a text from a client, it suddenly feels like work is infringing on your personal time.

For me, not giving clients my personal number is a hard boundary. Everyone’s boundaries look different, but if someone is comfortable with that, I hope they have other boundaries in place to protect their well-being.

Miranda: Absolutely. When I think back to the most burnt out, unhappy, and anxious I’ve ever been in my career, it was right after undergrad when I worked as a case manager. We didn’t have work cell phones—we used Google Voice numbers that went straight to our personal phones.

To this day, I still have a visceral response when Thanksgiving rolls around because I remember three Thanksgivings in a row where I got crisis calls on my Google Voice number, which rang directly to my personal phone.

When I left that job, I promised myself I would never blur that boundary again. I need to be off the clock and unreachable sometimes. That’s why crisis care exists. As outpatient therapists, we’re not crisis responders, and we shouldn’t be expected to be.

Shelby, I love the point you made about making sure clients have a broader support system so they’re not always relying solely on their therapist.

Have either of you read Trauma Stewardship?

Shelby: Yes! I love it.

Taylor: Oh my gosh, me too! The author came to Kansas City a few years ago, and I got to meet her—she even signed my book. I was so excited.

I was just talking to a client about this book recently. I have a few clients in grad school training to become therapists, and I was telling them how Trauma Stewardship was life-changing for me. It breaks down secondary trauma, compassion fatigue, and burnout in such a powerful way.

Miranda: There’s one chapter I always recommend—even if you don’t read the rest of the book. It lists warning signs that you’re not being an effective therapist anymore because of secondary traumatic stress, compassion fatigue, or burnout.

The first time I read that chapter, I felt so called out. I recognized the avoidance you mentioned, Taylor. I also saw that sense of grandiosity—the belief that I’m the only one who can help these clients. That’s never true.

One of the biggest warning signs for me was a loss of creativity. When I stop painting, writing, or being creative in my personal life, it’s a red flag that I’m getting overwhelmed professionally. That book really helped me recognize my own warning signs and take action before I hit burnout.

I think it’s crucial to know your own warning signs and communicate them—to your partner, to your colleagues. I tell my coworkers, If you notice I’m buried in emails or staying late past the time I said I’d stop seeing clients, call me out. Because usually, that means I’m blurring boundaries or not prioritizing myself.

What other warning signs have you both noticed in yourselves?

Shelby: So I think something that I have to own is that some of my warning signs are embarrassing and disheartening to acknowledge. The fact that I don’t want to do things I normally enjoy, that I’m not seeing my friends as often, or even as a leader, when someone comes to me with a problem and my response is just “okay”—that’s minimizing. And I’m not proud of that. That’s a warning sign for me. When I don’t have as much empathy as I’d like or as much to give, I know I need to start pouring into myself. Because at that point, it’s not just impacting me—it’s impacting my team members, their clients, and it creates a trickle effect.

As a leader, it’s important to pour into yourself and also model self-care. Recently, I took a self-care day and told my team, “Hey guys, I’ve had a lot going on, so I’m taking a self-care day. Here’s who you can contact if you need anything while I step back.” I was grateful when my team responded with support, saying they were glad I was taking time for myself. That feedback meant a lot. I want my team to know I’m taking a step back for my well-being because modeling that is important. We all have crummy warning signs sometimes, and we have to own them. If someone brings a problem to me and I respond with “okay,” that’s a sign I need to check myself.

Miranda: Oh my gosh, that’s such a good example. I can think of times when I’ve done the same thing with my spouse. He comes home and says, “I had a bad day at work,” and I’m like, “Bet you didn’t have to make a CPS report today.” I’m so guilty of that.

Shelby: Same! When I worked in crisis, someone would say, “My boyfriend broke up with me,” and I’d think, “Yeah, but you’re not hospitalized, so keep going, sis.” That’s such a crummy response.

Miranda: Minimizing is a real warning sign that if you’re not taking care of yourself, you can’t have empathy for others. We need to be able to sit with someone struggling with a breakup and validate their pain just as much as we do for those in more immediate crisis.

Taylor: So what do you two do for self-care?

Taylor: Self-care is preventative, constant, and non-optional. It’s not just something to do when you’re burned out—it’s something to do all the time. For me, I have a ritual when I get home from work. I don’t do these things because I need them that day; I do them because I need them consistently. When I get home, I stretch for five to ten minutes. If I have more time, I’ll do a dance workout because I genuinely enjoy it. I danced growing up, and I realized I wasn’t feeling motivated by traditional workouts. But with dance workouts, I focus on the choreography, and it’s fun. At the least, I move my body in some way because we sit all day, and I need to reconnect with myself.

Miranda: Where do you find these dance workouts? Because I love this idea. Dancing is so good for mental health.

Taylor: I use Apple Fitness Plus. They have choreographed dance workouts, which I love because I get really into perfecting the moves. If I’m short on time, I’ll just put on my favorite pop songs, grab the TV remote, and dance around my living room.

Miranda: Full-on Lizzie McGuire moment.

Taylor: Exactly! My dog hates it, but I have fun.

Shelby: He’s getting a free concert—what’s his problem?

Taylor: Right?! I sing to him, and he just looks at me with his ears down.

Shelby: My after-work ritual is working out. If I sit on my couch, I’m not getting up again. So I take my dog for a walk as soon as I get home, then I change into gym clothes. If I put the effort into dressing for the gym, I’ll actually go. Another thing I do is check in with myself: Do I need people today, or do I need alone time? Some days, I’m all about socializing; other days, I just need quiet. I’ve even started doing diamond painting as a solo activity—it’s been fun making little gifts for my nieces and nephews.

Miranda: I get that. I’m an outgoing introvert. I like being around people, but I also need alone time to recharge. When I worked in child protection, I had a long drive home, and I didn’t realize how much that decompression time helped me until COVID hit. Suddenly, I was home all the time, surrounded by people, and I struggled. That’s actually why I got a dog—having a reason to take walks really helped. Even now, if I have a stressful day, I make sure to take a quick walk around the block. Just getting fresh air and sunlight can make a huge difference.

Shelby: That’s such a good point. We’ve talked a lot about self-care after work, but what about during the workday? Taylor, how do you handle those seven-session days?

Taylor: Sometimes we overcomplicate self-care. At its core, it’s about basic human needs—eating meals, sleeping, drinking water, moving your body. These things feel like givens, so we devalue them, but they’re essential. During my day, I make sure I have snacks, I drink water, and I pay attention to what I need between sessions. If I feel social, I chat with coworkers. If I need to decompress, I stretch or meditate. My physical therapist gave me shoulder exercises, and I make sure to do them because I carry so much tension there.

Shelby: Finding those little “work perks” is key. One of ours is having comfy couches in our offices. I went to a self-care CEU event recently, and they normalized things like turning off the lights and resting between sessions. At my first therapy job, I was scared to do that, but my supervisor told me, “You have 20 minutes before your next session—use it to reset.” That advice stuck with me, and now I encourage my team to do the same. If taking a quick break helps you show up fully for your next client, it’s worth it.

Miranda: Exactly. Self-care isn’t just about time off—it’s about what we do daily to sustain ourselves.

Taylor: So I’ve been like, okay, let’s turn this into something productive. Now when I get to this one stoplight, where I have service again, I can listen to music or call someone. I take those first few minutes to just decompress.

Miranda: Shelby, you made me think of a couple of different things, but that decompression time—yes, it’s so crucial. For me, in that job I was in, it was necessary. But also, let’s normalize not staying in jobs that require so much more self-care. Yes, we should be taking care of ourselves, but before I came to LA, I had so many jobs that took so much out of me.

And I think for those jobs, a long drive was really helpful because I needed that separation way more than I do now. Yes, self-care is crucial for any helping profession, but no amount of self-care is going to make a toxic job not suck. If you’re in a work environment where you’re not appreciated, underpaid, or just completely drained, self-care alone won’t fix that.

Also, let’s call out that changing jobs can be an act of self-care. You are a highly skilled, highly educated professional, and you deserve a job that prioritizes your mental health too. That’s crucial.

This is going to sound backwards, but I don’t need as much self-care as I used to in those really bad jobs—because being in a job that I love is also a form of self-care. That’s just super important, and it does exist for people.

Shelby: I think you bring up a good point. With clients, we give them all these coping skills, and they tell us they’re using them—but they’re still struggling. At some point, we have to ask: Okay, maybe it’s not you. Maybe it’s the relationship. Maybe it’s the job. Maybe it’s the city.

I remember my first job in community mental health. It was a 40-hour-a-week job, seeing clients back to back. And if you weren’t with a client, you were expected to jump into a group to hit your productivity. It was just constant. I was exhausted. It was the first job I had when I moved to Kansas City, and I wasn’t making any friends because I was so drained all weekend.

I realized, This is not sustainable. I didn’t know anyone in the city. I was lonely, but I didn’t have the energy to meet people. Eventually, I moved into a leadership role that gave me more capacity to pour into myself, but that initial experience really showed me the importance of environment.

Miranda: I think you’re right. At some point, you have to ask yourself: Is it that I’m not taking care of myself, or is my environment just not set up for me to thrive? And if it’s the latter, what needs to change?

So, Shelby, you mentioned the ProQOL—did I say that right?

Shelby: Yeah, that’s how I say it.

Miranda: Could you give a little background? You started talking about how this is a tool you use with the therapists who work for you. Can you tell me more about the ProQOL and how you actually use it?

Shelby: Yeah! So, it’s the Professional Quality of Life survey, and it measures three things: burnout, compassion fatigue, and secondary trauma.

I think it’s great—it’s somewhere between 20 and 40 questions. People can take it online quickly or print it out, score themselves, and see where they’re at in those three areas.

Something we’ve all been saying, but maybe not explicitly calling out, is that we have to keep assessing ourselves. Just like our clients need to check in on their mental health, we, as therapists, have to do it even more. If we’re not taking care of ourselves, it trickles down.

This survey is a great way for me, as a leader, to encourage my team to check in. I send it out once a quarter via email, with both a printable version and a link to take it online. I don’t ask them to share their scores, but I let them know: If you want to talk, I’m here.

Therapists often prioritize everyone else over themselves, and I see it as my responsibility to make sure they’re checking in on themselves. Honestly, I can’t even remember where I first learned about the ProQOL, but it’s stuck with me as a leader.

Some therapists have even shared with me, Hey, since coming to LA, my compassion fatigue score has dropped five points. That’s when I know the change in environment was what they really needed.

Miranda: We’ll share a link to the ProQOL in the description. I think everyone listening should take it—just as a self-inventory to check in with yourself.

Maybe you’re recognizing some warning signs in yourself. Maybe you’re realizing you’re more burned out than you thought. Having an assessment like this can be so valuable.

Are there any other tools you all use to encourage therapists to take care of themselves? Or things you’re doing for your clients—or even yourself?

Taylor: There’s this app that one of my clients told me about called How We Feel. The whole purpose is to track your emotions, practice identifying them, and become more aware of them overall.

You can set it to send reminders however often you want. I have mine set for twice a day—just a little check-in. It asks, How are you feeling? Then it gives you a list of emotions, complete with definitions, which I love.

I think we often overgeneralize—I feel stressed. I feel overwhelmed. But why do you feel that way? Breaking it down into more specific emotions helps you understand what you actually need.

The app also provides coping skills and emotion education videos, and it’s completely free—no subscription or anything.

A lot of my clients love data, so they like that the app has an analysis section where it tracks trends. You can journal a little when you check in, noting who you’re with, where you are, and what you’re doing. It even connects to a Fitbit or a cycle-tracking app.

Over time, it shows patterns—like, Why am I marking myself as anxious every morning? What’s going on then? That insight can be really helpful. Honestly, almost all of my clients who’ve tried it have loved it.

Miranda: That’s really cool. I’ll include a link to that as well. Anytime we find resources that work for clients, that’s great—but when they help us gain more insight into ourselves, that’s even better.

Any last thoughts before we wrap up?

Shelby: The biggest rule—it can’t be said enough—is that every good therapist should have a therapist.

It’s like personal training. You might know how to work out, but a personal trainer keeps you accountable. I always have a gym buddy—if I don’t, I’ll make excuses. But if someone’s waiting for me? I’ll show up.

It’s the same with therapy. Even if you’re just checking in biweekly or monthly, having someone to hold you accountable for your self-care is invaluable. I’ve had clients come in just for that—a check-in buddy to say, Hey, are you actually taking care of yourself?

What we do is really hard. It’s also really unique. I think about some of my days and realize, No one else had that kind of conversation at work today—but I had it twice.

We do such a challenging job. We pour into others all day long, so we have to double down on how we pour into ourselves.

Miranda: Thank you so much for joining. This has been such a great episode—I’ve gotten so many good ideas, and it’s been a great reminder of how I can better check in with my supervisees.

Thank you both for being here, and thanks to everyone for listening!

Shelby: Thanks for the invite—we appreciate it!

The post Self-Care for Therapists: Proven Strategies to Manage Work Stress and Prevent Burnout appeared first on Ellie Mental Health, PLLP.

Have you ever turned down a vacation because you don’t like flying? Denied a road trip because driving is scary? Heck, maybe you despise going into your basement due to those pesky, freaky spiders! Perhaps you’re like me and threw a book through a bedroom door because a centipede was walking across it (true story, I had to buy a new door and everything)! Fear has a nasty habit of running our lives, but virtual reality exposure therapy is flipping that script.

To make things even more tricky, overcoming fears is hard because to overcome them, you have to face them head on and, often, alone. It’s not like you can take your therapist on a plane, right? Well, that used to be true but now… cue the baller music… Virtual Reality enters the chat!  

Virtual Reality (VR) has been around for a hot minute at this point, but only in recent years has it been a truly viable piece of technology. When most people think of VR, they often think of video games or cheesy experiences that you can have at the Mall of America but at Ellie Mental Health, we have a different perspective. We are using virtual reality therapy as a professional therapeutic tool to help people take back control of otherwise fearful experiences.

What is VR Therapy?

Virtual reality (VR) therapy is a mental health treatment that uses immersive virtual environments to help people process emotions, confront fears, and build coping skills in a controlled setting. Think of it as exposure therapy meets cutting-edge tech—clients can practice real-world situations in a safe, guided way. It’s been used for everything from phobias and PTSD to mindfulness and stress management. As technology evolves, VR is becoming an increasingly accessible and powerful tool in mental health care.

How VR Therapy Works

VR therapy works by immersing clients in a virtual environment tailored to their therapeutic needs. Using a VR headset and handheld controllers, individuals can engage in guided scenarios designed to help them process emotions, confront fears, or practice coping strategies. A therapist customizes the experience, adjusting difficulty levels and providing support in real-time. Because everything happens in a controlled setting, clients can work through challenges at their own pace, with the reassurance that they can pause or step back at any time.

For example, someone with a fear of public speaking might start by standing in a virtual empty room, gradually progressing to speaking in front of a small virtual audience. Over time, the therapist might increase the challenge by adding distractions or a larger crowd, helping the client build confidence and resilience. This step-by-step approach aligns closely with exposure therapy, a well-established method for treating anxiety and phobias. The key difference is that VR therapy offers a safe, repeatable, and fully customizable environment—making exposure more accessible and less intimidating than real-world practice.

Virtual Reality as Therapy for Mental Health Treatment

VR therapy is sometimes called “fear therapy” because of its ability to help people gradually face and overcome anxiety-provoking situations in a safe, controlled way. By immersing clients in realistic yet customizable environments, it’s especially effective for conditions like phobias, PTSD, and social anxiety. But its usefulness goes beyond fear! VR is also being used for mindfulness, stress management, and even pain reduction in therapy. The next sections explore how VR therapy is transforming mental health treatment across different areas.

VR for PTSD

Virtual Reality Exposure Therapy is helpful for PTSD and healing from past traumas. By immersing clients in controlled virtual environments that simulate aspects of their traumatic experiences, VR therapy allows them to gradually confront distressing memories in a safe, guided way. It follows the same principles as traditional exposure therapy but adds an interactive, immersive element that can make the process feel more manageable and engaging.

Research backs up its effectiveness. One study found that VRET significantly reduced PTSD symptoms, with some participants no longer meeting the criteria for diagnosis after treatment. Another 2024 study showed that combining VR exposure with brain stimulation led to even greater improvements, especially for military veterans, and had higher efficacy rates than traditional exposure therapy.

VR for Phobias

Whether it’s a fear of flying, heights, spiders, or public speaking, VR lets clients interact with their specific phobia in a virtual setting while their therapist guides them through the process. Because it’s customizable and repeatable, clients can ease into exposure at their own pace without the pressure of real-world consequences.

And the research backs it up. This article reviewed studies that compared VR therapy and traditional exposure therapy, and it found that VR therapy is just as effective for treating phobias, with some studies suggesting it might even have extra benefits. Another study found that people with social phobia saw significant, lasting improvements after VR therapy. As VR keeps evolving, it’s making exposure therapy more accessible—and maybe even a little less intimidating.

VR for Anxiety Disorders

Virtual reality isn’t just effective for phobias and trauma. Recent studies also show VR’s effectiveness with anxiety. A meta-analysis published in the Journal of Medical Internet Research found that VR found significant improvements in symptoms for people with severe anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder.

Additionally, a systematic review indicated that self-guided VR interventions effectively reduced symptoms of social anxiety disorder, public speaking anxiety, and specific phobias, with positive user experiences and low attrition rates. These findings suggest that VR therapy offers an effective approach to anxiety treatment.

VR for Depression

As therapists are using VR therapy more and more with clients, we are seeing its effectiveness across different diagnoses, including depression. VR therapy immerses individuals in interactive environments that promote mood improvement and coping strategies. Through guided virtual experiences, patients can practice mindfulness, reframe negative thoughts, and engage in activities that boost motivation.

Research supports its effectiveness. One particular study from 2019 found that VR interventions can help reduce depressive symptoms by translating CBT techniques (like psychoeducation and cognitive restructuring) into virtual reality experiences.

The Benefits of Virtual Reality Therapy

1. Controlled Environment
2. Controlled Exposure
3. Personalized Treatment

1. Controlled Environment

As previously discussed, VR therapy offers a level of control that traditional exposure therapy can’t. In real-world settings, variables are unpredictable—VR allows therapists to adjust intensity, ensuring a gradual, personalized approach. This control allows for a more gradual, personalized approach.

Clients appreciate that they can start with lower-intensity exposures and work their way up at their own pace, reducing the risk of being retraumatized or overwhelmed. VR also ensures consistency—each session replicates the exact scenario needed, something that’s nearly impossible to guarantee in real life. This makes exposure therapy more accessible, flexible, and tailored to each person’s unique needs.

2. Controlled Exposure

VR therapy gives therapists and clients more control over the exposure process, making it a safer and more adaptable approach than traditional exposure therapy. In real-world settings, exposure can be unpredictable—clients might face unexpected triggers or overwhelming situations. With VR, therapists can tailor the experience, adjusting intensity and pacing to match the client’s comfort level.

This level of control allows for gradual, repeatable exposure without the risk of overstimulation. Clients can build confidence at their own pace, knowing they won’t be thrown into a situation they’re not ready for. It also ensures consistency, making progress easier to track and refine over time.

3. Personalized Treatment

With the controlled environment therapists are able to offer highly personalized treatment, adapting exposure to each client’s specific needs and progress. Therapists can adjust factors like intensity, duration, and specific triggers, ensuring a gradual and manageable approach. This flexibility helps clients build confidence at their own pace while minimizing distress, making treatment more effective and tailored to individual goals.

VR Therapy with Ellie Mental Health

Virtual Reality (VR) has been around for a hot minute at this point, but only in recent years has it been a truly viable piece of technology.

At Ellie Mental Health, we’re using virtual reality as a professional therapeutic tool to help people take back control of otherwise fearful experiences. 

In creating the VRT program at Ellie, we pulled over 30 peer-reviewed research papers from the last 5 years.

Our process is based on Systematic Desensitization and evidence-based Exposure Response Prevention methods. This includes creating what we call a SUDS (Subjective Units of Discomfort Scale) Ladder. Meaning, we determine a series of steps that are increasingly more distressing and work our way through it.

Intrigued? Virtual reality therapy is seriously amazing! Learn more about VRT with Ellie Mental Health.

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Burnout: When Your Brain Waves a White Flag

Burnout is what happens when stress overstays its welcome. It’s that state of emotional, physical, and mental exhaustion that makes you wonder if you should quit your job and go work at an ice cream shop instead (when I was dealing with burn-out, that was my fantasy).

Signs You Might Be Burnt Out:

• You’re always tired, no matter how much sleep you get
• You find yourself thinking, Does anything I do even matter?
• Your patience is wearing very thin (with clients, colleagues, loved ones, or even strangers on the road)
• You’re mentally checking out, even in sessions you used to enjoy
• The idea of answering another email makes you want to cry (so you avoid avoid avoid)

How to Fight Burnout:

Set Boundaries Like Your Sanity Depends on It (Because It Does)

Work ends at a certain time? Stick to it. Clients emailing you at midnight? They can wait.

Find Joy Outside of Work

What did you like to do before you became a therapist? Do more of that. How would you spend your time if you didn’t have to work anymore? Try to incorporate more of those things.

Talk It Out

Supervision, therapy, or venting to a trusted colleague can help you process what’s draining you.

Reassess Workload & Expectations

If you’re drowning, it’s okay to ask for a life raft. Ask your boss to help you prioritize, let them know you’re struggling, and see if some of your tasks can be delegated.

Compassion Fatigue: When Caring Feels Like Too Much

Compassion fatigue is like empathy burnout. You still care, but you’re so emotionally drained that caring feels like an Olympic sport you didn’t sign up for.

Signs You Might Be Experiencing Compassion Fatigue:

• You feel emotionally drained after listening to clients’ struggles
• You’re running on autopilot and feeling disconnected from your work
• Your ability to empathize is… well, not what it used to be
• You feel more irritable, cynical, or just over it
• You need extra time to emotionally recover from tough cases

How to Combat Compassion Fatigue (Without Becoming a Robot):

1. Check In With Yourself: How are you doing? No, really. When’s the last time you actually asked yourself that? If you need some extra help, take the ProQOL assessment.
2. Make Space for Reflection: Whether it’s journaling, mindfulness, or talking it out with a friend, process your emotions instead of bottling them up.
3. Balance Your Caseload: If possible, mix in less emotionally intense cases with the heavy ones. It’s tough to do back to back to back trauma processing cases some days.
4. Surround Yourself with Support: Find your therapist friends, commiserate, and remind each other that you’re doing great (even when it doesn’t feel like it). If you’re in this alone, consider joining a Facebook community—or better yet, join an Ellie Mental Health group practice.

Secondary Traumatic Stress (STS): When Clients’ Trauma Feels Like Your Own

STS happens when you’re exposed to clients’ trauma so much that your brain starts treating it like your trauma. It’s like emotional secondhand smoke— still harmful, even if you’re not the one directly experiencing it.

One of our Ellie therapists just joined our podcast recently to discuss her experience with secondary traumatic stress, how it was different than burnout and compassion fatigue, and how she was finally able to move forward and heal. Listen here:

Signs You Might Be Experiencing STS:

• You’re having intrusive thoughts or distressing dreams about clients’ experiences
• You feel emotionally numb or disconnected from reality
• You avoid certain cases, conversations, or topics because they feel too triggering
• You’re hypervigilant, anxious, or having trouble sleeping
• Your body is reacting—headaches, muscle tension, nausea—all the fun stuff

How to Manage STS (Without Quitting Therapy Forever):

1. Set Emotional Boundaries: You can care without carrying every client’s trauma like it’s your own personal baggage.
2. Supervision is Your Friend: Regularly talk through tough cases with someone who gets it.
3. Educate Yourself on Trauma Responses: Understanding your own reactions can help you navigate them better. One of the most helpful, influential books I’ve read on this topic was Trauma Stewardship—highly recommend!

Taking Care of Yourself Isn’t Optional

Therapists are human first. This job is a part of us, but it is not our full identity. Burnout, compassion fatigue, and STS are real, but they’re also manageable when we prioritize ourselves the way we prioritize our clients. Set boundaries, take breaks, and remind yourself that taking care of you is what allows you to take care of others. Self-care isn’t selfish—it’s essential.

Listen to our full episode about self care as therapists here:

The post Burnout, Secondary Traumatic Stress, and Compassion Fatigue in Helping Professions appeared first on Ellie Mental Health, PLLP.

What Self-Care Is (and What It Isn’t)

Self-care is often mistaken for a luxury, like bubble baths, vacations, or treating yourself to something fancy. While those things can be nice, real self-care is about consistency. It’s about building habits that support your emotional, mental, and physical well-being. That might mean setting clear boundaries between work and personal life, doing something you actually enjoy (not just scrolling on your phone), or paying attention to how you talk to yourself. Small, intentional choices make a big difference over time.

Signs of Stress and Burnout

Burnout doesn’t hit all at once– it sneaks up gradually. A little stress is normal and can even be motivating, but if you’re noticing any of these signs, it’s time to reassess:

• Feeling emotionally drained or exhausted after work
• Increased irritability, cynicism, or detachment
• Trouble concentrating or making decisions
• Chronic fatigue, even after a full night’s sleep
• Frequent headaches, muscle tension, or stomach issues
• Trouble sleeping (either too much or too little)
• Procrastinating on emails, meetings, or work tasks
• Avoiding certain coworkers or dreading work altogether
• Struggling to disconnect from work thoughts after hours
• Feeling stuck, unmotivated, or questioning your career

One of the most eye-opening books on burnout is Trauma Stewardship by Laura van Dernoot Lipsky. While it’s geared toward helping professionals, the insights apply to anyone dealing with stress-heavy jobs. It helped me recognize my own warning signs and adjust before burnout took over.

Checking In With Yourself

It’s easy to keep pushing forward without stopping to check in, but a little self-reflection can go a long way in preventing burnout. If you’re feeling stretched thin, overwhelmed, or just off, these questions can help you figure out what needs to change:

• Am I practicing any of the self-care habits I tell others are important?
• Do I feel guilty when I take breaks or set boundaries?
• Am I dreading work, procrastinating, or zoning out more than usual?
• Do I actually have a manageable workload, or am I just pretending I do?
• How often do I check emails or think about work after hours?
• Do I have a solid way to decompress after work, or do I carry everything home with me?
• Do I still find meaning in my job, or does it just feel like a burden?
• Is my workplace supporting my well-being, or is it the main source of my stress?
• If a friend told me they were this stressed at work, what advice would I give them?

Listen to our interview with therapists about how they manage stress and burn-out:

Small Changes That Make a Big Difference

Managing work stress doesn’t require a complete life overhaul– small changes throughout the day can make a real impact. Here are some simple strategies:

Creating an After-Work Transition

Having a clear shift from work mode to personal time makes a huge difference. Whether it’s listening to music on the drive home, taking a walk, or changing into comfy clothes, these rituals signal to your brain that the workday is over. Without them, stress lingers, and it’s harder to unwind.

A therapist I know shared in a recent podcast episode that she mentally “clocked out” when she passed a specific road sign on her way home. It sounds small, but that act of intentionally leaving work stress behind made a difference. Find your version of that.

Self-Care at Work (Yes, It’s Possible)

Self-care isn’t just for after hours. Small moments during the workday—stretching, stepping outside, taking deep breaths—help maintain energy and focus. Instead of doomscrolling between tasks, try one of these:

• Deep breathing (box breathing: inhale for 4, hold for 4, exhale for 4, hold for 4)
• Progressive muscle relaxation (tense and release different muscle groups)
• Grounding techniques (use the 5-4-3-2-1 method to refocus on the present)
• Desk stretches (loosen up your neck, shoulders, and wrists)
• A short walk (even a quick lap around the office helps)
• Watching a funny video or sharing a joke with a coworker (I am totally guilty of watching a Nate Bargatze stand up show in between sessions before when in need of a “palate cleanser”)
• Organizing your workspace (a clutter-free desk always reduces mental clutter for me)
• Prioritizing tasks (use the Eisenhower Matrix to cut down on overwhelm)
• Taking a nap (if your job allows it, a quick power nap can work wonders)

During the podcast episode, Taylor added: “Sometimes we overcomplicate self-care. At its core, it’s about basic human needs—eating meals, sleeping, drinking water, moving your body. These things feel like givens, so we devalue them, but they’re essential. During my day, I make sure I have snacks, I drink water, and I pay attention to what I need between sessions. If I feel social, I chat with coworkers. If I need to decompress, I stretch or meditate.”

When Self-Care Means Finding a New Job

Not all burnout is personal—sometimes, it’s the work environment. If your job constantly demands more than you can give, lacks support, or makes you dread every Monday, no amount of deep breathing will fix that. In some cases, the best self-care decision is finding a workplace that actually values and supports your well-being.

Rethinking Work-Life Balance

When I was younger, I thought work-life balance meant hustling hard and then taking big vacations as a reward. Now, as a parent, it looks completely different. It’s not about sprinting until I can take time off, it’s about maintaining a sustainable rhythm every day so I can be present for my family and still do work I love.

For me, that means:

• Having firm work hours and actually sticking to them
• Not answering work emails on weekends or when I’m off
• Being intentional about the projects I take on
• Having coworkers I can lean on when needed
• Making sure my schedule works for my life, not the other way around
• Feeling supported by my employer instead of drained by them

Leaning on Support Systems

We all need people to lean on, whether it’s coworkers, friends, or a mentor. Having a trusted support system to talk things through helps keep stress from piling up. If you’re struggling, don’t tough it out alone.

Not sure who to turn to? A therapist can be the professional support you need when feeling stressed. Find a therapist that specializes in stress management here.

Work, Stress, and What Comes Next

Taking care of yourself isn’t just about feeling better…. it directly impacts how you show up at work and in life. By making self-care a priority, you can build a career that’s fulfilling, sustainable, and doesn’t leave you completely drained at the end of every day.

Bottom line: Your job is part of your life, but it shouldn’t consume your entire identity. Make space for the things that bring you joy and balance.

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