Approximately 1 in 5 women experience a perinatal mood and anxiety disorder (PMAD) after giving birth. In fact, mental health conditions are the most common complication of pregnancy and childbirth. A large portion of women struggle during the postpartum period and many of these women go without treatment or support.
There are many reasons why women don’t get the help that they need for PMADs like postpartum depression and anxiety. One of the most common reasons that I hear is that women are unsure of how to seek help—and where to get started.
When you’re struggling with your mental health while caring for a new baby, it’s hard to get the motivation to get started in therapy. It can also be nerve-wracking to consider potentially being diagnosed with a condition like postpartum depression, which is very common and nothing to be ashamed of.
The decision to start therapy is a big step. As a new mother, it can feel like a very daunting task to find a therapist and start working on your mental health. Therapy is an investment in you, so taking time to find the right person to work with is important.
Here, we explore how to find a postpartum therapist and discuss what to expect when you start therapy. It will answer your most common questions and give you a good sense of what it’s like to seek postpartum therapy.
Finding the right therapist
The first step in getting help is finding the right therapist. Sometimes this happens on the first try. Other times it takes trying out a couple of therapists to find the right one. Different people will “click” with different therapists. For example, some people prefer a therapist that gives you a lot of space to talk, while others want a therapist who is very active. If you don’t click on the first try, don’t give up. There is a therapist out there that is right for you!
There are several ways that you could go about finding a therapist, including:
- Searching an online therapist directory like Postpartum Support International’s Provider Directory.
- Asking your healthcare provider, trusted friends and family for a local referral.
- Calling your health insurance company or searching their website for a list of in-network providers.
- Conducting an online search of therapists in your area who work with postpartum clients
- Asking friends and family for personal recommendations.
Therapists may provide in-person therapy, telehealth, or both. If you’re open to telehealth, then you will have more options available. You can technically see any provider who is licensed in your state. This can help expand your search from therapists in your town, to therapists in your entire state.
You can usually learn a lot about a therapist through their website or online profiles. Typically, their website will include a little bit about them and their experience, their specialties, and their fees. Some therapists offer a free, 15 to 30-minute phone consultation where you can share a little bit about yourself and ask questions to see if you are a good fit.
If you’re seeking therapy for a perinatal mood and anxiety disorder (PMAD), it’s important to find a therapist who is experienced in this area. Treating PMADs is different from treating regular anxiety and depression. The symptoms of these conditions are different and so are the treatment approaches so you will want to find a provider that specifically knows how to work with these issues.
If possible, you will want to find a certified perinatal mental health provider (PMH-C). These providers have completed training through Postpartum Support International and passed a national exam. They understand the issues that are unique to postpartum women and how to help them. During your consultation, don’t hesitate to ask about their experience working with PMADs and if they are certified.
What to expect in the first session
The first session with a new therapist is called an “intake.” During an intake, your therapist will ask you several questions about your presenting problem and your past. They may cover topics like:
- Your experience trying to conceive, including whether or not you had treatment for infertility.
- Past episodes of depression or anxiety.
- Any previous pregnancy losses.
- Your relationship with members of your support system.
- Your labor and delivery experience and any birth trauma you experienced.
- How your postpartum recovery has been going so far—emotionally and physically.
- Why you are seeking out therapy.
It can be difficult to answer personal questions when you don’t know your therapist yet. If you feel uncomfortable answering any questions, you can let them know. A good therapist will respect your boundaries. If you don’t share everything in your first session, you can still benefit from therapy. As you grow more comfortable, you can start to open up more. It’s important to go at your own pace.
Most therapists will share a bit about how they work with their clients and give you a chance to ask any questions that you may have. It may be helpful to ask questions like these to determine if their methodology and approach is compatible with your needs: :
- What kind of experience or training do you have when it comes to my specific issues?
- How long do you usually work with clients? Do you see clients for a set number of sessions?
- What is your approach to working with clients?
- Do you give homework assignments?
- Do you communicate with clients in between sessions?
It can be challenging to get a sense of your therapist’s style based solely on the first session. I encourage clients to give it at least three sessions before deciding whether a therapist is a good match.
After about three sessions or so, you should know whether your therapist is a good fit for you. Each person has their own preferences, but most postpartum women are looking for a therapist that is caring and supportive, yet knowledgeable about postpartum and motherhood.
Some people feel comfortable in therapy right away and don’t hold back. For others, it takes time to develop rapport and feel safe to open up about personal topics. If you’re having trouble opening up, try to take some time to reflect on whether it’s because your therapist isn’t helping you feel heard and supported, or whether there is something else influencing it. If you’ve had a bad therapy experience in the past or have a history of being betrayed by other people, it may take you longer to feel comfortable.
When it comes to therapy to treat PMADs, sessions are typically held once a week. There are, of course, exceptions to this. Some people benefit from seeing their therapist more or less frequently. It’s worth noting most therapists require weekly sessions until the client has met most or all of their treatment goals.
When you’ll see progress
The length of time that it takes to see noticeable changes from therapy varies from person to person. You may notice benefits right away or it may take several weeks or months. Studies show that most clients report improvements in 12 to 16 sessions.
Many factors can play a role in how quickly you see progress, including:
- Your specific diagnosis: Some conditions require longer treatment durations to experience improvements.
- Frequency of sessions: Generally, if you’re attending therapy once a week then you’re likely to improve faster than someone who is attending less often.
- The type of therapy: Some therapy approaches are intended to achieve improvements in a short period, while others are meant to be long-term.
How to get the most out of your sessions
When you’re experiencing a PMAD like postpartum depression, you want to feel better as quickly as possible. While you can’t necessarily control how long it takes to recover, you can get the most out of your sessions by:
- Being open and honest with your therapist.
- Attending your appointments consistently and arriving on-time.
- Incorporating what you learn in therapy outside of your sessions.
- Taking time to meditate, journal, or reflect on what you learn in your sessions.
- Completing any homework assigned by your therapist.
- Keeping the focus of therapy on you and not allowing distractions to get in the way or avoiding difficult topics.
- Letting your therapist know if you experience any feelings toward them that could impact your sessions.
Choosing to ending therapy
The decision to end therapy is ideally a joint one between you and your therapist. A client is usually ready to end therapy when their symptoms have improved and they have reached their treatment goals. Unfortunately, sometimes other factors play a role, like scheduling changes or finances.
If you’re thinking about ending therapy, it’s a good idea to talk to your therapist about it first. Ending therapy, or termination, is one of the most important parts of the therapy process. Endings can be difficult and saying goodbye to your therapist in a healthy way can be very healing, especially if you have a history of abandonment or rejection.
The process of ending therapy usually takes place over several weeks or months. During this time, you and your therapist will review your progress and prepare for therapy to end. You’ll also review warning signs that you need help again and talk about a plan of action.
Remember that it’s always okay to return to therapy down the road. Many people benefit from therapy for some time and improve, only to need it again in the future. There is nothing wrong with this. It is a sign of good self-awareness to notice when you’re struggling and reach out for help.
