Why We Don't See Everyone For Counseling

Compassionate Counseling St. Louis specializes in anxiety management for kids, teens and college students.

We work with a ton of families, with diverse backgrounds, concerns, and presentations. We love the work that we do! But we also know, even if we love working with you, that we’re not always the best fit.

If things aren’t feeling better, we want to check in with your weekly outcomes scores, to track our progress. We want to try out a few new interventions. And if we’re still not seeing the progress we want to see, we might refer you out.

When to meet with a new therapist at our office:

You or your child may still need anxiety-focused therapy. Compassionate Counseling St. Louis currently has three amazing therapists on staff, and while we all have been trained in assessing for anxiety and anger management, we come from different clinical backgrounds.

Sometimes, even when we’re building the same anxiety management and mindfulness skills, just meeting with a different therapist in our office can get your outcomes back on track. That’s why we try so hard to find the best fit for you during your first call - and we’re so focused on regular check ins to make sure we’re really meeting your needs.

Deciding to transfer to another therapist in our office is always an option, when it’s recommended by your current therapist. We really value the feedback we get from you or your child each and every session, so while we might try a different clinical approach first, we can always consult with the potential new therapist before switching. We need to ensure a smooth transition. This doesn’t happen right away. We need this to be really, clinically sound before we just move you to someone else. But we promise there’s no hard feelings! The whole reason we expanded to include multiple therapists is because we know how important clinical fit is when it comes to making progress.

When we might recommend a therapist outside of our office:

Let’s say you come in for anxiety work, but it turns out that there’s something else going on - like trauma, grief, or depression. A lot of times, we’re still going to be able to help with these underlying issues. Sometimes, we need you to meet with an outside specialist.

Mental health needs we might work with, or we might refer out:

• Oppositional Defiant Disorder/Conduct Disorder:

  Yes, we do work with a lot of defiance. We love working with defiance! Sometimes we even find that those defiant behaviors are covering up underlying anxiety, grief, depression, or trauma. Your therapist will be able to assess - and if they have any concerns about not making progress, they’ll be sure to let you know.

• Self-harm:

  Our therapists are experienced working with self-harm. If it’s really active or severe, they may refer you to a self-harm specialist or behavioral health response, potentially in addition to continuing therapy with them.

• Suicidal Ideation:

  If it’s severe, or if you’ve recently been released from the hospital, we might want you to work with a specialist or a program instead seeing us for outpatient therapy. This is especially important when we can only meet virtually, because we want to be sure we can really, effectively assess your safety. Meeting online is not always the best fit.

• Depression:

  We do work with depression, because that CBT we use for anxiety works with depression, too. That being said, we’re a better fit for depression that is co-occurring with (meaning happening at the same time as) anxiety.

• Addiction:

  We do not work with addiction, because you need specialized training to work with addiction - but, we have several amazing St. Louis therapists we refer out to when this is going on. We have plenty of teen clients where we have to check on their substance use, but if it’s becoming abuse or dependence, we highly recommend having it assessed by an addiction specialist. If this is a concern, you can email us at hello@compassionatecounselingstl.com and we’ll pass along names.

• Eating Disorders:

  While we work with disordered eating - perfectionism, anxiety, and disordered eating often go hand in hand - when it tips to the point of an eating disorder, our therapists want you to work with a specialist. That behavior needs to stabilize before we can start working on the other stuff.

• Borderline Personality Disorder and Narcissistic Personality Disorder:

  Usually, if you have this diagnosis, you need to receive a specialized treatment called DBT. Our therapists don’t provide it, but we love STL DBT and often refer to them.

• Obsessive-Compulsive Disorder:

  • If it’s severe: We want you to meet with an OCD specialist. Traditional CBT, the type of therapy we use most often here, can actually make OCD worse.

  • If it’s mild to moderate with co-occurring anxiety: Sometimes, our therapists can start with the anxiety work and then refer you to an OCD specialist, and other times it’s more helpful to work with an OCD specialist first and then see one of our therapists to work on the other anxiety symptoms. We can point you in the right direction during our initial screening call.

Ultimately, our biggest goal is helping you and your child feel better.

Whether it’s with us or not. So reach out, ask questions, and do your research. Or, you know, let us do the research for you! We want to find the best option for you. It can be so overwhelming when you think it’s time for counseling, but you don’t know who to go to for help. That’s why we’re here to support you during that process - getting you set up to start therapy with us, or connecting you to other resources we know and care for in the St. Louis area.

Kelsey Torgerson Dunn, MSW, LCSW specializes in child and adolescent anxiety counseling, and is the owner of Compassionate Counseling St. Louis.

Curious to hear more, or are wondering if an increase in therapy is something you should consider? Compassionate Counseling St. Louis provides specialized anxiety and anger management therapy for kids, teens, and college students. We work in Clayton, MO and serve kids, teens, and college students throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Coeur, Kirkwood, Richmond Heights, and Brentwood. You can set up your free phone screening to see if we’re a good fit for your needs right on our website.

Thumbnail image provided by: Patrick Buck