How to Choose the Right Therapist
Starting therapy is a big step, and picking the right person to walk through it with you can feel overwhelming. Between credentials, insurance panels, specialties, and a hundred profile photos on Psychology Today, it's easy to throw in the towel before you even book a consultation.
Here's what actually matters when you're choosing a therapist, and what to pay attention to once you're in the room (or on the screen) with them.
The Concrete Stuff
Licensure. Look for letters like LISW-S, LPC, LMFT, PhD, PsyD after a name. Each represents different training, but the more important question is whether the person is licensed to practice in your state. If you're looking for someone for your child, ask specifically about their experience with kids or teens. While anyone with the licensure can work with children, it’s best to find someone with experience and a desire to work with them.
Specialty. A therapist who lists "anxiety" as one of fifteen areas they treat is different from one whose whole practice is built around it. If your child is dealing with school avoidance, for example, you'll likely get further faster with someone who works in that space regularly rather than with someone trying to cover everything.
Approach. CBT, MI, DBT etc. While it seems our profession sure loves acronyms, it is important to know which one your therapist prefers. Even if you have no idea what any of them mean (which is totally okay), a good therapist will be able to explain what their modality is and why, without the alphabet jargon.
Logistics. Insurance or private pay, telehealth or in-person, and actual availability all matter more than you may expect. A perfect-on-paper therapist who can't see you for eight weeks isn't the right fit for a family in crisis right now.
The Part You Have to Feel
Research consistently shows that the relationship between client and therapist, often called the therapeutic alliance or rapport, predicts outcomes more than any specific modality or licensure type does. Rapport accounts for 15% of the therapy outcomes vs just 0-10% for the modality type (CBT v EMDR etc).
That's part of why many therapists (myself included) offer a brief consult call before the first real session. It’s a way for you and your potential therapist to determine if it feels right. If the vibes are off, trust your gut.
A few signs of good fit:
It feels like a safe place. You should feel like you can be open honest without being judged.
They explain things in a way that makes sense to you.
You leave sessions feeling like you were heard and validated.
Progress, or relief, starts to feel more attainable.
Where I May Be Different
Much to the dismay of the therapy myths and probably my Grad school professors- I believe self-disclosure is necessary! While therapists were once thought to be firmly neutral and somewhat closed off from discussing their own lives- times are changing. I want my clients to feel comfortable asking me things too! For example; what are my favorite coping skills? Do I have pets? Play video games? What did I do over the weekend? We are in this together and who I am as Bree should not feel like a mystery.
If It Feels Off
Trust your instincts. If after a session or two it doesn’t feel right, that’s okay! It’s not a sign that therapy doesn’t work for you. It more likely means the fit was off. If you find yourself thinking that is the case, let your therapist know. Most would rather you find the right match (including myself), even if it isn’t them.
Not Sure Where to Start?
If you're navigating school-related anxiety or avoidance with your child, or you're an adult looking to work through anxiety or negative thought patterns, I'd be glad to talk it through on a free consult call to see if we're a good fit. And if we aren’t, that’s okay! I am always happy to recommend someone who might be. Feeling better matters the most!
My Child Says Their Stomach Hurts Every School Morning — Is It Anxiety?
If you're reading this at 7:15am with a kid on the couch clutching their stomach and refusing to put their shoes on, first: breathe in, breathe out. You're not imagining the pattern and you're not a bad parent for feeling exhausted by it.
Here's the thing about kids and anxiety: it rarely shows up looking like anxiety. It shows up looking like a stomachache. A headache. Sudden nausea that seems to vanish by 10am, or on weekends, or the second summer break starts. Parents often go through the pediatrician route first (which is exactly the right move, ruling things out physically always comes first) and then land in my office asking some version of, "Is this actually anxiety? And if it is, why does it feel so real to them?"
So let's talk about that.
Are the school tardies and absences adding up already? Let’s talk about what could really be going on.
Why Anxiety Shows Up in the Body First
Kids don't usually have the language yet to say "I'm anxious about the math test" or "I'm worried I won't have anyone to sit with at lunch." What they do have is a nervous system that reacts to stress the same way an adult's does. Think racing heart, tight chest, upset stomach. The body prepares for fight or flight. Except they don't yet have the vocabulary to connect the feeling to the cause. So instead, the body just... talks. Loudly. Usually right around 6:45am on a school day.
This isn't manipulation. It isn't your child "faking it" to get out of school. The stomachache is real, the nervous system doesn't know the difference between "I'm scared of the pop quiz" and "there's a tiger in the room." It reacts the same way either way.
A Few Questions That Can Help You Tell What's Going On
Does the stomachache show up mostly on school mornings, and ease up once they're actually settled at school, or by afternoon?
Does it disappear almost completely on weekends or during breaks?
Is there a specific part of the school day they seem to dread — recess, a certain class, lunch, the bus?
Has anything changed recently like a new teacher, a friendship shift, a bigger transition like a new grade or new school?
None of these questions diagnose anything on their own. But a pattern like "fine on Saturday, miserable by Sunday night, stomach hurts every weekday morning" is a pretty strong signal that something at school, big or small, is weighing on them more than they can put into words yet.
What Actually Helps (Beyond "Just Push Through It")
The instincts to either force them out the door or let them stay home both come from a loving place, but neither one, on its own, actually helps a kid build the skills to move through the anxiety. A few things that tend to make a real difference:
Naming the feeling without judgment. Something as simple as, "Your body's telling you it's worried about something, let's figure out what," takes the shame out of it.
Small, specific problem-solving. Not "school is scary" in the abstract, but "the walk into the building after the bell feels scary". When we can find the specific trigger, that's something we can actually work on together.
Consistency over avoidance. Every day a child stays home to avoid the anxious feeling, the anxiety gets a little more confirmation that school really is something to fear. Gentle, supported exposure, even just getting to the building, matters more than people expect.
Getting support before it snowballs. School anxiety that goes unaddressed for a semester looks very different from school anxiety caught in its first few weeks. Look for support from your child’s school. A preferred staff member, the school counselor, or a loyal friend can make a huge difference.
If This Sounds Familiar
You don't have to figure this out alone, and you don't have to wait until it's a full-blown crisis to ask for help. I work with kids and families navigating exactly this: school anxiety, school refusal, the stomachaches, headaches and meltdowns that come with it, all through online sessions that fit into your actual schedule, not just the once-a-week-if-you're-lucky in-person slot.
If you're nodding along right now, I'd love to talk. Reach out here to set up a consultation.
What an Ohio Thunderstorm (or Tornado) Can Teach Us About Riding Out Anxiety
It’s been an absolutely wild week of storms in Ohio; from an actual tornado, a car flipping over on the freeway, downed power lines and power outages to flooded streets, fallen trees, and side-ways rain. There has been a constant humidity and often a rumble of thunder in the distance. Despite my usual love of thunderstorms- it’s been a lot. But after each little round of storms the sun has been popping back up again and I’ve seen our community come together for clean up.
I think of this pattern a lot in my work, becaus it so closely mirrors what the pattern of anxiety can feel like.
The build up. Sometimes it’s sudden- with no warning and other times it’s constantly churning underneath; you know it’s coming, it’s just a matter of when. In ourselves it can feel like a slight “something is off feeling”, a tight chest, an increase in snappy responses. For children it can be a change in appetite, a refusal to go to school or engage in activity- or also that increase in snappy responses! Either way, we sometimes write these signs off because nothing “big” has happened yet.
Then the storm hits. Then it happens and it’s loud (even if just internally). Thoughts racing, heart pounding, tears, a full shutdown or meltdown depending on the person. In the middle of it all it can feel scary, like it’s not going to end and you’re unsure of what to do or how to stop it. Like this is the new weather forever.
It passes. But an anxiety storm will end, every time. Just like an Ohio storm, it can be dramatic, but even in a week like this one- it has to end. Our nervous systems work the same way. The spike is real and intense but it’s also biologically only temporary. We can’t sustain at that level forever.
The Aftermath. Sometimes there is destruction in the wake; hurt feelings, a thrown object or a tear stained face. Sometimes you may look around and never realize it had just been storming. When you get to the other side there is such relief and almost clarity about it. Not because the anxiety storm itself was good, but because it reminds you the sky can clear, you can come back to safety. That is always worth remembering the next time you are in the midst of a storm, whether it’s your own or your kids. You know you’ve been through this before and just like these Ohio storms- it passes.
A few things that help while you're waiting out the “storm”.
Naming it out loud. -"This is a wave, it's going to peak and then it's going to come back down". This works wonders by labeling it and reassuring it’s not forever, especially for kids.
Slow, Deep Breaths. - Breathe in and count to 4, then out and count to 4. This helps stop the fight or flight response that is anxiety. It sends oxygen to the brain, slows your heart-rate and the storm.
Don’t fight it. - Once you are this deep in- it’s happening you can’t fight it. Trying to rationalize, deny it or give consequences will only make it feel longer. Riding it out with these strategies helps get you or your loved one to the other side.
None of this makes the anxiety storm fun. But it might make it a little less scary to know that the sky always, always clears.
If storms — the emotional kind or the actual kind, have been rolling through your house more than usual lately, I'd love to help you and your family find some calmer ground. Reach out here.