Therapy for career transitions that honours who you are becoming
Therapy for career transitions in New York, for people leaving, losing, changing or questioning their work, and finding that the change reaches far deeper than a job title.
A career change can look tidy from the outside: a new role, a resignation, a retraining plan. Inside, it often stirs up fear, grief for a professional identity you have outgrown and old beliefs about what success should look like. I offer reflective psychotherapy, somatic awareness and psychiatric support to help you understand yourself more deeply as your working life changes shape.
“Before asking what you should do next, it can help to ask who you have been in your work, and who you no longer need to be.”
Career transitions are rarely only about work. They touch identity, belonging, security and meaning, and they deserve that level of attention.
Why changing work can unsettle everything
In a city like New York, work often answers the question of who you are before anyone has asked. When that answer changes, the ground can feel unsteady.
Some career transitions are chosen and exciting, yet still frightening. Others arrive uninvited through redundancy, illness, burnout or a change in family circumstances. Whether you are leaving law for something creative, stepping back after parental leave, retiring, or recovering from a job that wore you down, the emotional impact can be larger than you expected. Anxiety, low mood, insomnia and a sense of being lost are common responses, not signs that you are handling it badly.
Therapy for career transitions is different from career coaching. I will not help you polish a CV or set quarterly goals. Instead, we look at what this change means to you: the parts of your identity bound up with your previous role, the voices telling you what a respectable career should look like, and the feelings that may be steering your choices without your full awareness. Clarity about the next step often emerges once those layers are understood.
I bring my own experience of change into how I work, having moved from primary care and HIV medicine into psychiatry, and having lived and studied across different cultures. I know that professional reinvention can be both enlivening and disorientating. My role is to accompany you through it with steadiness, curiosity and clinical care, including medication support if anxiety or depression is making the transition harder than it needs to be.
Grieving a professional identity
Even when you want to leave, you may miss the status, structure, colleagues or sense of competence your old work provided. That loss is real and it deserves to be mourned. Allowing space for grief, rather than rushing to the next achievement, can make the new chapter feel more grounded and less like an escape.
Inherited ideas of success
Many of us carry definitions of success absorbed from family, culture, class or schooling: the right salary, the right title, the right kind of respectability. A career change can bring those expectations into sharp relief. Drawing on feminist and psychoanalytic perspectives, we examine which of these ideas you truly hold and which you have simply been carrying for someone else.
Fear, uncertainty and the nervous system
Uncertainty about money, status and the future can keep the body on high alert, making clear thinking difficult. Somatic awareness and mindfulness help you notice when fear is driving the decision, and find enough calm to consider options more freely. Where anxiety or low mood become persistent, I can assess and, if appropriate, offer medication support.
You might be in transition if
Career transitions take many forms and unfold over different timescales. Some people come to me while still in a role they know they need to leave; others arrive months after a change, surprised by how unsettled they still feel. Wherever you are in the process, therapy can offer a stable place to think.
- Considering leaving a long career
- Recently made redundant or let go
- Burnt out and needing a different path
- Returning to work after a long break
- Approaching or adjusting to retirement
- Retraining in a completely new field
- Missing the identity your job gave you
- Paralysed by fear of choosing wrongly
- Questioning what success means to you
Making sense of change from the inside
My approach to career transitions focuses on depth rather than strategy. We combine conversation, body awareness and, where relevant, psychiatric support, so you can make decisions that feel aligned with who you are rather than driven by panic or pressure.
Reflective psychotherapy
We explore your history with work, the roles you have played and the expectations you have absorbed. Psychoanalytic and relational approaches help reveal the deeper motives and fears shaping your choices, so the next step is made with more freedom.
Space for grief
Leaving a profession can mean leaving a community, a routine and a version of yourself. We give that loss proper attention rather than rushing past it, which often makes room for genuine enthusiasm about what comes next.
Nervous system support
Somatic exploration helps you recognise how uncertainty registers in your body, from tight shoulders to restless nights. Learning to settle those responses can make it easier to tolerate the not-knowing that every transition involves.
Values and meaning
Feminist and cultural perspectives help us question whose standards of success you have been living by. Together we clarify what you truly value, so your next chapter reflects your own priorities rather than borrowed ones.
Medication if helpful
When a transition triggers anxiety, depression or sleep problems that do not ease on their own, I can assess and, where appropriate, prescribe. We start cautiously, review regularly and adjust gradually, always in partnership with you.
Lifestyle and rhythm
Losing the structure of a job can unsettle sleep, eating and movement. A comprehensive lifestyle evaluation helps rebuild supportive routines. Supplements may support mood, and are always reviewed for safety and interactions alongside any medication.
Career coaching and career therapy
Both can help, and some people use them together. They simply work at different levels.
Career coaching
- Focuses on goals and action plans
- Polishes CVs and interview skills
- Looks mainly at the future
- Works with your stated preferences
- Measures progress by outcomes
Therapy for career transitions
- Focuses on identity and meaning
- Works with fear, grief and doubt
- Connects past, present and future
- Explores what lies beneath preferences
- Values self-understanding as progress
Support through every stage of change
A clear, unhurried path that adapts as your circumstances shift.
-
1
Free consultation 15 minutes
We have a brief conversation about the change you are facing and what feels hardest about it. I explain how I work, and we consider together whether therapy with me suits what you need at this point.
-
2
Understanding your story
In our first full session we explore your working life so far, the transition itself and its effect on your mood, sleep, health and relationships. This gives us a shared picture of where to focus first.
-
3
Working through the transition
We meet in 60 or 90-minute sessions, often more frequently during intense phases such as resignations or job searches, and less so as things settle. Each session offers time to think without pressure to decide.
-
4
Consolidating the change
As your new direction takes shape, we review what has shifted in how you see yourself and your work. If medication has been part of your care, we consider together whether and how to adjust or taper it, gradually and safely.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Therapy for Career Transitions FAQs
Is therapy for career transitions the same as career counselling?
No. Career counselling and coaching usually focus on skills, options and practical next steps. Therapy for career transitions focuses on the emotional and psychological side: identity, fear, grief, self-worth and the beliefs that shape your choices. Many people find that once these are understood, practical decisions become easier. You are welcome to work with a coach alongside therapy if that suits you.
I was made redundant and feel ashamed. Can therapy help?
Yes. Losing a job unexpectedly can bring shame, anger, anxiety and a painful sense of rejection, especially in a culture that ties worth so closely to work. Therapy offers a private space to feel those reactions without judgement, to separate your value as a person from an organisation's decision, and to regain enough steadiness to think about what comes next on your own terms.
What if I do not know what I want to do next?
That is one of the most common reasons people come to me. Not knowing can feel unbearable, so there is often pressure to grab the first option that appears. We slow that pressure down. By exploring your history, values and what genuinely engages you, clarity tends to grow gradually. I will not tell you what to do, but I can help you hear yourself more clearly.
Can a career change cause depression or anxiety?
Major transitions are significant stressors, and for some people they trigger or worsen anxiety, low mood or sleep problems. This is especially true when the change was unwanted or coincides with other losses. As a psychiatric nurse practitioner I can assess these symptoms properly. If medication might help, we discuss it openly and proceed carefully, alongside therapy rather than instead of it.
Do you work with people approaching retirement?
Yes. Retirement is a profound career transition that is often underestimated. Leaving a lifetime of work can bring freedom, but also a loss of purpose, structure and social connection. We explore what retirement means to you, what you hope it will hold and what you fear, and look at how to build a life that feels meaningful beyond your professional role.
How long does therapy for a career transition usually last?
It depends on the change and on you. Some people want focused support for a few months around a specific decision or departure. Others find the transition opens up deeper questions about identity and relationships that they choose to keep exploring. We review regularly, and you decide how long you would like to continue.
Steady ground for your next chapter
If your working life is changing and you would like support making sense of it, book a free 15-minute consultation. We can talk about where you are and what might help.