Therapy with Sarah Betz, LCSW

Sarah Betz is Licensed Clinical Social Worker and yoga teacher in Midtown Manhattan. She specializes in the treatment of trauma and PTSD and is passionate about providing LGBTQIA affirming, body-positive, and sex-positive therapy.

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

Sarah’s background and personal life

1. How did you decide to become a therapist?

I've known since high school that I wanted to be a social worker. I looked into sociology and psychology as college majors but always felt there was something missing. When I found social work, I fell in love with the mix of sociology, psychology, and social justice. I have always been fascinated by the inner workings and motivations of individuals and firmly believe that there is no separation between that and the environment in which we grow up. Social justice and activism are core tenets of social work, and I found these to be missing in alternate professions.

2. What do you find most rewarding about your work?

The "small" things. For example, I frequently work with clients who come to therapy with dissociation or feeling disconnected from life. It is incredibly rewarding when, through our work together, I get to hear about their growing presence in life and moments where they feel connected to themselves and the world around them.

3. What do you enjoy doing in your free time?

I enjoy reading, journaling, yoga, camping, gardening, doing jigsaw puzzles and playing piano.

Sarah’s practice specialties

4. Can you tell us more about your specialty in trauma?

I often work with people who have undergone traumatic events or relationships that have impacted many areas of their lives, most frequently their relationships, careers, and body/self image. Commonly, no one has identified or educated a client on what trauma is or recognizes someone's life experiences as being important, meaningful or impactful on our brains and bodies. I first work to provide education around trauma and help someone name and identify language around their experience. From there, we work together to understand the impact that trauma has had on all facets of their life, from relationships to coping skills to career choices and beyond. There is no one set path for someone working through their trauma, but I will often focus on helping clients tolerate all their emotional experiences, reorient themselves to the present moment and to their bodies, and learn ways to move through survival mode to thriving within their world.

5. Can you tell us more about your specialty in addiction?

I believe that addiction is an individual's attempt to cope with serious, often traumatic, life events. And for many people, their particular addictions often work well for a period of time. Whether it helps to reduce stress, help someone sleep, reduce symptoms of trauma, make someone more social, or just help someone escape, addiction often creates a temporary respite from life issues. But addictions can only work for so long before more serious repercussions come into play. Through my work with clients struggling with addiction, I will help them identify their current coping methods, understand the events that have led to or shaped current functioning, and help create new, more helpful coping strategies instead of drugs, alcohol, food, sex, relationships, love, TV, social media, shopping or any number of numbing behaviors. Once coping has been established, I will then begin working with someone toward understanding their life history and how the events in their lives have impacted the kinds of coping that they have turned to. I have found it important to process deeper issues and understanding how to tolerate being present within the world in order to continue learning new, more helpful ways of coping.

6. Can you tell us more about your specialties in depression and anxiety?

Anxiety and depression are two of the most common reasons that people attend therapy. I believe that these two issues represent different types of energy, one more energized or frenetic (anxiety) and the other more lethargic (depression). People commonly get stuck in one or both of these types of energy. I will often use body-based interventions and talk therapy to help people feel, understand and process each of these different emotional experiences. Understanding where these issues come from and how to harness them often begins in understanding the foundation of who you are and what you learned from caregivers as a child. I work to understand the kinds of attachments an individual had with their caregivers while also looking at the major life events that may have continued to create cycles of anxiety and/or depression. Traumatic events often also play a part in these cycles and I work with clients to understand the correlation between anxiety and/or depression and trauma.

7. Are there any books you often recommend to clients?

About therapy sessions with Sarah

8. What would our first session together be like? What happens in ongoing sessions?

The initial consultation session is a semi-informal 45 minute session to discuss in more depth what is bringing you to therapy. It is also a chance for me to discuss more about the logistics of my practice (fees, cancellation policy, etc.) and about the work I do as a therapist. We will also discuss what to expect in working with me (length of our work together, what to do if you are unhappy with any part of therapy, etc.). I welcome any questions someone has about the therapeutic process and aim to discuss any worries or concerns based either in what they have heard about therapy or from past therapy experiences.

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

If you decide to work with me as your therapist, we will create goals for treatment in our third session together. These goals are helpful in identifying what is bringing you to therapy and will change and grow as we build a therapeutic relationship. I check in with you every three months about these goals in order to understand how you feel you're doing, if there are things you'd like to be working on, or anything that needs to be changed, added or removed.

10. How long do clients typically see you for?

Clients typically see me for 24-48 months (1+ years).

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

Part of the reason that I create goals with you is to help you understand when you feel ready to end your time in therapy. These goals are a great way to track whether you feel you have worked toward creating sustainability in your life that allows you to move through the world without the additional support of therapy. Whenever possible, I will talk to you over the course of multiple sessions before making any changes to the frequency of our sessions together. Ultimately I find that therapy is a tool like any other and that people utilize it during many different life stages or transitions, and it is important to go out and live in the world on your own when you feel ready.

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

It can be incredibly helpful to have someone to talk to with professional knowledge of any issues you may be facing that doesn’t have the emotional attachments that come with a partner, friend or loved one. I always remind clients that I want to hear when they are mad at me or when I've said something that hurt or upset them. In this way, therapy can create a space for safely practicing interpersonal conflict and relational skills.