Therapy with Rachel Williamson, LPC

Rachel Williamson is a Licensed Professional Counselor in St. Louis, MO specializing in anxiety, relationship issues, family issues, addiction, and burnout. In sessions, Rachel draws upon Cognitive Behavioral Therapy (CBT), motivational interviewing, and Cognitive Processing Therapy (CPT) to equip clients with tangible strategies they can use to reduce their mental health symptoms. Rachel’s goal is to provide a safe space for her clients to be authentic—no matter their background, race, religion, gender, sexuality, and body type—so clients can grow into who they want to be.

We asked Rachel more about her work with clients and her guiding philosophies on therapy.

Rachel’s background and personal life

How did you decide to become a therapist?

I always say I became a therapist on accident! I went to school for psychology to learn about myself and my experiences. After school, I started working as a case manager helping clients learn how to access community resources and learn life skills, while providing them with education to remain sober and free from substance use. While I was a case manager, I got to witness first hand the benefits that therapy had on my clients, and made the decision to go back to school to pursue this career.

What was your previous work before going into private practice?

Prior to going into private practice I worked with individuals involved in the criminal justice system. Most of the individuals I worked with were either being released from Missouri institutions or trying to make changes to avoid going into the institutions. A lot of the behaviors came from extensive history of trauma, depression, and lack of support. During a previous position I assisted in creating and implementing a women's substance use program. I conducted group and individual therapy.

What do you enjoy doing in your free time?

In my free time, I enjoy spending time with my family and listening to audiobooks. I find that getting wrapped up in something crafty like a puzzle or paint by number can be incredibly peaceful for me.

Rachel’s specialties and therapy philosophies

What guiding principles inform your work?

I believe in providing a non-judgmental and safe space for my clients to be authentically themselves. I also believe that due to everyone having different values, beliefs, and behaviors all treatment should be individualized to that person. Not every modality will work well with every client, so being flexible to each person's needs is an important part of being a therapist.

What clientele do you work with most frequently?

I generally see adults, but am open to teenagers as well. I like to work with people that know something needs to change, but are not sure how to start making those changes. The individuals I see are usually the folx that appear to have everything together from the outside, but inside feel like they are failing or unable to keep up. Usually this comes from having learned some unhealthy beliefs, is reflected by the way they were raised, or a history of trauma. I am drawn to this population because I have been there! Sometimes when we are in this situation it feels like there is no way out. I like helping people find the small amount of hope, and turning that hope into change!

Can you tell us more about your specialty in trauma?

Trauma is usually the basis of many people's struggles, and is not always identified as trauma. People oftentimes have the belief that because others had it worse, their own experiences are not valid. Even though these experiences impact their everyday lives. Sometimes this comes out as anger, depression, anxiety, a lack of trust in others and many more. To help individuals cope with trauma I use a combination of CBT and CPT. We all have beliefs about ourselves and the world, and oftentimes think in absolutes. These two modalities help challenge those beliefs.

Can you tell us more about your work with clients facing burnout?

Regarding burnout, this can be both personally and professionally. Generally these individuals are the caretakers of others. They give so much of themselves to other people around them, that they oftentimes do not have anything left to give themselves. This leads to feeling like they are letting everyone down. To assist with this we work on creating boundaries for ourselves and with others and learn barriers to hold to these boundaries.

Relationships within families are sometimes hard. I do not treat families, but individuals that struggle with the relationships in their family. As more individuals learn about generational trauma and are able to identify beliefs and behaviors in their family unit that are outside of their own values, therapy is a great way to explore the disconnect. Sometimes the disconnect leads to unhealthy coping, perfectionism, and even substance use. Together we work to identify unhealthy coping skills, and build new skills for a positive lifestyle change. We also work to reconcile the separation or change in beliefs from childhood to adulthood.

What do you find most rewarding about your work?

The thing I find most rewarding about my work is getting to bear witness to individuals' realization that they do have the capacity to make the changes they need!

Therapy sessions with Rachel

What will our first session together be like? What happens in ongoing sessions?

During our first session, we will explore your reasons for seeking therapy. We will discuss your individual goals and what you have tried in the past to reach your goals. The first session (or two) will be about getting to know each other, and helping you feel safe talking with me. I understand how difficult it can be to talk to a stranger, so these first sessions are important to allow you time to adjust to sharing your thoughts and feelings with someone new.

How long do clients typically see you for?

The length of time a client is in therapy also depends on each individual person and sometimes (unfortunately) the limitations of their insurance. Generally someone seeking therapy would start out with weekly appointments, and as their goals are met would titrate down to biweekly, then monthly. Some individuals like to maintain therapy long term as a safe way to process their life and continue to reinforce their healthy skills and changes.

There are many books that I recommend to clients. They are generally specific to the needs of that client. I often find that many clients want to process the information from the books, but are not always up to reading them.

Do you assign “homework” between sessions?

Every person needs and wants different things from therapy. For some clients therapy is a place to talk, learn coping skills, and leave. In those cases, homework would be to practice the coping skills we discuss in therapy to see if it is useful. Other clients prefer pen and paper assignments, and for those individuals I have plenty of resources available to give.

For any client interested in participating in Cognitive Processing Therapy (CPT) to heal from trauma, there is daily homework required. This comes in the form of worksheets that are to be done each day in between sessions.

How do you help ensure I'm making progress in therapy?

I ensure progress is happening in two ways. First, I ask. Are we addressing your needs for therapy? Do you feel like you are able to discuss the things you came to therapy to discuss? Do you believe your life is improving? Secondly, and depending on the reason for starting therapy, I use evidence based measures to detect a change in symptomatology, such as the GAD-7, PHQ9, PCL5.

How do I know that it’s time to start seeking therapy?

You know it is time to start therapy when you want to make changes, but have not been able to take the steps to make them. Therapy can help increase motivation, process past events or relationships, and help you explore feelings you are having. Some common indicators that show you may need to seek therapy are feeling overly anxious, quick to angry, fearful of the future, overwhelmed by life or even being unable to identify what feelings you are having.

How can I prepare for our first session?

Clients do not need to bring anything but themselves and some open mindedness to session. Regarding mentally preparing, I think a gentle reminder to yourself that my entire purpose is to support you, and help you meet your goals. You are walking into a space that is free of preconceived feelings or beliefs about you.

How will I know it’s time to end my time in therapy with you or reduce session frequency?

We will talk about it. We will have established goals. When you have met those goals, we will either create new goals, or discuss reducing therapy to allow you to practice maintaining on your own. You always have the ability to increase frequency if you feel like it is necessary.

Why should I seek therapy, rather than turning to my partner, friends, or other loved ones?

Seeking therapy rather than talking to friends and family can be a difficult decision. Many individuals choose therapy to get unbiased and confidential feedback from a trained professional. Having a support system is very important. However, family and friends are not equipped with the skills or knowledge to help you make the changes, process the experiences, or identify the feelings you have experienced.

Therapy can feel scary and bring up some uncomfortable feelings, but it can also help you make the changes to live a meaningful and fulfilled life.

Visit Rachel’s profile to read more about her and book an initial call!