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KARA CRUZ | Therapist • Trainer • Speaker

@karacruzwellness

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Therapist | Speaker🎤| Trainer
Healers Support Group🤍
Women's ADHD Support Group🌈
Training & CEs for Therapists👩🏼‍🏫
@saltairwellness
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Things I’m ghosting this holiday season 👻✨

💀 Masking my authenticity
☕ Self-doubt fueled by too much caffeine (and overthinking)
🌸 Over-compliance / people-pleasing
💐 Ignoring my intuition

This season, we’re making space for self-connection, energy, and boundaries. No ghosts or haunting allowed. 🤍🫶🏼

Are you in? Join us for It Begins With Us, a women’s group starting this December, Wednesdays, for reconnecting with yourself, your nervous system, and your power.

Visit karacruz.com or bio to schedule your consultation call for It Begins With Us Women's Group. Open to Women in California! 🌊

#WomenWithADHD #NeurodivergentWomen #SelfConnection #BoundariesMatter #InHarmonyCollective #ADHDAwareness #ADHDWomen by @karacruzwellness

Well, there goes my 12-month countdown. 🩸😂

Perimenopause really does keep things interesting.

Did you know that menopause is technically ONE day?

✨ Menopause is reached after 12 consecutive months without a menstrual period, assuming there isn’t another medical explanation.

✨ The years leading up to that milestone? That’s perimenopause.

✨ And after that one-year milestone? You’re officially postmenopausal.

So every time Aunt Flo decides to make another appearance during perimenopause, the countdown starts over. 🙃

And yes, irregular periods, skipped cycles, and surprise visits can all be part of the experience.

Just another fun chapter in the hormonal adventures of midlife womanhood. 🌈

P.S. Apparently I’ve reached the stage of life where I’m discussing my menstrual cycle with the entire internet.

You’re welcome. 😂

Anyone else playing the world’s least entertaining waiting game?

#perimenopause #menopausehumor #womenshealth #midlifewomen #menopauseawareness by @karacruzwellness

🧠 A normal hormone blood test doesn’t rule out perimenopause.

Surprised? Many people are.

Hormone levels can fluctuate significantly during the menopause transition, meaning a single blood test may not reflect what’s happening over time.

Meanwhile, someone may be experiencing anxiety, irritability, disrupted sleep, brain fog, or changes in emotional regulation.

And guess who they may turn to first? Their therapist.

As mental health professionals, we have an opportunity to help clients recognize patterns, track symptoms, advocate for appropriate medical support, and learn strategies to manage the psychological and physical challenges of this transition.

🌿 I’m covering this and much more in my upcoming training, Supporting Women Through Perimenopause: A Trauma-Informed Approach for Psychotherapists.

📅 December 10 | 9 AM–12 PM PT
💻 Live via Zoom | Replay available

Interested in joining? Registration link in the Facebook comments or in my Instagram bio!

#perimenopause #menopausementalhealth #therapisteducation #reproductivementalhealth #mentalhealthprofessionals by @karacruzwellness

Learning to love your ADHD Brain Women's Group starts soon! Join the interest list. Comment, DM or email kara@karacruz.com

@karacruzwellness by @karacruzwellness

✨ THERAPISTS, what if growing your practice didn’t mean adding more individual clients to your schedule?

I love individual therapy. And I also LOVE group therapy!

After more than 18 years working in mental health, developing and facilitating groups, I’ve seen how powerful group work can be for both clients and therapists.

Imagine creating a therapy group around a topic you’re passionate about, working with your best-fit clients, and helping more people access meaningful support at a lower per-person fee.

And yes, there’s an opportunity to increase your revenue per clinical hour, too! 🙌🏼

Of course, groups take planning, preparation, and marketing. But the possibilities are worth exploring!

Here’s something to think about:

What’s ONE topic you could talk about all day? Something you love learning about, teaching, or helping clients navigate?

ADHD? Trauma? Perinatal mental health? Burnout? Relationships? Life transitions?

That might just be the beginning of your signature therapy group! 💗

Want to bring that idea to life?

✨ Join my FREE Group Creators Community on Facebook for resources, ideas, encouragement, and support from other therapists interested in group work.

🎉 Registration is NOW OPEN for Create Your Signature Therapy Group in February 2027!

In this 3-hour online training, I’ll walk you through my framework for turning your expertise into a group concept, structuring your group, identifying your ideal participants, and learning how to market and fill it.

Whether you’re creating your first group or ready to launch another, I’d love to help you get it going!

🔗 Find the free community and February training through the link in my bio on Instagram or in the comments on Facebook.

Cheering you on,
Kara 💗

#therapists #grouptherapy #privatepractice #therapistcommunity #therapygroup by @karacruzwellness

🧠 ADHD in women: From puberty to postmenopause

ADHD doesn’t necessarily change with every hormonal transition, but how symptoms show up can.

💗 What research suggests:

• Puberty: Hormonal shifts and increasing demands may make ADHD symptoms more noticeable.

• Menstrual cycle: Some women experience increased distractibility, emotional reactivity, and executive functioning difficulties before their periods.

• Pregnancy: Symptoms vary by trimester. Some women report improved focus during periods of higher estrogen, while others experience more challenges.

• Postpartum: Hormonal changes, disrupted sleep, and increased demands may intensify existing difficulties.

• Perimenopause: Fluctuating estrogen may contribute to brain fog, working memory difficulties, and challenges with emotional regulation.

• Postmenopause: ADHD symptoms may persist, improve, or change. Research remains limited.

✨ For women and the clinicians supporting them: Understanding the relationship between ADHD, reproductive hormones, sleep, and mental health can lead to more informed assessment and care.

References:
Osianlis et al. (2025), Journal of Attention Disorders.
Kooij et al. (2025), Frontiers in Global Women’s Health.
Young et al. (2020), BMC Psychiatry.

Research is emerging, particularly regarding pregnancy and menopause. Individual experiences vary.

Follow Kara Cruz Wellness for more

#adhdinwomen #womensmentalhealth #perimenopause #adhdtherapist #reproductivementalhealth by @karacruzwellness

MYTH: OCD compulsions are always visible.

FACT: Rumination, mental reviewing, and reassurance-seeking can be compulsions.

MYTH: Challenging intrusive thoughts always helps.

FACT: Repeatedly disputing thoughts can reinforce OCD when it becomes a mental ritual.

MYTH: All CBT techniques work equally well for OCD.

FACT: ERP is a first-line, evidence-based treatment.

OCD treatment isn’t about proving thoughts wrong. It’s about changing how we respond to them.

OCD isn’t always what you can see. And not every therapeutic intervention is equally effective.

Some compulsions happen entirely inside someone’s mind.

Mental reviewing, rumination, silently repeating phrases, neutralizing thoughts, and seeking certainty can all function as compulsions.

Here’s where treatment gets complicated.

Traditional CBT strategies, such as repeatedly challenging intrusive thoughts, searching for evidence, or generating reassuring alternatives, can inadvertently reinforce OCD when they become rituals designed to eliminate doubt.

That doesn’t mean CBT is ineffective for OCD.

Exposure and Response Prevention (ERP) is a first-line, evidence-based form of CBT for OCD.

The goal isn’t to prove every intrusive thought wrong. It’s to reduce compulsive responses, increase tolerance of uncertainty, and help clients disengage from the obsessive-compulsive cycle.

Recent research continues to emphasize the importance of identifying both overt and covert compulsions.

For clinicians: Are we helping clients change their relationship with intrusive thoughts, or inadvertently helping them seek certainty?

Research (2023–2026):

* Common Rituals in Obsessive-Compulsive Disorder and Implications for Treatment (2023).
* Diagnosis and Management of Obsessive-Compulsive Disorder in the Primary Care Setting (2024).
* Exposure and Response Prevention in OCD: A Framework to Capitalize Change (2025).
* Management of Obsessive-Compulsive Disorder in Adults (2026).

@karacruzwellness
#ocd #erptherapy #ocdrecovery #ocdtreatment #womensupportingwomen by @karacruzwellness

ADHD in women is not a social media trend. 🧠

While awareness has increased in recent years, research on the underrecognition and misdiagnosis of ADHD in women has existed for decades.

What does the research tell us?

• Masking: Girls and women may internalize symptoms or develop strategies to conceal their difficulties.

• Overcompensating: Perfectionism, overworking, and high achievement can mask significant executive functioning challenges and emotional distress.

• Diagnostic overlap: ADHD can share features with anxiety disorders, bipolar disorder, and borderline personality disorder (BPD), particularly emotional dysregulation, impulsivity, and difficulties with attention.

• Delayed identification: Some women receive treatment for other mental health concerns for years before ADHD is considered.

• Clinical implications: A comprehensive assessment should examine developmental history, symptom onset, functional impairment, co-occurring conditions, and patterns of emotional and attentional difficulties.

Importantly, anxiety, bipolar disorder, BPD, and ADHD can coexist. An accurate differential diagnosis matters.

For clinicians: We need to look beyond outward functioning, academic achievement, and the presenting symptoms. Being capable and successful doesn’t rule out ADHD.

And for women who have spent years wondering why everyday tasks require so much effort, your experiences deserve to be taken seriously.

📚 Peer-reviewed references:

Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A systematic review of ADHD in adult women. Journal of Attention Disorders.

Young, S., et al. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach. BMC Psychiatry, 20, 404.

#adhdinwomen #womensmentalhealth #adhdassessment #neurodivergentwomen #mentalhealthprofessionals by @karacruzwellness

🧠 Women with ADHD aren’t always recognized.

And no, this isn’t just a trend fueled by social media. There’s peer-reviewed research.

@karacruzwellness

🔎 What the research tells us:

• Masking: Women may hide their difficulties to meet social and professional expectations.

• Overcompensating: Perfectionism, overworking, and rigid routines can conceal executive functioning challenges.

• Diagnostic overlap: ADHD symptoms can overlap with anxiety, bipolar disorder, and borderline personality disorder (BPD).

• Delayed diagnosis: Some women spend years receiving treatment for other concerns before ADHD is identified.

This doesn’t mean those other diagnoses are necessarily wrong. ADHD can coexist with them.

For clinicians: A thorough developmental history, assessment of functional impairment, and careful differential diagnosis matter.

Women deserve assessments that look beyond how well they appear to be functioning.

📚 Peer-reviewed research:

Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A systematic review of ADHD in adult women. Journal of Attention Disorders.

Young, S., et al. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach. BMC Psychiatry, 20, 404.

#adhdinwomen #womensmentalhealth #adhdawareness #neurodivergentwomen #mentalhealthprofessionals by @karacruzwellness

🧠 Women with ADHD have been overlooked for decades. And we have research to support that.

Some women spend years masking symptoms, overcompensating, and working twice as hard to manage everyday demands.

🔎 Research highlights:

• Masking: High achievement and carefully developed coping strategies can hide significant executive functioning difficulties.

• Diagnostic overlap: Emotional dysregulation, impulsivity, and internal restlessness can overlap with anxiety, bipolar disorder, and borderline personality disorder.

• Delayed diagnosis: Women may receive treatment for other mental health concerns before ADHD is recognized.

• Clinical implications: Assess developmental history, symptom patterns, functional impairment, and co-occurring conditions.

This doesn’t mean anxiety, bipolar disorder, or BPD diagnoses are always incorrect. These conditions can coexist with ADHD.

The goal isn’t to replace one diagnosis with another. It’s to improve diagnostic accuracy and treatment.

📚 References:
Attoe & Climie (2023). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders.

Young et al. (2020). Females with ADHD: An expert consensus statement. BMC Psychiatry.

#womenwithadhd #adhdinwomen #womensmentalhealth #adhdassessment #mentalhealthprofessionals
#mentalhealthprofessionalsindia by @karacruzwellness

🌸 Therapists, are you asking your midlife clients about perimenopause?

Changes in mood, anxiety, sleep, attention, and emotional regulation can all be influenced by hormonal transitions. Yet perimenopause is often overlooked in mental health assessment and treatment.

I’m excited to be joining Leading Edge Seminars this week for:

🌸 Supporting Women Through Perimenopause: Clinical Approaches & Interventions

We’ll explore the intersections of hormones, mental health, ADHD, trauma, and sleep, along with practical strategies for screening, assessment, interventions, and referrals.

📅 October 29 & 30, 2026
🕐 10:00 AM–1:15 PM PT / 1:00–4:15 PM ET both days
🎓 6 CE hours (check your board for acceptance)
💻 Live on Zoom

🎥 CAN’T ATTEND LIVE? No problem! You’ll receive ONE FULL YEAR of recording access!

💵 A savings tip for my US colleagues!

🇺🇸 Be sure to switch to USD at checkout for the lower US price!

✨ Use my code CRUZ10 for an additional 10% off.

With the discount and fees, your total is approximately $191.44 USD.

Whether you join us live or watch the replay on your own schedule, I’d love to have you!

🔗 Register through the link in my bio!

#perimenopause #menopause #womensmentalhealth #therapisteducation #continuingeducation by @karacruzwellness

🟣 Marketing Tip for Therapists Creating Groups

One thing I see therapists overlook when creating a group:

What happens AFTER someone says they’re interested?

Before you start promoting, map out these 5 steps:

1. Inquiry
2. Screening for fit
3. Registration
4. Payment + paperwork
5. Welcome + first-session expectations

A simple enrollment pathway makes the process easier for you and much clearer for potential group members.

Your takeaway:
If you can’t explain your enrollment process in 3–5 simple steps, it’s probably time to simplify it.

This is actually what we’re talking about inside the Group Creators Community. Free to join. You can find us on Facebook.

If you’re creating or trying to fill a therapy group, you’re welcome to join us!

📸 Cobie pic for fun! 🤩 🐾🦇

#therapygroup #grouptherapy #supportgroup #therapistsofinstagram #therapisteducation by @karacruzwellness