This is Dr. Paula Alvarez's avatar and link to their profile

Dr. Paula Alvarez

Clinical therapist offering therapy in MO, Rensselaer
Counselor License Type(s): EdD,LCSW,MBA
Stress, AnxietyTrauma and abuseAnger managementBipolar disorderDepression
30 years of experience

Greetings! I am a licensed clinical social worker (LCSW) in the states of California, Illinois, and Missouri, and I have a doctorate in Organizational Psychology. I have worked in locked and outpatient mental health facilities for the last 30 years. I facilitated group treatment of domestic violence perpetrators in Spanish and English for eight years. I specialize in treating trauma-related symptoms, anxiety and depression, anger management, geriatric well-being, mental health recovery, cultural diversity issues, and self-esteem issues. My doctorate degree (EdD) In Leadership and Learning with a specialization in Organizational Psychology was conferred on May 27, 2021. I use a client-centered approach (Carl Rogers), and I know that the client is the expert. I tailor my therapy sessions to what the client wants. I used cognitive-behavioral therapy (CBT) with those who like CBT interventions. I offer homework assignments and bibliotherapy for those clients who want those interventions. I also use Brief-Solution Focused Therapy, Trauma-Informed Therapy, and Motivational Interviewing techniques. I invite you to contact me to see if I am a good fit to help and empower you on your journey to better living.

This is Cynthia Moses's avatar and link to their profile

Cynthia Moses

Clinical therapist offering therapy in MO, Rensselaer
Counselor License Type(s): LSCSW,LCSW
Stress, AnxietyLGBTTrauma and abuseGriefAnger management
3 years of experience

I am a licensed clinical social worker in Kansas and Missouri for over 20 years. In my years working as a social worker, I have worked in a variety of settings, including private practice for over 15 years, where I have provided counseling services to individuals, couples, families and groups. I have experience working with adults of all ages, children and adolescents. I have worked with survivors of childhood physical and sexual abuse, as well as survivors of domestic violence and other traumas. I also have experience in working with clients who are attempting to manage grief and all types of loss, as well as anger and emotional management and all forms of anxiety and panic disorders, including agoraphobia. In addition, I have also worked with couples on gaining clarity in their commitment to each other, improving their communication, understanding of themselves individually and as a couple and in building/rebuilding their trust, respect and affection for each other. My treatment approach is warm, open and welcoming to all clients and their life experiences. I attempt to find commonality in experiences in building rapport and use this commonality to normalize clients feelings and experiences. I partner with clients in developing their realistic and achievable goals for treatment, as well as working toward those goals. It is my belief that all of us have the answers to our problems, but obstacles sometimes obscure those answers; therefore, my role as counselor is to partner with and assist clients in exploring and minimizing their obstacles in order to clearly see their solutions and formulate the appropriate response to those solutions. I recognize that it takes an aware and determined person to take the steps to improve their life; I honor my client's decision to enhance their life. I am here to assist and empower you on your journey to better well-being. Taking the first step to sign up for individual therapy can take courage and commitment and I am proud of you for getting started! I look forward to hearing from you!

This is Jean Helfer's avatar and link to their profile

Jean Helfer

Clinical therapist offering therapy in MO, Rensselaer
Counselor License Type(s): LCSW
Stress, AnxietyRelationship issuesTrauma and abuseGriefDepression
20 years of experience

I am a clinical social worker with over 20 years of experience practicing in the mental health field. I have extensive experience treating people with clinical conditions such as PTSD, depression and anxiety. I also specialize in relationship and marital issues, and grief and loss. My therapy style capitalizes on client's strengths. I believe clients are the experts about their own experiences, and I am here to help you achieve your desired goals. My clinical approach combines cognitive-behavioral therapy, psychodynamics, family systems, attachment theory, dialectical behavioral therapy, and EMDR. Seeking help is not always easy and many people do not have the support they need. Therefore, I aim to make the transition into therapy smooth, while also providing a confidential, and safe space to talk about sensitive and challenging problems. I am here to support and empower you.

This is Melissa Loudon's avatar and link to their profile

Melissa Loudon

Clinical therapist offering therapy in MO, Rensselaer
Counselor License Type(s): LCSW,LSCSW
Stress, AnxietyLGBTTrauma and abuseSelf esteemCoping with life changes
6 years of experience

How’s your stress level? If you’re anything like the millions of other people adjusting to significant changes over the last few years, it’s likely your stress has crept up over this time. With change and uncertainty as one of our only constants as of late, it makes sense that life might feel heavier now than it once did. I’m a Clinical Social Worker licensed in both Missouri (LCSW) and Kansas (LSCSW). I am active in the greater Kansas City area with over 18 years of experience in the field of human services. The people I have had the privilege of serving come from all walks of life and have encountered a myriad of personal and professional challenges. Over the course of my career, I have served adjudicated youth, children and families within the child welfare system, adults with identified substance use issues, and individuals with developmental and intellectual disabilities. Most recently, I have worked with adults to develop employment goals as well as strategies to achieve them. I have recently transitioned to providing therapy on a full-time basis and I work exclusively using telehealth/virtual sessions. I am eager to support adults experiencing job satisfaction concerns, self-esteem or confidence issues, depression, anxiety, unpacking past trauma, communication and relationship issues, family dynamics, grief and loss, and individuals in the LGBTQ+ population. My approach is warm and supportive as I believe in the dignity and worth of every person. I most often utilize cognitive-behavioral therapy, motivational interviewing techniques, and acceptance and commitment therapy, but am happy to tailor your treatment plan to your unique needs. Verbally processing the challenging things in life can make them significantly more manageable. Seeking therapy is such a vulnerable and brave thing to do and I'm inspired by that courage! Years ago as a young adult, I was drawn to the social work field out of a desire to help others. To me, nothing was more interesting in college than learning about people. One of my greatest joys is watching clients grow and evolve out of struggle. We all experience obstacles in life, and it is my honor to help you find new approaches to the many and varied problems that pop up. My commitment to you as a helping professional is to keep you and your values front and center and to leave judgment at the door. I believe therapy is a partnership and I’m so eager to partner with you! So, are you ready for this? I’m excited to meet you and I consider it a privilege to walk alongside you on your journey. I hope you’ll reach out so we can get something scheduled today!

This is Rachel Jones's avatar and link to their profile

Rachel Jones

Clinical therapist offering therapy in MO, Rensselaer
Counselor License Type(s): LPC
Stress, AnxietyGriefSelf esteemCareer difficultiesCoping with life changes
20 years of experience

You are courageous for taking this step to better your mental health. I have been serving our community as a Licensed Professional Counselor for 18 years. I enjoy helping people overcome depression, anxiety, grief, and life changes through my eclectic approach including Cognitive Behavioral, Solution Focused, Rational Emotive, Person Centered and Brief Focused Therapist. Through developing skills to process grief, increase mood, or navigate life changes, I find happiness as you reach your mental health goals. Outside of the office, my passions include nature walks, hiking, snorkeling, exploring new cultures, playing the piano and flute, singing, dancing, and game nights. I am best friends with my twin sister and her family. My cats, Bob and Precious, are so loved, they have their own room with a view. My undergraduate studies at Missouri Western State University included playing in the marching band as a first year music major. As part of my courses, I developed a love for other cultures and how they celebrate life through music. My second year, I took time to explore other studies and fell in love with psychology. I graduated with a Bachelor's of Science in Psychology. I went on to the University of Central Missouri were I completed my Master's of Science in Psychology. My first position as a Counselor was working with urban youth in the area of Substance Abuse. With this role, I gained a wealth of knowledge in Substance Abuse, which I applied to helping adults overcome their addictions. I went on to work in this field for 13 years. In Hawaii, I developed skills in Behavior Modification working with troubled youth , their families, and school staff. At Metropolitan Community College, I helped displaced workers develop workplace skills to re-enter the work force in a new career. I have had a private practice for 6 years helping individuals like you with grief, anxiety, and life changes. When you are ready, I am here to assist you in your journey for better mental health. Please note, the one area I am not trained in is trauma. As I am not trained in this area, my licenses prevent me from working with anyone who has had a traumatic experience, even if it is not the reason you are currently seeking therapy. Thank you for your understanding in this.

This is Donna Thomas's avatar and link to their profile

Donna Thomas

Clinical therapist offering therapy in MO, Rensselaer
Stress, AnxietySelf esteemCareer difficultiesCoping with life changesCompassion fatigue
21 years of experience

I am licensed in Missouri with 21 years of professional work experience. I have experience in helping clients with stress and anxiety, motivation, self esteem, and confidence, career difficulties, & coping with life changes. I work with my clients to create an open and safe environment where thoughts and feelings can be shared without fear of judgment. It takes courage to seek out a more fulfilling and happier life and to take the first steps towards a change. I am here to support & empower you in that journey.

This is Tiffany  Hilke's avatar and link to their profile

Tiffany Hilke

Clinical therapist offering therapy in MO, Rensselaer
Stress, AnxietyLGBTSelf esteemDepressionCoping with life changes
9 years of experience

I am so happy you are reaching out! I am a licensed professional counselor in Missouri with 9 years of professional work experience. I have experience in helping clients with stress and anxiety, lgbtq+ related issues, motivation, self esteem, and confidence, & depression. I believe that each person has the potential and power to make changes in their lives and treat my therapy space as a chance for clients to be heard, affirmed, educated, and supported. I believe the best support comes from consistency and boundaries, as well as creating a village of support that fits who you are and what you need. I look forward to being on your mental health journey with you!

This is Nicole Gaines's avatar and link to their profile

Nicole Gaines

Clinical therapist offering therapy in MO, Rensselaer
Stress, AnxietySelf esteem
5 years of experience

I am licensed in Missouri with 20+ years of professional work experience. I have experience in helping clients with stress and anxiety, motivation, self-esteem, and confidence. I believe in treating everyone with respect, sensitivity, and compassion. I will tailor our dialog and treatment plan to meet your unique and specific needs. It takes courage to seek out a more fulfilling and happier life and to take the first steps towards a change. I am here to support & empower you in that journey.

This is Morgan Light's avatar and link to their profile

Morgan Light

Clinical therapist offering therapy in MO, Rensselaer
Stress, AnxietyFamily conflictsAnger managementDepressionCoping with life changes
3 years of experience

I am licensed in Missouri with 3 years of professional work experience. I have experience in helping clients with stress and anxiety, family conflicts, anger management, & depression. I specialize in DBT therapy, but my approach to therapy is individualized to each client. I work with my clients to create an open and safe environment where thoughts and feelings can be shared without fear of judgment. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in that process.

This is Tracie Holder's avatar and link to their profile

Tracie Holder

Clinical therapist offering therapy in MO, Rensselaer
Stress, AnxietyTrauma and abuseParenting issuesDepressionCoping with life changes
4 years of experience

I am licensed in Missouri with 4 years of professional work experience. I have experience in helping clients with stress and anxiety, trauma and abuse, parenting issues, & depression. I believe in treating everyone with respect, sensitivity, and compassion. I will tailor our dialog and treatment plan to meet your unique and specific needs. It takes courage to seek out a more fulfilling and happier life and to take the first steps towards a change. I am here to support & empower you in that journey.

How to find a therapist for counseling in Rensselaer

Finding the best therapist close by in Rensselaer can feel challenging, but know that once you narrow your search for a counselor serving your area, you can find a therapist in your city that is accepting new clients and fits your goals. Whether you're struggling with depression, anxiety, marriage, family issues, or other emotional challenges, feel proud that you have begun your search to find the mental health care services with therapists in Rensselaer that work best for you in order to begin your personal journey towards emotional healing with a therapist.

Understanding the type of therapy you'd like to search for is crucial before finding a therapist or psychologist in Rensselaer. Perhaps you're interested in narrowing your search for a psychotherapist that can offer psychodynamic, cognitive-behavioral (CBT), talk therapy, provide group therapy, marriage and family therapy for individuals or couples, or couples therapy. Each type of support of this kind with BetterHelp therapists can offer various benefits and address or treat different disorders. If you're still unsure or are new to counseling in Rensselaer, feel free to contact the provider via email to find out which methods they practice.

It is also important to understand that mental health professionals in the United States are accredited to provide care, helping individuals and couples, with a variety of licenses for therapists. These include licensed marriage and family therapist (LMFT), licensed clinical social worker (LCSW), and clinical psychologist or doctor of psychology (PsyD). Regardless of their licensure, they are trained able to treat individuals and couples counseling, and sometimes children, in any type of therapy in the Rensselaer region and in the state of Missouri. Find a therapist under any of these distinctions and know that the sessions they offer can provide a safe place to heal.

A mental health counselor working through their own in-person therapy practice in Rensselaer or online may assist clients in improving healthy relationships, communication skills, working through life transitions, couples counseling, managing a mood disorder, improving coping skills, self help tips, offer life coaching, family therapy, or change in negative thinking patterns. A Rensselaer therapist may also provide a safe place and validation for clients experiencing emotional pain, or that simply want a psychological assessment. Verified providers and therapists can provide licensed marriage and couples therapy, tailor to individual needs, and create a therapeutic relationship as a National Certified Counselor.

There are all kinds of therapists working with clients today across the United States and in the greater Rensselaer area offering:

  • CBT
  • DBT
  • Substance use therapy
  • Couples therapy

When you're ready to start your search keep in mind what support you'd like your provider to be most experienced with and choose an experienced provider with a practice located near you in the city of Rensselaer, elsewhere in Ralls, or in the greater state of Missouri. Get matched with one of the therapists working on the BetterHelp platform today.

Frequently asked questions (FAQs) about therapists and mental health services

Some other commonly asked questions on therapy with a licensed counselor and BetterHelp serving the Rensselaer area can be found below:

How does the cost of in-person counseling with a therapist compare to the cost of BetterHelp with a licensed Rensselaer therapist?

The average price of an in-person therapy session in the US with most therapists is $100 to $200 per hour. These prices may be higher in Rensselaer due to a higher cost of living, and a limited number of therapists taking new clients. The price also depends on the type of provider you are looking for. See the following average prices for various mental health providers without insurance:

  • Counseling with a psychiatrist: $150-$500
  • Counseling with therapists: $100-300
  • Therapy with a psychologist: $100

While many psychologists in Rensselaer may not take health insurance, some in the state of Missouri may work on a sliding scale, meaning they'll factor in your income and charge what you can afford per session. With a BetterHelp therapist throughout the state of Missouri you can expect significantly more affordable options, with therapists sessions ranging from $65 to $100 per week (billed every four weeks). 

How is a licensed therapist on this Rensselaer online therapy platform verified?

Therapists in Rensselaer, Missouri working on BetterHelp are licensed, trained, experienced, and accredited as a doctor of psychology (PhD / PsyD), licensed marriage and family therapists (LMFT), licensed clinical social worker (LCSW / LICSW), or licensed professional counselors (LPC). All of these psychology clinicians have a Masters Degree or a Doctorate Degree in their field of psychology sciences, and follow the APA Code of Ethics. Therapists have been qualified and certified by their state's professional board after successfully completing the necessary education, exams, training and practice with a patient, and extensive experience in a healthcare clinic or treatment centers, in order to become a mental health provider. While their lived experience, expertise, careers, and background vary, therapists here all possess at least 3 years and 1,000 hours of hands-on experience with adult and sometimes teen patients, and have the necessary therapist credentials to provide a safe space for long lasting emotional healing in therapy. 

Please note BetterHelp does not offer or provide care from Rensselaer psychiatrists to prescribe a drug or medication as treatment, or perform psychological assessments and other psychiatric services.

How does working with a professional counselor in BetterHelp online therapy sessions work?

BetterHelp clinicians and therapists treat clients online across the United States (individuals and couples) through life transitions, inner child exploration, long term depression or anxiety, post traumatic stress disorder, and more. An online mental health professional, including the therapists in Rensselaer above, can work with young adults, children, adolescents, and adults virtually as an accredited licensed clinical social worker (LCSW) or licensed marriage and family therapist (LMFT). You do not have to commute to a an office as a psychotherapy client.

Through BetterHelp therapy, you can partake in video, phone, or live chat therapy sessions with your licensed therapist. You can work through various symptoms, use the in app journaling feature, and receive worksheets. You'll also find support groups or group therapy helping individuals on topics including managing life transitions, symptoms affecting sexual health, behavioral health, coping skills for anxiety, depression, trauma, stress, marriage counseling, and more. Get matched today.

What mental health issues can psychotherapy address with the help of psychologists?

BetterHelp's verified therapists specialize and have clinical experience in a wide range of mental health issues and modalities, helping clients to feel better and improve their lives every day. See below for examples.

Our therapists specialties on BetterHelp include:

  • Cognitive behavioral therapy - This is provided by professional counselors, helping clients identify and change negative thought patterns through structured sessions.
  • Behavior therapy - Behavior therapy techniques are used to help clients modify harmful behaviors and develop healthier habits, often through the guidance of a professional counselor.
  • EMDR therapy - EMDR therapists assist clients in processing traumatic memories to alleviate emotional distress and improve overall well-being, utilizing the expertise of a professional counselor.
  • Talk therapy - Clients explore their feelings and develop strategies for dealing with various mental health issues, often guided by a professional counselor.
  • Depression - This counseling is designed to help individuals manage symptoms of depression and improve their mood and functioning, often working closely with a professional counselor.
  • Anxiety disorders - Sessions for anxiety disorders, offer strategies to manage and reduce anxiety symptoms effectively, often through counseling sessions with a professional counselor.
  • Stress - Tools and techniques to help clients cope with stress and improve their mental resilience, frequently under the supervision of a professional counselor.
  • Eating disorders - Professionals experienced in eating disorders offer specialized counseling to address unhealthy eating patterns and body image issues, with the support of a professional counselor.
  • Grief - Support and guidance are offered to clients experiencing grief, helping them navigate the stages of loss, often in collaboration with a counselor.
  • Attachment therapy - Therapists use this to help clients understand and improve their emotional bonds and relationships, often with the assistance of a counselor.
  • Relationships - Therapists work with clients to improve communication, resolve conflicts, and strengthen their connections with others, often using the skills of a counselor.
  • Children, adolescents, and teens - Therapists specializing in youth therapy address the unique mental health needs of children, adolescents, and teens, often involving a counselor in the process.
  • Addiction (substance abuse) - Therapists offer counseling for addiction, helping clients overcome substance abuse and maintain long-term recovery, often under the guidance of a counselor.
  • Divorce - Therapists support individuals through the emotional and practical challenges of ending a marriage, often working with a psychologist to provide comprehensive care.
  • Trauma or PTSD - Therapists specializing in trauma and PTSD help clients process traumatic experiences and reduce their symptoms, frequently collaborating with a psychologist.
  • Bipolar disorder - Therapists provide counseling to manage the mood swings and challenges associated with bipolar disorder, often in consultation with a psychologist.
  • Psychodynamic treatment - Therapists use psychodynamic treatment to explore unconscious processes and how they affect current behavior, often guided by psychologists.
  • Career counseling - Therapists assist clients in making informed decisions about their professional paths and resolving work-related issues, often with the help of psychologists.
  • Alcohol use disorders - Therapists offer specialized counseling to help clients manage and overcome alcohol use disorders, frequently under the supervision of psychologists.
  • OCD - Therapists provide strategies and support to manage obsessive-compulsive disorder symptoms, often via psychotherapy.
  • ADHD - Therapists offer counseling to help clients with ADHD improve focus, organization, and overall functioning, often via psychotherapy.
  • Mood disorders - Therapists work with clients to stabilize and improve mood through various therapeutic approaches, frequently in psychotherapy.
  • Sex addiction
  • Complex trauma
  • Life transitions

You may also be struggling with relationship problems that could be addressed in couples therapy or with a sex therapist. In that case, you may choose to work with one of BetterHelp's experienced cognitive-behavioral therapists or licensed marriage family therapists (LMFT) who work with clients in relationships. You can also try a Rensselaer provider through BetterHelp's sister platform, ReGain, which is dedicated to couples and spouses worldwide with licensed therapists. 

How do I know if online counseling is right for my family in Rensselaer?

One of the potentially rewarding aspects of working with a Rensselaer therapist is the validation and active listening they can provide. Your friends and loved ones may also be available to listen, but you may feel that they may lack the skills to provide objective guidance. Counselors and therapists are trained to respond to various concerns, symptoms, and mental health conditions.

Therapists in your city can support you toward a healthier emotional state, regardless of your mental health, life concerns, or healing needs. While supporting individuals in developing healthier habits, another good benefit of Rensselaer therapy is having an understanding, safe space with a non-judgmental party who can support you through challenging experiences.

Many people have sensitive topics that they may feel ashamed to discuss with their friends or partner. A Rensselaer therapist can help you confront these concerns and open up through unique methods of support. There are also many types of therapy, such as art therapy, where you may find you can express yourself through creativity instead of words with a psychotherapist.

With a lot of people in MO, therapists may be booked out with clients. Through the list of profiles or therapists above and others within BetterHelp's team, you may be able to find a psychologist within 24 to 48 hours. If you're searching to find a a nearby psychotherapist close to 63401 or the surrounding zip codes, consider others available through the BetterHelp site where you can schedule a session based on your and the therapist's schedule. No matter if you are seeking help from therapists in your area or beyond, online therapy can be a great option.

How should I prepare for my first therapy session with a Rensselaer counselor?

Before seeing your Rensselaer therapist, prep for your session by reading to understand the process. You might write a list of questions you want to ask your psychotherapist, any emotional pain you may feel, and the ways in which you hope to improve. When you attend your session, you can let our therapists know if you have any concerns or feel unsure about what to talk about. Rensselaer therapists here may help guide you with open-ended therapeutic questions while offering mental health services. The first session will often serve as an intake to get to know you as a person and learn why you're attending therapy.

Should I find a therapist or psychologist for therapy if I feel fine? 

Some simply don't feel the need to see a psychologist. However, some people may avoid attending therapy due to stigma or preconceived notions of what it might entail. Although psychologists often support people with mental health conditions, you do not need a diagnosis or specific condition. You can discuss grief, relationship concerns, stress, or life changes and ask for general feedback. A Rensselaer licensed clinical social worker may help you gain power over your life and emotions while you navigate day-to-day experiences.

Gaining a new perspective on yourself through various therapies might allow you to improve your self-esteem, work through relationships, and gain a better sense of your mental health goals. The success you may find with a Rensselaer counselor can be dependent on your process.

People may also attend therapy for specific motives, such as bullying, an autism diagnosis, a desire to learn mindfulness meditation, personality concerns, trouble with office workers, specific phobias, and many other principles that a counselor can help with.

Is mental health care and therapy with a therapist worth it?

Therapy with a licensed counselor is effective and has the power to change individuals' lives. Each client is at a different stage of their emotional healing journey in life, as each human can be unique in their personality, expression, skills, and goals. A psychologist can target various symptoms, experiences, and personalities to help you feel your best and put you on the path to healing. Unlike advice from a friend, family, or non-professional, a mental health therapist has an understanding of various disorders like ADHD and depression with many hours of experience in treating adults in their practice. For this reason, seeing an evidence based psychologist in Rensselaer, Missouri can be worth it. Over 41 million adults in the US attend therapy services each year, showing it's a popular option and is proven to be effective.

Rensselaer has many clinicians who practice person or client-centered individual therapy in-person and through online sessions to assist clients in their healing journey. If you opt into online therapy, you might also be able to meet with providers all over the United States and change therapists easily at any time. Many people struggling with anxiety and depression, substance abuse, body image issues, and more find therapists that are a good fit for them, feel supported, and gain further insight into their lives through internet-based therapy.

Do therapists judge you in therapy sessions during telehealth appointments?

The boundaries between you and a therapist are in place to help you and them regarding ethical concerns. Mental health professionals are held by ethical standards through the American Psychological Association (APA) and are not allowed to judge or harm their clients. If you are concerned about sharing details about yourself, feel free to withhold personal information. Their job in the therapeutic relationship is to create a safe place, help you gain a deeper understanding of your mental health, and support you. You might consider changing counselors if you don't feel safe or respected.

Stay up to date with the leading online counseling platform for Rensselaer, Missouri

To stay up to date with BetterHelp's initiatives through their social channels, you can follow them on PinterestLinkedInInstagramTwitter, and Facebook. For mental health tips, check out the BetterHelp YouTube channel.

Take some time today to learn more about the team of Rensselaer therapists at BetterHelp to understand the services available to you clearly. If you are new to therapy or have any questions about the services and terms, please reach out to customer service through the contact page or send an email to contact@betterhelp.com.

If you’re ready to sign up for online therapy, consider signing up with a platform like BetterHelp and get matched within 24 to 48 hours.

If you are experiencing a crisis or emergency, don't use this site's online services. If you are in life-threatening danger, call 911. If you require support for a crisis, reach out to the hotlines below:

A woman meets with a therapist online in her home city of Rensselaer.

Below are some of the zip codes served by BetterHelp therapists in Rensselaer:

63401

Find the right therapist for your needs
Match with a qualified therapist