A Guide to Therapy in Sarasota
Author: Dr. Mary Perleoni, Ph.D., LMHC
Published September 19, 2025
You know that feeling when you're lying in bed at 2 AM, thoughts racing, wondering if maybe you should talk to someone? Or when you catch yourself snapping at people you love over nothing, again? Yeah, I've been there too. And chances are, if you're reading this, you're probably wondering whether therapy might actually help.
Living in Sarasota, we're lucky to have tons of mental health professionals around. But honestly? Figuring out the whole therapy thing can feel more confusing than helpful sometimes. I wrote this because these are the questions I get asked constantly - and because I remember having the exact same questions myself before I understood how this all works.
How do I know if I need therapy?
Look, if you're even asking this question, that's already telling you something. But let me get more specific, because "you'll just know" isn't exactly helpful advice.
Here's the thing - you don't have to be falling apart to benefit from therapy. I see people who are doing pretty well in most areas of their life but feel stuck in one particular way. I also see people who are barely keeping it together. Both are completely valid reasons to be here.
You might want to consider therapy if:
Your emotions feel bigger than you can handle. Maybe anxiety is running the show, or you're sad more often than not. Or maybe you feel... nothing. Numb.
The same problems keep showing up in your relationships. Different people, same drama. If you're thinking "why does this always happen to me," therapy can help you figure out those patterns.
You're going through a major life change. New job, breakup, loss of someone important, becoming a parent - even good changes can throw us off balance.
You're using things to cope that you know aren't great for you. Too much wine, shopping when you can't afford it, working 70-hour weeks to avoid dealing with feelings.
You feel stuck and don't know how to move forward. Like you're living someone else's life, or you know what you want but can't seem to make it happen.
You don't wait until your car completely breaks down to take it to a mechanic. The same should go for your mental health.
Is there a difference between therapy and counseling?
Not really, no. People use these words interchangeably - therapy, counseling, psychotherapy. It's all basically the same thing: talking with a trained professional about whatever's going on with you.
Some therapists might prefer one term over another, but don't get hung up on it. What matters is whether the person can actually help you with what you're dealing with.
I see all these letters after therapists' names—what do they mean?
I completely understand why all these credentials can be confusing. The mental health field has several different types of professionals, each with distinct training and specialties. Here's the breakdown:
LMHC (Licensed Mental Health Counselor): These clinicians hold master's degrees in counseling or related fields, plus extensive supervised clinical experience. They're trained to treat a wide range of mental health conditions including anxiety, depression, trauma, and life transitions.
LCSW (Licensed Clinical Social Worker): Also master's-level professionals, but with specialized training in how social, economic, and environmental factors impact mental health. LCSWs are uniquely positioned to understand the broader context of your life circumstances.
LMFT (Licensed Marriage and Family Therapist): These therapists have completed specialized graduate training focused specifically on relationship dynamics, family systems, and couples counseling. If you're dealing with relationship conflicts, communication issues, or family dysfunction, an LMFT brings additional training upon graduation within these areas.
Psychologist: Psychologists hold doctoral degrees (PhD or PsyD) and have extensive training in psychological theory, research, and treatment. They can provide therapy and are also qualified to conduct psychological testing and assessments. However, they cannot prescribe medication in most states, including Florida.
Psychiatrist: These are medical doctors (MDs) who have completed specialized training in mental health and can prescribe psychiatric medications. While some psychiatrists provide therapy, many focus primarily on medication management and work collaboratively with therapists who handle the talk therapy component.
PMHNP (Psychiatric Mental Health Nurse Practitioner): These are advanced practice registered nurses with specialized mental health training who can both prescribe medications and provide therapy. They're becoming increasingly common and offer a unique combination of medical and therapeutic expertise.
All of these professionals must be licensed in Florida and complete ongoing continuing education to maintain their credentials. While the level of education varies, what matters most is finding someone whose training aligns with your specific needs and who you feel comfortable working with.
Do the credentials actually matter?
Here's something that might surprise you: not as much as you'd think. Don't get me wrong - education and licensing are important foundational pieces. But what makes someone a truly excellent therapist often has little to do with where they went to graduate school or how many letters follow their name.
As someone who runs a group practice, sees clients myself, and has taught thousands of master's-level students over the years, I can tell you that the therapists who consistently get the best results share certain qualities that you can't learn from textbooks. They're genuinely curious about people, they can sit with discomfort without rushing to fix it, and they have this ability to make you feel truly seen and understood.
Here's what's equally important: what makes one therapist incredible for one person might make them completely wrong for someone else. Take a highly structured, goal-oriented therapist who loves worksheets and homework assignments. They might be perfect for someone dealing with anxiety who wants concrete tools and clear progress markers. But that same approach could feel overwhelming or even retraumatizing for someone who needs to slowly explore childhood trauma through a gentle, relationship-based connection.
I've seen brand-new therapists with natural empathy and strong instincts help people in ways that more experienced but rigid practitioners couldn't. I've also watched seasoned therapists who never stop learning and growing become more effective with each year of practice.
What really matters is ongoing education, life experience, and the therapist's willingness to keep examining their own stuff so it doesn't get in the way of helping you with yours. The best therapists I know are constantly reading, attending workshops, getting their own therapy, and honestly assessing what they're good at - and what they're not.
So while credentials tell you someone met the basic requirements and can legally practice, they don't tell you whether that person will be the right fit for you. Trust your instincts about whether someone gets you and can help with what you're specifically dealing with.
Do I need a referral for therapy?
Usually not. At practices like It Begins Within Therapy, you can just call and make an appointment.
But - and there's always a but - if you are specifically looking to use your insurance, some plans (especially HMOs) want you to get a referral from your regular doctor first. It's annoying, but worth checking before you make appointments. You can usually figure this out by looking at your insurance card or calling.
How long does therapy last?
I wish I could give you a neat answer, but it really depends. Some people come in for a few sessions to work through a specific thing - maybe they're dealing with a breakup or adjusting to a new job. Others stick around for months or even years because they're working on deeper stuff.
Short-term (a few months)
Good for specific problems or learning particular skills. Like if you're having panic attacks and need to learn how to manage them.
Medium-term (6 months to a year)
This is pretty common. Enough time to really work through patterns, deal with depression or anxiety, process some difficult stuff.
Long-term (a year plus)
Some people find ongoing therapy helpful for staying mentally healthy, kind of like going to the gym but for your brain. Others need longer to work through complex trauma or major life stuff.
Most therapists will talk with you about this upfront and check in regularly about how things are going. You're in control of how long you stay - there's no graduation requirement or anything.
Is therapy covered by insurance?
The short answer is usually yes, but the details matter. Mental health coverage is way better than it used to be, but insurance companies still make it unnecessarily complicated.
Most plans cover individual therapy. You'll probably have a copay - usually somewhere between $20-50 per session - or you'll pay until you hit your deductible.
The catch is finding someone "in-network" with your insurance. You can search for providers on your insurance company's website, though those lists aren't always up to date. When you call therapists, just ask if they take your insurance and what your cost will be.
If you can't find someone in-network who feels right, some plans offer out-of-network coverage (you'll pay more), and some therapists offer sliding scale fees based on what you can afford.
Also check if your employer offers an Employee Assistance Program (EAP) - lots of employers provide a few free therapy sessions through these programs.
Is therapy worth it?
I mean, I'm obviously biased here since it's what I do for a living. But yeah, I think it's worth it for most people who are genuinely ready to engage with the process.
The research backs this up - therapy works for most people, often as well as medication and sometimes better. But more than that, I've seen people develop skills and insights that help them significantly transform their life.
That said, it's not magic. It requires you to show up and be honest about difficult stuff. Some sessions will be hard. Change usually happens gradually, not overnight. And sometimes you might feel worse before you feel better as you start dealing with things you've been avoiding.
The people who get the most out of therapy are those who come in willing to do the work, not expecting someone else to fix them. If that sounds like you, then yes, it's probably worth the investment.
What does a therapist actually do?
Good question! If you've never been, it can seem pretty mysterious. Here's the reality:
We listen. Like, really listen. Not waiting-for-our-turn-to-talk listening, but genuinely trying to understand what's going on for you.
We ask questions that help you think about things differently or see patterns you might be missing. Sometimes these questions can be surprising or challenging, but in a supportive way.
We notice things. Therapists are trained to pick up on patterns in how you think, feel, and behave that might be getting in your way.
We teach skills when that's helpful. Depending on what you're working on, that might be techniques for managing anxiety, better ways to communicate, or strategies for dealing with difficult emotions.
We create a safe space for you to practice things - like having difficult conversations, expressing emotions you usually keep hidden, or trying out new ways of thinking about situations.
What we don't do: We don't give advice like your best friend would. We don't judge you (or at least, good therapists don't). And we don't try to "fix" you - we help you figure out how to make the changes you want to make.
How do I pick the best therapist?
This is probably the most important question, and it's a lot like dating - you need someone who's not only qualified but who you actually like and trust.
Then think about what kind of help you need. If you're dealing with trauma, addiction, eating issues, or specific relationship problems, look for someone who specializes in that area.
Consider your personal preferences. Do you care about the therapist's gender, age, or background? There's no wrong answer - whatever makes you most comfortable opening up.
Look at how they describe their approach. Some therapists are more structured and skill-focused. Others are more exploratory and insight-oriented. Most therapists' websites give you a sense of their style.
Don't be afraid to have brief phone calls with a few therapists before deciding. Most are happy to chat for a few minutes about whether they might be a good fit.
Trust your gut. If something feels off after a session or two, it's completely fine to try someone else. The relationship between you and your therapist is crucial to making progress.
What's next?
If you've read this far, you're probably seriously considering therapy, which honestly takes guts. There's no rush to decide, but if it feels like it might help, I'd encourage you to take that step.
Sarasota has a lot of great therapists who would be happy to work with you - and I invite you to explore our team to see if they may be a fit for you. Whether you're dealing with something specific or just want to understand yourself better, therapy can be an incredible investment in your wellbeing.
Here's the thing: asking for help isn't weakness. It's actually pretty brave. Everyone deserves support, and everyone deserves to feel good about their life. If therapy seems like it might be right for you, trust that instinct.
