Questions people ask us.

There are four realistic routes, and they are not mutually exclusive.

• Public and hospital programs. Women's College Hospital, Mount Sinai and Sunnybrook run perinatal mental health services. They're free with a referral from your doctor or midwife. Waitlists can be long, so it's worth asking for a referral early.
• Community programs. Some public health units and organizations run free postpartum support groups. Good for isolation, not a substitute for treatment.
• Private specialist practice. Registered Social Workers or Registered Psychotherapists who work specifically in perinatal mental health. Typically $150 to $250 per session in Toronto, usually covered in part by workplace insurance, and you can normally start within a week or two.
• Psychiatry. If medication is part of the picture, that is a physician's decision. A perinatal psychiatrist can be accessed by referral, and is covered by OHIP.

Toronto Therapy Practice is the third kind. We are a group of seven registered therapists who specialize in perinatal and reproductive mental health. Virtual across Ontario, and in person in Toronto. If your situation is urgent, or cost is the deciding factor, say so on the consultation call and we will point you toward the public options rather than book you.

Yes. Virtual therapy is widely used in reproductive and perinatal mental health, and it's not a second-best option. Research on video-delivered therapy for perinatal depression and anxiety shows outcomes comparable to in-person care. It also makes therapy easier to fit in, whether you're juggling early-morning monitoring appointments during IVF or trying to get out the door with a newborn.

When you're comparing providers, check the clinician is registered with the Ontario College of Social Workers (OCSWSSW) or the College of Registered Psychotherapists (CRPO), and ask whether perinatal work is their specialty or one of a long list. Our sessions are virtual across Ontario, with in person availability in Toronto, and we have evening and early morning slots.

Yes, and pregnancy is one of the better times to do it, because the pattern you set now is the one you carry into the first year.

The communication problems that show up during pregnancy tend to be specific rather than general: one person is carrying the physical experience and the other is carrying an unspoken fear they have decided is not theirs to voice; decisions are arriving faster than you can discuss them; and if there is a previous loss or fertility treatment behind you, you may be grieving on entirely different timelines.

Couples sessions here are 50 minutes at $210 to $225, with a 75 minute extended option, virtual, with evening availability. Either of you can book the free consultation. It's okay if one of you is more ready than the other.

Fertility counselling in Ontario usually comes from three places: counsellors at fertility clinics, who often focus on short-term support and the counselling required for donor conception or surrogacy; private therapists who specialize in reproductive mental health; and general therapists, whose experience with fertility varies.

To find the right fit, try these three things. Search their name on the public register at ocswssw.org for social workers or crpo.ca for psychotherapists. This confirms they're registered and shows any discipline history. Ask how much of their work is with fertility clients. And ask something specific on the consultation call, like what they often see come up for couples during the two-week wait. Someone who does this work regularly will have a lot to say.

You also won't see testimonials on most regulated therapists' websites. That's because Ontario's regulatory colleges don't allow them, so their absence isn't a red flag.

Two things matter and both are checkable in about a minute.

First, the protected title. "Registered Social Worker" (RSW) and "Registered Psychotherapist" (RP) are legally protected and require registration with a college. "Therapist", "counsellor" and "coach" are not protected and anyone can use them. Search the name at ocswssw.org or crpo.ca.

Second, the specialty. Ask how much of their current caseload is perinatal work, and where they trained in it. Everyone at this practice holds a current RSW or RP registration, and perinatal work is the whole of what we do.

Fifteen minutes, video or phone, whichever you prefer. You describe what is going on in whatever order it comes out. We ask a few questions, explain how we would approach it, and tell you which therapist we think fits.

If we are not the right place for you, we say so and point you somewhere better. There is no pressure to book and no follow-up sequence.

No. The consultation is free and takes a name, an email and a time. Payment details are only collected for paid sessions, and we will prompt you before your first one rather than in the middle of booking.

Most people have a consultation within two or three days and a first session inside a week. Current availability is shown on each therapist's card on the find your therapist page.

Tell us after the first session and you can switch to another therapist on our team at any time. Just let us know, and you do not have to explain why. Therapeutic fit is one of the strongest predictors of whether therapy works, so getting it wrong once is normal rather than awkward.

This is the most common sentence on a first call. There is no threshold you have to reach. People come here while functioning well at work, showing up for everyone else, and finding this one part of life unbearable. That counts.

If it helps to have a rule of thumb: if it has been going on for more than a couple of weeks, and it has started to affect how you see yourself rather than just how you feel, it is worth a conversation.

• Consultation call, 15 minutes: free
• Individual session, 50 minutes: $175 to $200
• Couples session, 50 minutes: $210 to $225
• Extended couples session, 75 minutes: 1.5 times the 50 minute rate

Fees vary by therapist. Your exact fee is confirmed on the free call, before you commit to anything. We also hold a limited number of reduced fee spots for people facing financial hardship. Just ask. You won't need to explain or provide any documentation.

Usually, in part. Sessions with a Registered Social Worker or Registered Psychotherapist are covered by most Ontario workplace plans, though plans differ on which of the two they include, so it is worth checking that specific wording.

We direct bill through Sun Life and TELUS eClaims, and provide receipts for all other insurers. Ask us when you book. Reimbursement on a submitted receipt is generally a week or two. Health spending accounts and wellness accounts are accepted.

Psychotherapy is not covered by OHIP unless it is delivered by a physician or through a hospital program.

Fees paid to a Registered Social Worker or Registered Psychotherapist can generally be claimed as a medical expense on your Canadian tax return. Keep your receipts, and check with an accountant for your own situation.

Yes, a small number of spots. Mention it on the consultation call. We would rather you asked than quietly decided against booking.

For a focused issue such as postpartum anxiety or intrusive thoughts, many people notice meaningful change within six to twelve sessions. Where there is birth trauma or older history underneath, it usually runs longer.

Your therapist will give you an honest estimate early rather than leaving it open ended, and will tell you when they think you are done.

Weekly to start is the usual pattern, because momentum matters early. Most people move to every second week and then to as-needed. We will not keep you at weekly for the sake of it.

For perinatal mental health, the evidence says yes. Video-delivered therapy shows outcomes comparable to in-person work for depression and anxiety, and in this population it substantially improves whether people attend at all, because it removes childcare and travel.

You can feed, rock or pace during a session. Nobody here will be surprised.

Yes, and most people do. Sessions are virtual, so there is nothing to arrange. If the baby needs you mid-session we stop and pick it up.

Medication is prescribed by a physician or nurse practitioner, not by a therapist, and we will not pretend to advise on it. What we can do is help you work out what you want to ask, and coordinate with your doctor, midwife or psychiatrist if you would like us to.

Untreated depression and anxiety carry their own risks in pregnancy and postpartum, which often gets left out of that conversation.

Ontario's regulatory colleges don't allow registered therapists to use client testimonials in their advertising. The rule protects people who are often in a vulnerable place when they're looking for support, and it keeps the focus on qualifications rather than marketing.

So if you don't see reviews on a therapist's website, that's simply a sign they're following their college's standards. What you can check instead is their registration on the public register, along with their training and areas of focus. You'll find ours on each therapist's profile.

Search any of our names on the public register at ocswssw.org for social workers or crpo.ca for psychotherapists. Registration status and any discipline history are both public.

Yes. There are a few legal limits that apply to every regulated therapist in Ontario. The main ones are a serious risk of harm to yourself or someone else, concerns that a child is being abused or neglected, a court order to release records, and reporting sexual abuse of a client by another regulated health professional.

Your consent to services form outlines these limits, and you'll review it before your first session. If anything is unclear, or you're unsure about something you want to share, ask your therapist first. That's a reasonable thing to do.

No. Unwanted intrusive thoughts about harm coming to your baby are a recognized and common anxiety symptom in the postpartum period, and they are treatable. Clinicians who specialize in this can distinguish an intrusive thought from a risk, which is precisely why it matters who you tell.

This is the single most common thing people are frightened to say out loud, and it is one of the things we treat most often.

No. We are not a crisis service and we cannot respond to urgent messages between sessions. If you are in crisis, call or text 988 for the Suicide Crisis Helpline, or go to your nearest emergency department.

If you are not in crisis but things feel like they are heading that way, say that on your consultation call and we will prioritize you.