Frequently Asked Questions

Questions About Starting Therapy

  • Therapy with me is collaborative, compassionate, and grounded in real life.

    We talk about what’s feeling heavy right now, gently explore what may be underneath it, and notice how stress and emotion are showing up in your mind, body and nervous system.

    Together, we develop practical tools to help you feel calmer, more steady, and more connected to yourself and your children.

    You don’t have to prepare anything or have the right words, we begin exactly where you are.

  • Yes. Many moms I work with are managing work, parenting, and everything in between. From the outside, it may look like they’re “doing fine,” but inside they’re carrying a lot and feeling exhausted.

  • Not at all. You don’t need a diagnosis to deserve support. Many moms reach out because something just feels heavier than it should, even if they can’t fully explain why.

    We work together to understand what’s underneath.

  • That’s completely okay. You don’t need to be convinced. You just need to be open to having support instead of doing everything alone.

  • Many moms experience anxiety, guilt, rage, numbness, or even a sense of losing themselves. These feelings are common, but they don’t have to become your normal.

    Therapy helps you understand what you’re experiencing and why, in a space free of judgment.

  • I no longer work with children individually as the primary client. Over time, I discovered that what children need most is a mother who feels connected, supported, and attuned within herself, because that inner confidence allows you to show up fully for your child.

    Instead, I provide mother–child relationship therapy (family therapy), which focuses on supporting connection, communication, and the parent–child bond. Parenting partners are welcome to join if that would be helpful. Children do not need to attend every session.

  • Relational therapy helps you reconnect with your child, strengthen your bond, and improve communication at any age, from infants to toddlers to teens.

    Sessions are playful and experiential. With little ones, we often reconnect through floor play and simple activities. With older kids, we mix in talking, role-play, and skill-building — but the heart of the work is always connection and shared experience.

    Many sessions focus on supporting you with tools, insight, and strategies so you can show up at home with more clarity, confidence, and connection.

    Parents often leave feeling closer to their kids, more relaxed in play and conversation, and better equipped to navigate the harder moments, and children often respond by softening, laughing, and letting their guard down.

Logistical Questions

  • I offer in-person therapy at 2 different offices in North County San Diego.

    • 191 Calle Magdalena, Encinitas, CA 92024

    • 334 Via Vera Cruz, #255, San Marcos, CA

    I also offer virtual therapy for moms throughout California, including San Diego, Orange County, Los Angeles, and the San Francisco Bay Area.

  • Yes. I am a proud paneled provider with Lyra Health.

    In a world that doesn't always prioritize the transition into motherhood, your EAP is a rare and powerful tool to ensure you are taken care of. Many companies (like Qualcomm, Apple, and Amazon) provide up to 25 sessions per year at $0 out-of-pocket cost to you.

    • Pro-Tip: Lyra sessions typically bypass your deductible, making them an incredible resource for maternity leave or postpartum support.

    • If you don't see an opening in the Lyra portal, please reach out to me directly as I hold additional space for these clients.

  • I am an out-of-network provider and do not work directly with insurance companies. This is a purposeful choice that allows me to provide the high-quality, specialized care you deserve.

    Why I choose this model for you:

    • Privacy & Freedom: Insurance companies require a formal mental health diagnosis and often limit the number or type of sessions you can have. By staying out-of-network, your care is dictated by your needs, not a corporate mandate.

    • Focused Care: This allows me to maintain a smaller caseload, ensuring I can show up fully for you as you navigate motherhood anxiety, identity shifts, and cycle-breaking.

    • Holistic Support: Many of the challenges of motherhood and matrescence aren't medical "conditions," yet they deeply deserve support. This model allows us to treat the whole person, not just a diagnosis.

  • Absolutely. If you have a PPO plan, you may be eligible to use out-of-network insurance benefits.

    How it works: Using OON benefits traditionally means you are responsible for paying for each session in full at the time of your appointment. To make this easier for you, I partner with Thrizer, a platform that takes the "paperwork headache" out of the process.

    • No More Superbills: Thrizer automatically files your claims and handles the insurance paperwork so you can get your money back faster.

    • Thrizer Pay: This is a game-changer for many of my clients. Once you have met your insurance deductible, Thrizer Pay allows you to pay only your co-insurance amount (e.g., 20–30%) at the time of session. They wait for the reimbursement check from your insurance so you aren't out-of-pocket for the full fee.

    • Deductible Tracking: If you haven’t met your deductible yet, Thrizer still tracks every session and ensures it is applied correctly toward your deductible without you having to mail in a single form.

    Note: Thrizer’s goal is to save you time and money. It's completely optional, and as your therapist, I do not benefit financially in any way from your participation.

  • Session fees are based on the length of the session and the number of people participating, allowing you to choose the level of support that best fits your needs, family dynamics, and schedule.

    30-minute session ($180)
    A focused session ideal for working moms who may only have time during lunch breaks, need brief check-ins, ongoing support, or help with a specific concern.

    50-minute session ($250)
    The standard session length, offering space for deeper exploration, emotional processing, and meaningful therapeutic work.

    90-minute session ($350)
    An extended session designed for more intensive work, specific specialized approaches, deeper therapeutic processing, or complex concerns that benefit from additional time and support.

    Parent–Child & Family Sessions ($280)
    When children, partners, or multiple family members participate, sessions shift to a family-focused approach. Fees may be adjusted based on session length and the number of participants. This work can support:

    • strengthening parent–child connection
    • navigating behavioral or emotional challenges
    • improving communication and family dynamics
    • supporting parenting with confidence and clarity

    If childcare falls through (or life happened) and your kiddo needs to attend session with you, they are welcome to join. This does not constitute a family session or additional fee. A separate section below offers more guidance about children attending sessions.

  • I understand that life happens, especially in motherhood, and schedules don’t always go as planned.

    If you need to reschedule within the same calendar week or switch to virtual, I’m happy to accommodate this at no additional cost whenever possible.

    I do maintain a 48-hour cancellation policy. This means I require at least 48 hours’ notice to cancel an appointment. Cancellations made with less notice will be charged the full session fee. Insurance does not cover this fee, so it would be out of pocket.

    This policy helps me keep my doors open and my practice sustainable. It also allows me enough time to offer openings to other clients and plan my schedule responsibly.

  • Yes. I hold a very limited number of reduced-rate spots for aligned clients when available so that I can meet moms where they are at.

  • Yes, you’re absolutely welcome to bring your child(ren) to therapy. As a mom, I understand that childcare isn’t always available, and life with little ones doesn’t pause for therapy.

    Babies are always welcome. Whether it’s tummy time, feeding, or diaper changes, we’ll make space for what you and your baby need. You’re free to nurse, bottle feed, or do whatever feels right.

    For toddlers or older kids, my office can be a cozy play space. Bringing a toy, book, or tablet can help keep them entertained.

    Sessions may feel a bit different with children present. We might pause or use “code words” for sensitive topics, so we can stay focused while respecting their presence.

    Therapy is for you and you deserve support, even when your little ones come along

  • At ēma therapy, your mental health information is fully confidential. We only collect what’s needed for your care, like your name, contact info, health history, and session notes. We use secure telehealth platforms, encrypted email, and safe record-keeping systems to protect your information. We don’t share your data with insurance companies unless you give written consent, and we follow all federal HIPAA rules and California privacy laws. You can request copies of your records, corrections, or limits on what we share.

    If you contact us through our website, we collect only what’s necessary, like your name and email, to respond to your messages. We do not sell your information. You can unsubscribe from emails at any time or request your info be deleted.

    For the full legal details about your rights, see our [Full Privacy Policy].

Want you use out-of-network benefits but not sure what is covered? Find out using Thrizer below.

Ellie Smiling sitting cross-legged on a light gray couch, wearing a blue top, a denim jacket, colorful patterned pants, a watch, and a ring, with a background of abstract pastel colors.

Hi, I’m Ellie Messinger-Adams, a licensed therapist, maternal mental health specialist, and childhood development expert. I work with moms in San Marcos, Encinitas, Carlsbad, and across North County San Diego, as well as online throughout California.

At ēma therapy, I keep my caseload intentionally small so I can be fully present with each mom I work with. My sessions reflect over a decade of experience, advanced training, and a commitment to supporting you through the real challenges of motherhood: anxiety, identity shifts, trauma, and the overwhelm that comes with it.

You deserve therapy that’s tailored just for you, from someone who really gets it, is highly trained, and is deeply invested in your journey.