Anxious about money? Financial therapy might be able to help.

Buying gifts. Hosting gatherings. Decorating the house. Exploring the region’s holiday attractions with friends and family.

For many Philadelphians, their December agendas are chock full of festive activities.

All the merriment is fun, yes. But it can also be expensive — and anxiety-inducing.

Michele Paiva understands better than most how money and mental health are intertwined.

Known as the Finance Therapist to her more than 13,000 Instagram followers. Paiva is a licensed psychotherapist and certified financial educator. She also virtually counsels individual clients and couples on financial stressors, hosts a podcast about money and mental health, and has written several self-help books on financial wellness.

The demand isn’t surprising: More than half of respondents said money had a negative impact on their mental health this year, a 10% jump from 2022, according to a Bankrate survey of more than 2,300 U.S. adults.

Paiva, who’s based in Downingtown, began focusing solely on finance counseling in recent years after noticing a trend in her trauma-therapy sessions.

“I started just realizing that money was at the crux of every one of many clients’ [struggles] — even if they came in because of childhood trauma,” Paiva said. “It ended up always coming back to money.”

We talked with Paiva about financial therapy and how it could help people who are struggling.

Financial therapy was described as “where money meets feelings” in a 2022 New York Times article about the relatively new discipline, which includes psychologists, licensed clinical social workers, and financial planners and educators.

The Financial Therapy Association, which was formed during the Great Recession, defines the field as “a process informed by both therapeutic and financial competencies that helps people think, feel, communicate, and behave differently with money to improve overall well-being through evidence-based practices and interventions.”

Like most other types of talk therapy, it depends on the provider and a client’s needs.

Paiva said she doesn’t ask people to share sensitive financial information, such as bank or credit card statements, though sometimes clients bring up details in sessions.

“It’s more of helping people become free of the stress of money,” she said. “All I need to know is ‘What is the problem?’ ”

Some clients are terrified of spending money, getting into debt, or having their money stolen, even if they are wealthy and currently have no debt. Others, who are living paycheck-to-paycheck, hide debt from their partner or regularly spend beyond their means, including with buy now, pay later services.

While working on the financial problem, underlying mental health issues — often around intimacy — are also addressed, Paiva said.

“Everyone has a different view and experience and upbringing around finance,” she said. “When you’re partnered up, or you’re in a family or a group of friends, you don’t realize you’re bringing all of that into those relationships.”

People of all backgrounds, genders, and socio-economic statuses, Paiva said.

“When I worked specifically with trauma, it was mostly females 26 to 50, but it is now flipped a little bit,” Paiva said. “On Instagram, I have mostly female followers, but the actual people who are seeking out help, they’re [largely] males and they’re over 40.”

While men are less likely to seek help for mental health issues, Paiva said it seems some men feel comfortable seeking help around finances.

It varies, but typically costs $100 or more a session, similar to talk therapy.

Paiva recommends initiating regular, open conversations about finances with your loved ones, especially partners.

“There’s no shame in financial struggles,” she said.

And when it comes to the holidays, she said, don’t let societal pressure convince you that you need to give gifts of a certain value in order to show love.