What does a marriage and family therapist do? A marriage and family therapist (MFT) is a mental health professional who diagnoses and treats mental and emotional disorders within the context of marriage, couples, and family systems. Unlike traditional individual therapy, MFTs focus on how social and relational environments impact individual well-being.

We chatted with Sheila Gilbert, a licensed MFT and certified perinatal mental health practitioner practicing in Redondo Beach, CA, and a graduate of the online master’s in clinical psychology program from Pepperdine University. Gilbert is the founder of Laya Women’s Therapy, a private practice specializing in infertility, pregnancy, postpartum, identity shifts, relationship challenges, and other major life transitions. Learn more below about a day in the life of an MFT, transitioning into private practice, setting boundaries to protect one’s mental health, and more.

Gilbert’s own experiences with infertility, postpartum anxiety, and motherhood gave her a firsthand understanding of how deeply mothers need support, and how often they are expected to carry so much without enough of it. While spearheading women’s leadership initiatives at Meta, she connected with other women navigating many of the same challenges and realized she was far from alone.

Gilbert: “I silently navigated infertility for some years, and once I was able to have children, I experienced postpartum anxiety, which, at the time, I didn’t know was even a thing: people were just talking about postpartum depression. I was also learning firsthand how difficult it was to juggle motherhood alongside a demanding career, a relationship, and all the other parts of life that don’t simply pause once you become a parent.

When I worked at Meta, I had the opportunity to lead our women-focused leadership initiatives for the industry I supported. I had the privilege of hearing so many of these women’s stories, and I began to recognize a common thread. These were accomplished, very capable women who were also navigating very real challenges—pressure, stress, anxiety, grief, managing the invisible load, burnout, perfectionism, identity shifts, relationship strain, or often some combination of it all. Hearing their stories helped me realize that so many of the challenges I had experienced in my own life were not uniquely mine, but part of a much broader experience shared by many women and mothers. That realization ultimately drew me toward mental health and work that felt meaningful, allowing me to support women through these complex seasons of life.”

For Gilbert, choosing Pepperdine was largely due to her professors’ real-world experience across a variety of settings, and the coursework that prepared her to be a therapist before she even saw her first client.

Gilbert: “Aside from Pepperdine giving me a strong clinical foundation, they were also instrumental in helping me develop a deeper understanding of who I was as a therapist and how I wanted to show up for my clients.. Most of my professors—if not all of them—were leaders in their communities and within the mental health field. That’s a big reason why I went with Pepperdine. I had researched the people who were teaching, and I saw how involved they were in their communities and within the mental health space. Many were running their own group and private practices, nonprofit agencies, and consulting firms, while others were spearheading meaningful community mental health work.

We weren’t only learning clinical theory in the classroom. We were also learning from their real-world clinical experiences, which made the education feel a lot more relatable, grounded, and practical. I also really appreciated how accessible the professors were. So many professors generously offered guidance, advice, and informational interviews. Given the depth of their experience and knowledge, that kind of access is such a gift.”

Gilbert’s natural curiosity about people, relationships, and the environments that shape behavior was a big factor in choosing Marriage and Family Therapy over other counseling areas. It was a route that helped her to contextualize her curiosity about people and use it to understand her clients better.

Gilbert: “I chose the MFT route because I have always been naturally curious about people within the context of their relationships, cultures, upbringing, their families, and larger systems in general. I’ve always been drawn to the way people are shaped by the many intersections of their environments. It helps me understand not only what my clients are struggling with, but also the relational, cultural, and emotional contexts that have impacted how my clients came to carry what they’re carrying. It allows me to go a little bit deeper in understanding my clients.”

Gilbert chose private practice to build a meaningful career, with the flexibility she needed in her life as a wife, mom of two, and an active member of her community—on her own terms.

Gilbert: “I always knew that private practice was the long-term goal because I wanted and needed flexibility to build a career that felt both clinically meaningful and sustainable. I wanted to shape my work around the areas and populations I felt most called to support, while also creating a schedule that could sustain my life as a wife, busy mother, daughter, sister, friend, community member, and more. There are other commitments I have outside of being a therapist, and it was important for me to remain committed to them as well. Private practice gives me the stability and balance to be able to do both.”

Even though the early stages of being a counselor can be challenging, for Gilbert, seeing her clients progress in understanding themselves and the versatility of her MFT degree are a few benefits that aren’t discussed as often.

Gilbert: “One benefit that is not always discussed, but kind of quietly understood, is how meaningful it is to witness people become more connected to themselves and to the people they love. Sometimes the work is not about this dramatic breakthrough, and it’s more of a slower process as someone starts softening toward themselves. Sometimes, it’s someone understanding their patterns better, communicating differently for the first time, or feeling less alone or finally understood in something they’ve been carrying for a really long time. It’s a privilege to witness that growth in a way that may not be so obvious.

Another benefit is the versatility of the degree. I didn’t know this until I was at Pepperdine, as I saw my professors working in various places, but you can work in private practice, community mental health, schools, hospitals, agencies, consulting firms, and so much more. You can work across so many different clinical areas and populations. I’ve spoken to a lot of professors and veterans in the field, and they talk about the flexibility and how their careers have evolved. Knowing that helps to keep the work interesting and meaningful, while mitigating burnout.”

Gilbert: “It can be challenging for early-career clinicians, often managing high caseloads, financial uncertainty, and the long road to licensure. It requires a lot of humility, and you are constantly learning and reflecting on your own reactions and limitations. It’s hard work, which is why it’s so important to be clear on why you’re doing this.”

Gilbert organizes her weekday schedule into two parts: client sessions and business building. On weekends, she sees clients on an ad hoc basis.

Gilbert: “I try to structure my business in a way that allows me to be clinically present and not to be overloaded with everything that needs to be done. One way this worked for me was prioritizing my clients and the work I needed to do to support them during the first half of the week, while the kids are in school. From Monday through Wednesday, I may see five to six clients per day and normally have 15–20 people in my caseload.

If I have six clients in one day, I try not to do more than three clients back-to-back to protect my emotional energy and to recharge in between.

Gilbert: Thursdays and Fridays are dedicated to building and growing my practice, which might include marketing, being a guest speaker, connecting with my referral network, pursuing advanced training, or volunteering with nonprofit organizations. I serve on the Board of Directors for Maternal Mental Health NOW and facilitate a support group for postpartum moms through Postpartum Support International. The community work is especially meaningful to me because it keeps me connected to the broader mental health landscape and informed about the needs and gaps that still exist. I notice when I break it up into those blocks, I’m able to be more focused and intentional with my work.”

Gilbert: “I’m very protective of my time, and try not to have work compete with my husband, family, or commitments outside of work. But when my schedule permits, I will try to see a few clients on Saturday or Sunday mornings, as I don’t do late afternoons or evenings. This can help accommodate clients who work full-time, but I’m cognizant of only doing it if I have the availability already.

Gilbert acknowledges that setting boundaries can be a little difficult in the beginning, but being clear upfront on your availability can help set the expectation.

Gilbert: I know it can be difficult to hold boundaries around your schedule, especially when you need the hours or are early in your career as a clinician. There can be a lot of pressure to accommodate when clients are available, even when those times don’t work particularly well for you. But I learned pretty quickly that when I worked during times that competed with other commitments, I was more likely to feel burned out or resentful—and ultimately, that wasn’t serving myself or my clients.

What helped was being very clear upfront about when I see clients. Of course, there are one-offs, and I’m willing to be flexible when it makes sense, but I try not to let the exception become the norm.

It wasn’t always easy, but there are a lot of clients looking for support, and it is absolutely possible to complete your pre-licensure hours in a timely way while still honoring the schedule that works for you. I was able to finish my pre-licensure hours in less than two years post-graduation. The trade-off is that you may not always get to work with your ideal population or clinical specialty right away—and I actually think that can be a good thing. Practicum and associateship are some of the best opportunities you’ll have to stretch yourself, work with different populations, and gain experience across a range of clinical issues.

Self-care for Gilbert goes beyond words—she actively protects her schedule, checks in with fellow therapists for support, and stays connected to her life outside of being a therapist.

Gilbert: “Self-care, especially in this field, has to be more than a nice idea. It has to be built into the structure of the work, and that’s how I think about it. For me, that means being mindful of my boundaries around my availability, checking in with myself, and noticing when I’m overwhelmed or overextending myself. I also seek my own therapy and make sure I have that support frequently. A group of my close colleagues and I formed a therapist circle where we’re able to support each other in the work that we do. It’s been such a nice lifeline and emotional support, because the work can get really heavy at times.

It also means staying connected to my life outside of being a therapist. I try to stay grounded in the things that help me feel like myself, like being with my family and my friends, recharging, and doing activities that I enjoy. I’ve been trying to learn pickleball with my family and cousins, and although I don’t have a green thumb, I’ve been really into flower arranging with my girlfriends. These have also been great grounding exercises, and things I wouldn’t necessarily have considered on my own. It’s reminded me of how important it is to make room for new experiences and the parts of myself that exist outside of work.”

Honing in on your “why” is important to remember during the more challenging parts of a career in Marriage and Family Therapy. Staying open to evolving and the possibility of change is also a necessary part of being a therapist, according to Gilbert.

Gilbert: “Really reflect on why you are drawn to this work, because that ‘why’ will carry you through the harder parts of this path. It is worth taking some time to really think about it, as it becomes the anchor you come back to when the work gets challenging or asks more of you than you expected.

This is also one of those versatile fields that can continue to evolve as you evolve. You can continually stretch yourself within this work and explore different populations, clinical areas, and work settings, which I think really helps in terms of keeping things engaging and interesting.”

Created by the online Master of Arts in Clinical Psychology program from Pepperdine Graduate School of Education and Psychology.