Can a Registered Nurse Also Be My Therapist?
Laura Agresta. Registered Nurse, Psychotherapist in Nature on a swing.
This is one of the most common questions I receive as a Registered Nurse, Psychotherapist.
The short answer is yes.
In Ontario, psychotherapy is a controlled act that can be performed by several regulated healthcare professionals when they have the appropriate education, training and authorization. While many people automatically think of psychologists or social workers when they think of therapy, Registered Nurses can also provide psychotherapy within their scope of practice.
What I find interesting is that the real question people are often asking is not whether a Registered Nurse can legally provide therapy. What they are really asking is:
"What is it like to work with a therapist who also has a nursing background?"
As a Registered Nurse, Psychotherapist, I believe the answer goes far beyond credentials.
What Makes a Registered Nurse, Psychotherapist Different?
A Nursing Lens on Mental Health
Nursing provides a unique lens into the human experience.
Throughout my nursing career, I have worked with people experiencing medical crises, chronic illness, grief, loss, anxiety, trauma, uncertainty and some of the most vulnerable moments of their lives. I have cared for individuals and families navigating diagnoses, treatments, recovery, birth, death and everything in between.
Nurses don't just learn anatomy and physiology from a textbook. We witness firsthand how physical health, emotional health, stress and life circumstances are deeply connected.
We see how anxiety affects the body.
We see how illness affects mental health.
We see how grief affects sleep, relationships and daily functioning.
We see how chronic stress impacts every system in the body.
Because of this, I don't view mental health and physical health as separate experiences. They are deeply intertwined.
My nursing background allows me to understand medications, disease processes, health concerns and healthcare navigation while also helping clients understand how their nervous system, emotions, thoughts and body responses interact with one another.
Why I Chose to Become a RN, Psychotherapist
One of the reasons I pursued psychotherapy was a desire to help people address root causes rather than simply manage symptoms.
Healthcare often does incredible work in helping people through acute challenges. At the same time, many people continue to struggle with anxiety, stress, overwhelm, self-doubt or emotional patterns that affect their quality of life long after the immediate crisis has passed.
I became fascinated by what helps people create lasting change.
What helps someone move from constantly worrying to feeling more grounded?
What helps someone stop being controlled by anxiety?
What helps someone finally feel safe in their own body again?
Over time, I realized that insight alone is often not enough.
Understanding why you feel anxious can be helpful, but understanding something intellectually does not always change how your nervous system responds.
That realization led me to train in TEAM-CBT, Brainspotting, Somatic Stress Release and other approaches that help bridge the gap between awareness and transformation.
why Insight Alone Isn't Always Enough
Understanding Top-Down and Bottom-Up Approaches
Many of my clients have spent years trying to think their way out of anxiety.
They know where their stress comes from.
They understand their patterns.
They have read the books.
They have listened to the podcasts.
They may have even attended therapy before.
Yet they still find themselves stuck.
One of the biggest lessons I have learned through both professional training and personal experience is that symptoms are often messages, not enemies.
For example, many people experience anxiety as something they need to fight against or eliminate.
What if anxiety is not actually the problem?
What if it is information?
What if your body is trying to communicate something important?
Through somatic work, I learned that many of the sensations I once labeled as anxiety were simply body sensations that I had learned to fear. Once I became curious about them instead of fighting them, my relationship with those sensations began to change.
This is one reason I often integrate both top-down and bottom-up approaches in therapy.
Top-down approaches help us understand our thoughts and beliefs.
Bottom-up approaches help us understand how emotions, experiences, and stress are stored and expressed through the body and nervous system.
When those two approaches work together, meaningful change often becomes possible.
A Client Story: When Nursing and Psychotherapy Came Together
Judy's Experience With Health Anxiety
To protect confidentiality, details have been changed.
Let's call this client Judy.
Judy came to therapy struggling with significant health anxiety. She had a history of medical concerns and found herself trapped in a cycle that many people with health anxiety will recognize.
An ache would appear.
A physical sensation would show up.
A symptom would catch her attention.
Almost immediately, catastrophic thoughts would begin.
Her body would respond with fear.
Her mind would search for evidence that something terrible was happening.
The cycle would continue for days, weeks, or sometimes months.
Because of my nursing background, I understood the medical diagnosis she was living with and could view her concerns through both a healthcare and psychological lens.
What became clear was that the issue wasn't simply the physical symptom.
The issue was the meaning her nervous system had learned to attach to that symptom.
Over time, we used a combination of TEAM-CBT, Brainspotting and somatic approaches to help her recognize the connection between the body sensation and the emotional response that followed.
Gradually, something shifted.
Instead of immediately assuming catastrophe, she began noticing sensations with greater awareness and less fear.
She learned that a body sensation could simply be information rather than evidence of impending disaster.
The symptom itself wasn't always what changed.
Her relationship to it changed.
That shift transformed how she experienced her daily life.
Who Benefits Most From Working With a Registered Nurse, Psychotherapist?
The High-Functioning Client Who Feels Stuck
In my practice, the people who tend to resonate most with my approach are often high functioning individuals who appear to have everything together on the outside.
They are professionals.
Leaders.
Caregivers.
Helpers.
Parents.
High achievers.
From the outside, they look successful.
Inside, they are exhausted.
They often tell me:
"I'm tired all the time."
"My mind never shuts off."
"I'm always thinking about what's next."
"I can't enjoy the present moment."
"I've tried therapy before, but I still feel stuck."
"I know what my issues are, but nothing seems to change."
Many have spent years carrying stress, responsibility, and pressure while continuing to perform at a high level.
Eventually, they reach a point where enough is enough.
They aren't looking for someone to simply agree with them.
They want tools.
They want accountability.
They want meaningful change.
They want to understand why they keep getting pulled into the same patterns and what they can do differently.
The Importance of the Therapeutic Relationship
Questions to Ask When Choosing a Therapist
If you are searching for a therapist, I believe the most important question is not:
"What designation does this person have?"
A more important question is:
"Can this person understand my experience and help me move forward?"
Credentials matter.
Training matters.
Competence matters.
But the therapeutic relationship matters too.
I often encourage people to ask potential therapists questions such as:
• What is your approach to therapy?
• What types of clients do you typically work with?
• How do you measure progress?
• What happens if therapy doesn't feel helpful?
• How do you incorporate feedback?
One thing I appreciate about the TEAM-CBT framework is that client feedback is built directly into the process.
Clients are required to tell me how therapy is going after each session.
Did they feel understood?
Did they feel heard?
Did they feel supported?
Did I miss something?
Those conversations matter.
I am human.
I will not always get everything perfectly right.
Therapy should be a collaborative relationship where clients feel safe enough to express what is working and what is not.
My Perspective as a Registered Nurse, Psychotherapist
At the end of the day, I don't believe therapy is about hierarchy.
I don't see myself as someone who sits above my clients because of my education or professional designation.
I see therapy as a human connection.
A space where someone can show up exactly as they are.
A space where they can be understood, challenged, supported, and encouraged.
A space where they can develop greater awareness, learn practical tools, and create meaningful change.
Sometimes my role is to hold space.
Sometimes my role is to teach a skill.
Sometimes my role is to help a client notice what they are resisting.
And sometimes my role is to gently challenge them because I can see potential they may not yet see in themselves.
Whether your therapist is a Registered Nurse, Social Worker, Psychologist, or another qualified professional, the most important thing is finding someone whose experience, approach, and personality align with what you need.
The right therapeutic relationship can be one of the most powerful catalysts for change.