Therapy for helping professions, for people who care for everyone else
Therapy for helping professionals in New York: nurses, physicians, teachers, social workers, carers, chaplains and others who spend their working lives attending to other people's needs.
When your job is to hold other people's pain, your own can slip quietly out of view. Long shifts, under-resourced systems, distressing stories and the steady erosion of boundaries add up. I offer collaborative, non-hierarchical psychotherapy and psychiatric care for helping professionals living with compassion fatigue, secondary trauma, burnout and the strain of always being the one who copes.
“Being good at caring for others does not mean you have stopped needing care yourself. It often means you have needed it for longer than anyone noticed.”
Here you do not have to be competent, composed or useful. You can simply be a person who is tired and deserves attention.
The hidden cost of caring work
Helping professions draw people who are attuned, responsible and committed. Those same qualities can make it very hard to notice when you are running out.
I spent years working as a primary care provider and HIV specialist before focusing on psychiatry, so I know from the inside what clinical environments ask of people. Whether you work on a hospital ward, in a classroom, a shelter, a care home or a community agency, you are often absorbing distress all day while being expected to stay calm, kind and efficient. The emotional residue does not stay at work. It follows you home.
Compassion fatigue is the gradual dulling that can set in when you give care repeatedly without enough replenishment. Secondary or vicarious trauma describes how hearing about, or witnessing, other people's suffering can begin to affect your own sense of safety. Neither is a sign that you are in the wrong job or not strong enough. They are understandable responses to the work, and they deserve the same seriousness you would bring to a patient, pupil or client.
Therapy for helping professions offers a place where the roles are reversed in a respectful, collaborative way. I do not position myself as the expert on your life. You know your work, your systems and your limits; I bring clinical knowledge, psychiatric expertise and a steady, curious presence. Together we look at what you are carrying and what would genuinely help you carry less.
Boundaries in systems that keep asking for more
Many helping professionals work inside institutions that rely on goodwill: unpaid overtime, extra cover, being reachable on days off. Saying no can feel like abandoning the people you serve. We explore the beliefs and pressures that make boundaries so difficult, and look at realistic, sustainable limits that protect your wellbeing without compromising your values.
Moral distress and the gap between ideals and reality
One of the most painful parts of caring work is knowing what people need and being unable to provide it because of staffing, funding or policy. That gap can produce guilt, anger and cynicism that sit uneasily with why you chose this work. Therapy gives you room to acknowledge those feelings honestly and to separate your personal responsibility from the limits of the system.
When helping starts to hurt
Helping professionals are often the last to recognise their own distress, partly because they are so used to spotting it in others. These are some of the signs that caring work may be taking more than it gives back. You do not need to experience all of them, and you do not need to wait until things feel unmanageable.
- Feeling numb towards people you serve
- Intrusive images from work
- Dreading the start of every shift
- Irritability with loved ones at home
- Unable to switch off after work
- Guilt whenever you take time off
- Cynicism replacing your old idealism
- Physical exhaustion and disrupted sleep
- Always being the strong one
Support that does not add to the load
You already have enough demands on your time and energy. My aim is for therapy to feel like a relief rather than another task. Sessions are unhurried, practical where that helps, and reflective where that is needed, with medication and holistic support available in the same relationship.
Collaborative psychotherapy
We work as partners. Drawing on relational, feminist and psychoanalytic thinking, we explore why caring for others came to feel like your role, and how that pattern plays out at work, in relationships and in the way you treat yourself.
Working with secondary trauma
If distressing material from work is replaying in your mind or body, we approach it with pacing and care. Trauma-informed and somatic methods help your system process what you have witnessed without being overwhelmed by it.
Somatic decompression
Caring work often leaves people braced and hypervigilant. Body-based practices, including Trauma Center Trauma Sensitive Yoga where suitable, can help you notice that bracing and find ways to let your body come off duty.
Medication when needed
If anxiety, depression or sleep problems have taken hold, I can assess and prescribe where appropriate. Any medication is started thoughtfully, monitored closely and adjusted gradually, with full respect for your knowledge and preferences.
Sleep and shift patterns
Night shifts, early starts and on-call duties disrupt the rhythms that keep mood stable. We look at sleep and recovery in the context of your actual schedule rather than offering advice that ignores the realities of your rota.
Holistic replenishment
A comprehensive lifestyle evaluation can identify where your reserves are leaking. Nutrition, movement and, where suitable, supplements may support resilience; anything we consider is checked for safety and interactions with existing medication.
From depletion to sustainability
Outcomes differ for everyone, but therapy often helps helping professionals move from simply surviving their work towards a more sustainable relationship with it.
Running on empty
- Giving until there is nothing left
- Bringing work trauma home
- Boundaries feel like betrayal
- Your own needs come last
- Considering leaving the field
Caring sustainably
- Giving from a steadier place
- Processing what you witness
- Limits held without guilt
- Your needs are part of the plan
- Clearer choices about your future
Simple steps, no extra burden
Starting therapy should not feel like another shift, so the process is designed to be clear and manageable.
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1
Free consultation 15 minutes
A brief call where you can describe your role and what has been difficult. I will explain how I work with helping professionals and we can talk through practicalities such as scheduling around shifts before you decide anything.
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2
Initial assessment
Our first full session covers your work, history, health, sleep and current symptoms. I ask about any medication and support you already have. Together we identify what feels most urgent and what can wait.
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3
Ongoing sessions
We meet in 60 or 90-minute sessions. Many helping professionals value the longer format because it gives them time to decompress before reaching the heart of things. We can be flexible as your rota or academic calendar changes.
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4
Regular check-ins
Every so often we review how things are going, including your energy, mood and relationship with your work. Any medication or supplement changes are made gradually and collaboratively, never as abrupt switches.
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 Helping Professions FAQs
Which helping professions do you work with?
I see nurses, physicians, physician assistants, pharmacists, teachers and school staff, social workers, case managers, home carers, doulas, chaplains, emergency workers and many others in caring roles. I also work with people caring for family members alongside their jobs. If your work involves attending to other people's wellbeing day after day, you are welcome here. Therapists and psychoanalysts have their own dedicated pages, as their needs are somewhat different.
What is the difference between burnout and compassion fatigue?
Burnout is a broad state of exhaustion and detachment linked to chronic work stress, and it can happen in any job. Compassion fatigue is more specific to caring roles: it describes the emotional wearing down that comes from repeatedly engaging with other people's suffering. They often overlap. In therapy for helping professions, we look at both the workload and the emotional exposure, because addressing only one usually leaves the other in place.
I work in healthcare. Will my employer know I am in therapy?
No. Your sessions are confidential, and because I am out of network and not part of your employer's system, there is no internal referral or record shared with your workplace. If you seek reimbursement through your out-of-network benefits, that goes through your insurer, not your employer. Confidentiality has rare legal limits, which I explain clearly at the start so you know exactly where you stand.
I am a clinician myself. Will you treat me as a colleague or a patient?
Both, in a sense. I respect your expertise and will happily talk openly about diagnoses, medication options and evidence if that helps you feel informed. At the same time, I hold the role of your clinician so that you can stop being one for a while. Many helping professionals find it a relief to let someone else carry the clinical thinking during sessions.
Can you help if I am thinking about leaving my profession?
Yes. Many people arrive unsure whether they need to recover from their work or leave it altogether. We do not rush that decision. We explore what you love and what is hurting you, how much is about the role and how much about a particular system, and what your values point towards. If a career change does follow, therapy can support you through that transition too.
What if I am having thoughts of not wanting to be here?
Please tell me, or tell someone. Helping professionals sometimes feel they should be able to manage these thoughts alone, but you deserve support like anyone else. In therapy we can talk about them openly and safely. If you are in immediate danger or crisis, please call or text 988, the Suicide and Crisis Lifeline, or call 911.
How often would we meet?
We agree how often to meet together and adjust as things settle. Because helping professionals often work irregular hours, we can discuss a rhythm that fits your schedule during the consultation. My small caseload means I can usually offer consistency, which matters when the rest of your week is unpredictable.
It is your turn to be cared for
A free 15-minute consultation is an easy way to see whether working together could help. You do not need to have everything figured out first.