Nacre Psychotherapy
Mary Fensham Counseling
Treating OCD, Anxiety, and Life smacking you in the face. I provide customized counseling for those ready to work their grit into pearls.
Talking and Doing
We'll do real work together. I don't want either of us going through the motions week after week. There are plenty of tools in my bag, and we'll use them as we need them.
Aside from the Credentials
The license and degree are vital but don't tell you whether or not we'll click. Some of my experience includes emergency psychiatric crisis, hospice, and long-term care. I've seen what people live through, and what they're capable of—so there's very little you can bring me that I haven't sat with before. I'll push when you can handle it, and I won't go cold when you're hurting.
Specialties and Services
Areas and Conditions I Treat
Here's where I do my best work. Scan the list—if your thing is on it, good. If it's near it, reach out anyway and we'll sort out whether I'm the right fit before you book.
Obsessive Compulsive Disorders
I use Exposure Response Prevention (ERP) to treat OCD.
On paper it sounds terrifying; the whole point is to stop avoiding the thing you're scared of, and I won't pretend otherwise. But in my experience, it works where other therapy stalls. Clients get real relief, and the work is never boring.
While we are doing ERP you'll notice much more structure in our sessions, as opposed to other talk therapies.
And if you're not sure whether it's OCD or OCPD (Obsessive-Compulsive Personality Disorder)—people mix them up constantly, they're genuinely different beasts, and I treat both. Come in unsure. We'll sort out which one you're actually dealing with.
Anxiety and Intense Emotions
Sometimes it's a panic attack out of nowhere. More often it's quieter—saying yes when you want to say no, redoing what was already fine, replaying a conversation from three days ago, that low hum of guilt that won't even tell you what you did wrong. Sometimes it's intense and sudden, taking you by surprise, and sometimes it's this constant pull on your energy that won't let up. And most of all, it's avoidance—the quiet, full-time job of steering around the one thing you can't face.
Life Blowing Up
Whether it’s a divorce, a devastating diagnosis, an imploded career, or a betrayal that completely blindsided you, your reality has changed shape.
Now you're sorting through the rubble of the after. No silver linings, no "everything happens for a reason." Just concrete tools to process the shock, find your footing, and decide what to build with what's left.
Grief & Loss
Death, yes. But also the losses nobody sends cards for—a marriage, a friendship, the future you'd already started living in, the person you were before this happened.
I've sat with people at the actual end of life, so I won't flinch at the parts of grief you're not supposed to say out loud: the relief, the anger, the days you feel nothing at all. There's no rushing here.
Prices
Insurances and Fees
Insurance Credentials
In process of moving my credentials over to Optum (UHC), BCBS, Aetna and Medicare.Default length of session will vary by coverage, typically 45 to 53 minutes per session.
Therapy time is approximate.
An "hour" is about 53 minutes.
"45 minutes" is 38–52.
"30 minutes" is 16–37.
It's the same brackets every therapist uses—now you know.
OON or Cash Pay Rates
$185 Assessment
$150 Hour Session
$110 Session 45 minutes
$75 Session 30 minutes
Sliding Scale Available.
About Me
My Cred, My Vibe
The most common question I get in a consult is why I'm a therapist. It's a reasonable one—what people are really checking is whether they're safe with me. Am I going to be bored, or quietly judging them from across the room? Am I some kind of emotional voyeur, or a vampire feeding on the hard stuff? Am I just a soft idealist who can't handle what they're about to hand me?
All fair. So here's the honest version of who's in the chair.
Here's the honest version. I went through an obsessed-with-psychology phase, a trying-to-fix-myself phase, and an embarrassing savior-complex phase. I finally landed somewhere real: this is the only work I've never dreaded showing up to, and it turns out I'm good at it.
But here's what you're probably worried about, because there's such a thing as small talk and "polite" conversation, maybe you even hate when people want to get serious, and wonder, how can I stand it? The deep, heavy, serious stuff people are scared to say out loud feels more normal to me than small talk does—I'm genuinely bad at small talk, it bores me. This work is an honor, not a burden.
The next thing people want to know is what my style of therapy is. If you're asking which "kind" of therapy I do, the honest answer is: whichever one fits your brain and your goal. I pull from Acceptance and Commitment Therapy, Internal Family Systems, DBT skills, and mindfulness, and I mix them on purpose—the right combination for you, not whatever I happen to be loyal to. (For OCD specifically, that includes ERP—more on that in the OCD section.)
We will use mindfulness, but not the stock "picture your thoughts as leaves on a stream" nonsense. If your thoughts move like debris in a fire tornado, that's the image we use. True is the only kind of mindfulness that works. (We'll also laugh. Real work and humor aren't mutually exclusive.)
The Partnership
Here's the part that matters most: this is a partnership, not customer service. I won't treat you like a customer, and I won't work harder than you do. I'm warm—genuinely—but I'm not here to coddle you or validate you on a loop. I'm also not the doctor handing down exactly what you must do. I have the clinical knowledge; you have the knowledge and instincts about your own life that I'll never have. Those two things are complements, and that's the whole reason it works. We're both working toward the goals we set together. The one thing actually in charge is the treatment plan, and it's the boss of both of us.
Practically, that means you'll build real skills and do some amount of homework between sessions—the work doesn't only happen in the room. I don't carry you around or quietly judge you the other six days of the week. When I think about you on a Tuesday, I'm chewing on the puzzle of our treatment plan: what's going on, what hasn't worked, and which tool fills the gap. We both answer to that plan. We'll set small, immediate wins alongside the long-term ones, so the work actually feels like it's going somewhere.
Contact Me
How to Get Started
Reach out to me however you like, text, phone, email, or schedule a consult directly through sessions. From there we go over your needs in a 15 minute phone call to go over the basic needs and match. Our first session is a review of your history, your current situation, and your wishlist for therapy. From there, everything moves according to your individualized treatment plan and goals.
Currently Telehealth Only
[email protected]phone: 732-654-2318fax: 732-655-6037
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