For the people caring for someone else while carrying something no one sees.
Caregivers are among the most invisible therapy populations. Their needs are structurally subordinated to the person they're caring for. The grief they're carrying doesn't have cultural permission to be grief because the person is still alive. The resentment they feel exists alongside genuine love and can't be safely expressed. The identity erosion of a role that expands to consume everything else happens slowly enough that there's no clear moment when it became too much.
We provide therapy for caregivers in Johnson City, TN and across Tennessee via telehealth. We work with grief, caregiver stress, burnout, identity erosion, and the specific emotional complexity of relationships where love and obligation are deeply entangled. We're private pay and don't bill insurance directly.
If this is immediate: If you or someone else may be in immediate danger, call 911 or call or text 988. You can also see our crisis resources. A therapy inquiry is not the right starting point for immediate danger.
What caregiving costs that has nowhere to go
The cost of caregiving is real and cumulative, and it has almost nowhere legitimate to go. You can't complain about the person you love. You can't admit the resentment without feeling like a bad person. You can't grieve someone who is still alive. You can't put your own needs first without it feeling like abandonment. The result is a systematic suppression of your own experience that has a cumulative cost that eventually becomes impossible to contain.
The grief in caregiving is often called ambiguous loss: mourning the person as they were, the relationship as it was, and the future that will look different than you planned, while the person is still present and still needing things from you. That grief doesn't fit the standard definition, which means it doesn't get the standard permissions: the time, the space, the acknowledgment. It just accumulates alongside everything else you're managing.
East Tennessee has a strong culture of family obligation, faith, and self-sacrifice. Caregivers here often carry an additional weight: the expectation that caring for family is what you do, that asking for help is weakness, and that needing support for carrying this burden is somehow a failure of character or love. The cultural current running against acknowledging the cost of caregiving is real and specific to this region.
Concerns that frequently bring caregivers to therapy
These pages address the specific concerns that often sit underneath what brings caregivers to therapy. Each one connects to how that concern may be addressed at Willow & Arbor.
Burnout
When the sustained cost of caregiving has finally exceeded what's available, and the depletion is affecting not just your capacity to care for yourself but your capacity to care for the person you're here for.
Caregiver stress
The sustained, structural weight of being responsible for another person's wellbeing with no clear endpoint, inadequate support, and the cultural expectation that love should make it feel like enough.
Codependency
When the caregiver identity has become the whole identity, and the question of who you are outside the role of caring for this person has become genuinely unclear.
Emotional distance in relationships
When the emotional capacity caregiving requires has left little for other relationships, and the people outside the caregiving situation are getting what's left.
Empty nest and role loss
When a primary caregiving role ends -- through a loved one's death, placement in a facility, or a child growing up -- and the identity organized around it shifts.
Grief and ambiguous loss
The grief of the person as they were, the relationship as it was, and the future that will look different than planned, while the person is still present and still needing things from you.
Life transitions
The transition into the caregiver role, the anticipatory transition of what comes after, and the reorganization of identity that happens when the role eventually ends.
Loneliness
The specific loneliness of caregiving: present for someone else in the most demanding way possible, and genuinely alone with your own experience of it.
Not sure where to start
When something is wrong but the habit of subordinating your own needs to the person you're caring for has made identifying what you need feel almost impossible.
Self-esteem
The specific self-esteem challenge of caregiving: the comparison to an impossible standard of selfless care, and the verdict about what the resentment, the exhaustion, or the need for help says about you.
Sleep and insomnia
The disrupted sleep that comes with the demands of caregiving, nighttime monitoring, and the inability to fully disengage from responsibility.
Service types relevant to caregivers at Willow & Arbor
Individual therapy
The primary starting point for most caregivers. A consistent space that's yours, focused entirely on what you're carrying, without having to manage anyone else's experience of it.
Couples therapy
When caregiving has affected the relationship with a partner and the strain it's created needs to be addressed together rather than managed in isolation.
Family therapy
When the caregiving situation has created dynamics within the family system that need to be addressed with the family present rather than from within individual therapy alone.
Methods often used in therapy for caregivers
Narrative therapy
An approach for separating who you are from the role you're in, examining the story of the caregiver identity, and finding the person underneath the obligation.
Family systems therapy
An approach for understanding how the caregiving role functions within the larger family system, and how the dynamics around obligation, guilt, and responsibility are distributed and maintained.
Mindfulness-based therapy
An approach for reconnecting to present-moment experience and building the capacity to be with what is actually happening, rather than managing the anticipation of what comes next.
What's different about therapy for caregivers at Willow & Arbor
We work with grief, caregiver stress, and the emotional complexity of relationships where love and obligation are entangled, without requiring you to choose which feeling is the acceptable one.
The most important thing therapy offers caregivers is often the simplest: a space where your experience is the primary concern. Not the person you're caring for. Not how to do the caregiving better. Not what you owe or what you should feel. Just what you're actually carrying, received without judgment and without the expectation that you manage everyone else's response to it.
The ambiguous grief of caregiving is real grief, and it deserves to be received as such. The resentment that coexists with love is a legitimate response to an unsustainable situation, not a character flaw. The identity erosion of a role that consumes everything else is a clinical reality with a name and a treatment. The work here is built to name all of it and hold all of it, including the parts that feel unsayable anywhere else.
Practically: telehealth is available across Tennessee when it's a clinical fit. For caregivers whose schedules and responsibilities make in-person sessions logistically difficult, telehealth means sessions can happen from wherever works without requiring time away that's hard to arrange or justify.
Your experience is the primary concern: therapy here is about what you're carrying, not how to be a better caregiver.
Grief received as grief: ambiguous loss, anticipatory grief, and the resentment that coexists with love are all held here as the real things they are.
Telehealth available: sessions from wherever works, without requiring time away from caregiving responsibilities that's hard to arrange.
When therapy for caregivers may need a different starting point
We provide individual therapy through a standard appointment structure. For most caregivers seeking support with grief, caregiver stress, burnout, identity questions, or the emotional complexity of what they're carrying, this is an appropriate level of care.
If what you're experiencing involves active crisis, significant safety concerns, or a level of impairment a standard therapy appointment can't adequately address, a higher level of care or a different kind of support may be the right starting point. The consultation can help sort that out.
We also work with caregivers whose concerns connect to specific clinical presentations as well as those whose experience is more diffuse. You don't need a diagnosis or a clear category to begin.
Your needs qualify: the depletion of sustained caregiving is a real concern that deserves real support, not an obligation to manage better.
Telehealth available: therapy across Tennessee when telehealth is clinically appropriate and fits the realities of your schedule.
The consultation is free: a 15-minute conversation to understand what's bringing you in and whether we may be an appropriate fit.
In person and telehealth
Sessions are available in person in Johnson City, TN and by telehealth across Tennessee when appropriate. Clients from Kingsport, Bristol, Jonesborough, and surrounding communities are welcome.
Learn about telehealthFees and consultation
The initial consultation is free. Sessions are self-pay and vary by therapist and type of appointment. We don't bill insurance directly. Therapy is provided by associate-licensed therapists under the clinical supervision of Dr. Katherine Barteck.
View feesCommon questions about therapy for caregivers
Is it okay to feel resentment toward the person I'm caring for?
Yes. Resentment and love coexist in caregiving, and neither cancels the other. The resentment isn't a sign of a character flaw or inadequate love. It's a sign that you're carrying something that exceeds what any person should carry alone without support. Therapy is a place where both feelings can exist without requiring you to choose which one is the real one.
What if I can't leave the person I'm caring for to come to therapy?
Telehealth is available across Tennessee when it's a clinical fit. For caregivers whose schedules and responsibilities make in-person sessions logistically difficult, telehealth means sessions can happen from wherever you are without requiring time away that's hard to arrange.
Is what I'm feeling actually grief if the person is still alive?
Yes. What caregivers experience is often called ambiguous loss or anticipatory grief: mourning the person as they were, the relationship as it was, and the future that will look different than expected, while the person is still present. That grief is real regardless of whether it fits the standard definition, and it deserves to be received as such.
This page is provided for educational purposes only. The information here is not clinical advice about your particular situation, and reading it does not establish a therapeutic relationship with any Willow & Arbor therapist. Guidance that applies to your specific circumstances can only come from a direct professional relationship with a qualified provider.
Practical questions about starting therapy
If you're still working through the practical questions: what therapy costs, what the first session looks like, how confidential it is, or whether this is even the right time, our starting therapy guides answer those from the perspective of this practice.
Therapy for caregivers at Willow & Arbor is provided through individual therapy and telehealth therapy across Tennessee. See all therapy by concern or all services.
You've been taking care of someone else. This is somewhere to put what that costs you.
The consultation can help sort out whether we may be an appropriate fit and where the conversation should begin.
If you're in crisis or immediate danger, call 911 or call or text 988. See our crisis resources.