Life Transitions Therapy
with Rachel Santellano, LSW
I help teens and young adults navigate life transitions that feel harder than expected, including school changes, relationship shifts, career uncertainty, and loss. Therapy focuses on understanding what you’re grieving, what needs to change, and how to move forward with clarity and confidence. This service supports both acceptance and action during major transitions.
When Life Looks Different Than You Thought It Would
Most people don’t come to therapy during a transition because they expect things to fall apart. They come because something that was supposed to feel exciting, meaningful, or “right” suddenly feels heavy, confusing, or disappointing. You might find yourself wondering, Why is this so hard? or Everyone else seems to be handling this — why am I struggling?
I work with people who are navigating moments where expectations collide with reality. That might be starting college, leaving school, beginning a new job, moving to Chicago, ending a long-term relationship, entering a serious one, or realizing that a path you worked toward doesn’t feel the way you imagined it would. These moments can bring anxiety, sadness, self-doubt, and a sense of being unmoored — even when, on the outside, things look “fine.”
Why Transitions Can Feel So Destabilizing
Life transitions often involve loss, even when they’re chosen. You may be grieving a version of yourself, a relationship, a future you imagined, or a sense of certainty you didn’t realize mattered so much. At the same time, there’s often pressure to be grateful, excited, or confident — which can make it even harder to name what’s actually happening inside.
Social media doesn’t help. It can easily look like everyone else is thriving, keeping up, and enjoying milestones you’re barely getting through. Many people I work with are carrying anxiety, loneliness, or self-criticism quietly, afraid to burden friends or admit they’re struggling. Therapy can be a place where you don’t have to perform or keep it together — where your experience gets normalized instead of minimized.
Two Common Questions at the Heart of Most Transitions
In my work, most life transitions come down to one of two questions — and sometimes both at once:
Am I trying to accept something that has already happened or can’t be changed?
Or am I trying to figure out how to change something that isn’t working for me?
Accepting a loss, letting go of a relationship, or grieving an experience that didn’t unfold the way you hoped requires a different kind of support than building courage to make a change. Therapy helps us slow this down, clarify what you’re actually facing, and figure out what kind of work will help you move forward rather than stay stuck.
Grief as Part of Life Transitions
Grief shows up in many transitions, not just in the death of a loved one — though I do work with people processing losses like the death of a grandparent or other significant figures. Grief can also come from the end of a relationship, leaving a chapter of life behind, or realizing that something meaningful is over.
Grief isn’t something to “get over.” It’s a process that needs attention and structure. In therapy, I help people learn how to move through grief rather than avoid it or carry it quietly for years. When grief is acknowledged and worked with intentionally, it tends to loosen its grip. When it’s ignored, it often resurfaces in anxiety, numbness, or lingering sadness.
When You’re New at Something and Don’t Know How to Do It Yet
Many people come to therapy during a transition with very practical questions — not because they’re broken, but because they’re new at something. You might be thinking, I don’t know how to ask for a promotion, I don’t know how to talk to my partner about what I want, or I don’t know how to make this next move without messing it up.
A big part of my work is being helpful. Therapy doesn’t have to mean only talking about feelings while nothing changes. If you’re struggling with a specific situation, we can slow it down, think it through together, and talk concretely about options. That might include how to phrase a difficult conversation, how to approach dating in a way that feels less discouraging, or how to make a decision that actually fits who you are right now.
You won’t be the first person to come in saying, I don’t know if I should change jobs, being single feels awful, or everyone else seems to know how to do this except me. I spend my days helping people navigate these moments. My role isn’t to tell you what to do — it’s to help you understand your choices, practice new approaches, and leave therapy feeling more capable than when you came in.
How Life Transitions Therapy Can Help
- Adjusting to school, work, or major role changes
- Navigating breakups, new relationships, or commitment decisions
- Managing anxiety, overwhelm, or self-doubt during change
- Processing grief and loss
- Clarifying values, goals, and next steps
- Building confidence and practical skills for unfamiliar situations
How This Work Connects with Other Areas of Therapy
Life transitions often overlap with other challenges. Anxiety and emotional regulation can become harder during change. Neurodivergent clients may find transitions especially destabilizing. Relationship patterns often get tested during periods of uncertainty. Therapy allows us to work with the whole picture, not just one piece in isolation.
My approach is flexible and responsive. We focus on what’s most relevant to you — whether that’s managing anxiety, processing grief, building skills, or making sense of a major shift in your life.
Is This a Good Fit?
Life transitions therapy is a good fit if you feel unsettled, disappointed, overwhelmed, or unsure during a period of change — especially if you find yourself thinking that this should feel easier than it does. You don’t need a crisis to reach out. Therapy can help you regain footing, make sense of what’s happening, and move forward with more clarity and self-trust.
Frequently Asked Questions About Life Transitions Therapy
Is this just for big life events?
No. Transitions can be external or internal. Therapy can help with visible changes as well as quieter shifts in identity, direction, or expectations.
Do you give advice or just help people process feelings?
Both. Therapy includes emotional support, but I also help clients think practically about decisions, communication, and next steps when that’s useful.
What if I don’t know what I want yet?
That’s very common during transitions. Therapy can be a place to clarify what matters to you without pressure to have immediate answers.