Do you only work with autistic women?

My practice specializes in enthusiastically supporting autistic women, particularly those who discovered their autism later in life or are in the process of figuring that out. Many of my clients have spent years masking, pushing through sensory overwhelm, or wondering why things that seem effortless for others take so much energy for them.

My practice is built around the experiences of autistic women. 

I do not have the experience or training to work comfortably with ADHD or diagnoses such as bipolar, or with personality disorders. You would be better supported by someone who regularly practices that specialty. 

Do I need a formal autism diagnosis to work with you?

No. Many people begin therapy while they are still exploring whether autism might apply to them. Late-identified autistic women often arrive with a lot of questions and a lifetime of experiences that suddenly look different through a neurodivergent lens. Therapy can be a helpful place to sort through that process.

Do you offer formal autism evaluations?

No, this is something you’d need to contact a licensed psychologist to discuss. There are many resources for informal self-diagnosis, however, and I support whatever journey best fits your needs, budget and concerns. My own journey started with informal diagnosis and then progressed to a formal evaluation when it felt helpful. I’m happy to discuss all of this with you. 

What is your approach to therapy?

My work has a depth orientation, which means we’re interested in understanding the underlying emotional patterns that shape your life rather than just managing symptoms on the surface.

A lot of our work involves parts work (also known as IFS)—learning to recognize the different internal voices that show up inside all of us. The competent one. The overwhelmed one. The one that would like everyone to stop talking and turn off the fluorescent lights. When people begin to understand how those parts interact, long-standing patterns start to make much more sense.

Therapy with me tends to involve thoughtful conversation, curiosity, and sometimes a bit of humor. I take the work seriously, but I don’t believe therapy needs to feel stiff or overly formal to be effective.

What kinds of things do people usually come to you for?

Many of the people I work with are dealing with some combination of:

• autistic burnout

• chronic masking and exhaustion

• sensory overwhelm

• late diagnosis and identity shifts

• trauma related to long-term misunderstanding or invalidation

• relationship patterns that never quite made sense

Often people arrive with a fair amount of insight already, or they’ve been able to make a lot of observations but are struggling to put the entire picture together. What they’re looking for is a deeper understanding of why certain patterns keep repeating and how to actually shift them.

What are sessions like?

Sessions are conversational, thoughtful, and collaborative.

There is usually a fair amount of curiosity and thinking together about how your mind works. And occasionally some well-timed humor, because therapy is serious work but that doesn’t mean every moment of it has to feel heavy.

Do you offer in-person or online therapy?

I work with clients throughout California and Tennessee using secure telehealth. I’m 100% online. My clients find that meeting from their own space actually makes therapy easier and less draining. I also allow clients to do their own session scheduling, so our session time is reserved for meaningful work and not administration. 

How long are sessions?

Standard sessions are approximately 50 minutes.

Do you accept insurance?

I do currently accept some forms of insurance. I do not provide superbills. Please refer to my Psychology Today page (https://www.psychologytoday.com/us/therapists/tracy-de-soto-mft-san-bruno-ca/197180 ) for a current list of insurance panels accepted. 

I do not accept Medicare or Medical. 

What is your session rate if I’m not using insurance?

My current rate for individual sessions is $250/session. 

Do you work with all ages?

I work with adult autistic females. I do not work with minors. 

How about couples?

I don’t work with couples at this time. 

How do I know if we’re a good fit?

You don’t! That’s why you can use my Alma profile (https://secure.helloalma.com/providers/tracy-de-soto/) to schedule a brief initial consultation, and why we typically consider the first three sessions to be assessment and intake sessions. Most people have a pretty good sense of my style by that point, and I’ll also have a good sense of what you’re looking for. 

If the way I think about therapy resonates with you—especially if you’re someone who has already spent a lot of time trying to understand yourself—you’ll probably feel comfortable here. If you already have doubts, then trust your intuition. 

Generally speaking, if you’re ready to do the work rather than just talk about doing the work, you’ll likely find our sessions meaningful and my approach helpful. 

Who do you work with?

Any adult who believes their childhood trauma (including incest, sexual assault, emotional/physical abuse, neglect, etc.) is still impacting their adult life is someone I’m interested in working with.

The tricky part for most clients is admitting (sometimes believing) there was trauma in the past, and that this trauma gets “buried,” but resurfaces as other types of problems.

For example—relationship problems, difficulty expressing sexuality, hair trigger defenses, numbing out with various addictions, chronic anxiety, a tendency to dissociate and forget things, codependency, rage, and so many more issues I can’t list them all here. 

Do you work with kids?

No, I do not currently work with children. Kids are completely awesome, but teletherapy is not how I want to work with the youngest and most vulnerable population, as it makes it challenging and sometimes impossible to use certain tools and modalities that are so important in our work together, like sand tray, play, and art therapy. It runs the risk of underserving them. 

Adults 18 and older are welcome in my practice.

Do you work with a wide range of people?

Yes! I welcome anyone into my practice who is seeking their true self and wants to be less reactive to their own struggles. If you enjoying exploring your inner landscape, you’ll probably enjoy the therapy process.

Anyone of any gender identity, sexual orientation, race, and/or cultural orientation is welcome in my practice.

How do you work?

Great question! I’m a “trauma-informed therapist,” which means whatever you’re coming in to resolve or explore, is most likely connected to trauma from your childhood, or problems with the caregivers from your childhood. I use a variety of modalities, all of which are “mindful” or “person-centered,” to explore how symptoms in the present may connect to traumas in the past. By resolving the unresolved pain of the past, we can often spontaneously resolve the issues occurring in the present.

Do you take insurance?

I’m an in-network provider with Aetna, Cigna, and Optum in California and Tennessee. It is your responsibility to verify your insurance coverage before beginning a course of therapy. Any costs incurred not covered by insurance are the patient’s responsibility.

I don’t want to talk about all the awful things that happened to me. Are you going to force me to talk it out?!

Absolutely not. Never. Trauma-informed therapy doesn’t work like that. Study after study has shown that “rehashing” your trauma shuts down part of your brain and makes you feel like you’re reliving the things that happened to you. It doesn’t help.

What does help is something called “parts work,” and something else called “unconditional positive regard.”

We can work on trauma recovery without you ever telling me what happened to you.

I heard EMDR is a great treatment for trauma, do you do that?

I am trained and certificated in EMDR but at this time, I don’t offer it via telehealth. We have many other mindfulness-based approaches to select from when working with trauma (EMDR is one of many and I’m confident we will find what works for you.

Are you a Christian counselor?

No, I do not align myself with any faith, and cannot in good conscience explore faith-based issues with you. There are many faith-based counselors and therapists available across your state who are highly qualified to address these concerns with you.