Therapy & Approach

Therapy can begin with something immediate: anxiety that is interfering with your day, exhaustion, a painful relationship, or a change you are struggling to absorb. It can also begin with a sense that certain patterns keep repeating and a wish to understand why.

I offer one-to-one psychotherapy for adults. We can focus on a specific problem, work more deeply over time, or move between the two depending on what you need.

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What we can work on together

Anxiety, stress, and overthinking

You may find yourself replaying conversations, anticipating problems, or struggling to switch off. We can look at what sets worry in motion, how you respond to it, and how it is affecting your choices, relationships, and daily life.

You may feel depleted by the effort of staying productive, managing responsibilities, or working while dealing with health difficulties.

My work includes supporting people with workplace stress, burnout, disability leave, and concerns about returning to work. This can involve confidence, boundaries, routines, coping with demands, and questions about what a sustainable working life would look like.

Depression and disconnection

Feeling low or disconnected can affect your interest in things, your relationships, and how you see yourself. We can make room for what you are experiencing while working on manageable changes to daily life.

Painful experiences may continue to affect how you respond, relate to others, or feel about yourself. We can approach this carefully, paying attention to what feels manageable and what support you need in the present.

Relationships, grief, and life transitions

Changes in relationships, family life, work, or identity can unsettle familiar roles and expectations. Therapy offers time to work through loss, understand relationship difficulties, consider boundaries, and understand what has changed and how you want to respond.

Health anxiety, chronic illness, and pain

Health concerns can involve uncertainty, loss, frustration, and changes to everyday life. Our work can focus on the emotional impact of these experiences, including their effects on relationships, work, and your sense of self.

You do not need to be in crisis to come to therapy. You may want to understand yourself more deeply, work on recurring patterns, strengthen your relationships, clarify what matters to you, or make changes that help life feel more like your own.

How I work

Tiina Kivinen among sunlit trees.

I start by understanding what is happening from your point of view and what you want from therapy. From there, we can decide what kind of work makes sense for what you are facing.

I draw on several therapeutic approaches, and we can use them according to what we are working on and how you respond. You do not need to choose a method before we meet.

Understanding thoughts and behaviour

Cognitive behavioural therapy (CBT) helps us examine the relationship between situations, thoughts, emotions, and actions.

We might look at a fear or expectation that is keeping you from doing something, test an assumption, work with avoidance, or practice a different response. This work can include concrete steps between sessions, followed by time to discuss what happened and what you learned.

Working with intense emotions

I draw on skills from dialectical behaviour therapy (DBT) to support emotional regulation, distress tolerance, mindfulness, and communication.

This DBT-informed work can include recognizing emotions earlier, finding ways through a difficult moment, expressing a need, or preparing to set a boundary. We connect the skills to situations you are actually facing.

Connecting choices with values

Acceptance and commitment therapy (ACT) offers ways to relate differently to difficult thoughts and feelings while taking action guided by your values.

We might look at how much a particular thought is directing your choices, what you have been avoiding, what matters to you, and what small step would move you in that direction.

Exploring relationships and earlier experiences

Attachment-based and psychodynamic perspectives can help us explore how earlier relationships and experiences have shaped your expectations, reactions, and ways of relating.

Existential perspectives make room for questions about identity, loss, choice, and meaning. We can consider how these questions connect with the decisions and difficulties you face now.

Paying attention to physical responses

Sometimes there is something to notice in a change in breathing, a feeling of tension, or the impulse to withdraw from a conversation. If it feels helpful, we can pay attention to those responses as part of understanding your experience.

This may involve mindfulness, somatic awareness, guided relaxation, or breath awareness. My training also includes counselling hypnotherapy, and we can discuss guided imagery or hypnotherapy when it is relevant to the work.

These practices are optional. You do not need to practice yoga, meditate, or share any particular beliefs to work with me. We can work through conversation and practical exercises without using guided mind-body practices.

The goal isn’t to stop having difficult thoughts and feelings. It’s to notice how we react and have more choice in what happens next.

How these approaches connect

If saying no leaves you anxious, for example, we might practice the conversation, work with the discomfort that follows, and explore how you learned to put another person’s needs ahead of your own.

We might practice what to do differently while also looking at why the pattern has been so hard to change.

You can read more about my training and the experiences behind this way of working on the About page.

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Starting therapy

The free consultation

The free 15-minute consultation is an opportunity to talk briefly about what you are looking for and ask questions about working together.

You do not need a detailed account of your history or a clear treatment goal. We can begin with what prompted you to reach out.

The first session

We will spend time understanding what has been happening, how it is affecting you, and what you hope might be different. We can discuss relevant background without trying to cover everything at once.

We will also go over the practical arrangements, privacy and its limits, and any questions you have about the therapy.

Finding a direction together

Some people come with a focused concern. Others want longer-term work on relationships, emotions, or recurring difficulties.

We can decide together what to focus on and revisit that as the work develops. Therapy does not have to follow a fixed plan from the beginning.

Practical details

Sessions take place online.

Session fee: $150 for one-to-one psychotherapy.
Consultation: Free, 15 minutes.
Sliding scale: Limited spaces may be available.
Insurance: Psychotherapy may be covered by extended health plans that include Registered Psychotherapists. Coverage depends on your plan.

For contact details, questions about appointments, or a consultation, visit the Contact page.