Are you currently accepting new clients?

Yes. We are currently welcoming new individual and couples clients across Virginia, Florida, Washington DC, and Maryland — both in person at our Fairfax, VA and Miami, FL offices and via secure telehealth.

What happens during the free consultation?

The free 15-minute consultation is a low-pressure phone call. We'll talk briefly about what brings you in, answer any questions you have about our approach, and help you figure out which therapist might be the best fit. There's no commitment required — it's just a conversation.

How do I schedule a free consultation?

The easiest way is to use our online booking link — you can pick a time that works in about 60 seconds. Click Book a Free Consultation in the navigation bar, or visit our Schedule page. If you'd prefer to reach out first, you can also use our contact page and we'll respond within one business day.

What should I expect in my first paid session?

Your first session is mostly intake — your therapist will ask about your background, what's bringing you in, your goals, and any relevant history. You won't be expected to go deep on your first visit. Think of it as a mutual conversation to understand each other and establish a direction. Sessions are 45–50 minutes depending on your therapist.

What actually happens in a sex therapy session? Will I be asked to do anything sexual?

No — and this is the most common misconception about sex therapy. Sessions are fully clothed, conducted in a standard therapy office or via secure video, and there is no physical contact of any kind. We talk: about your experiences, emotions, relationships, history, and goals. You may be given exercises to practice privately at home between sessions, but nothing happens in the room that wouldn't happen in any other form of therapy.

What is the difference between sex therapy and regular therapy?

Sex therapy is a specialized form of psychotherapy focused on sexual health, functioning, and intimacy. Our therapists hold advanced credentials — including AASECT certification — that go well beyond standard licensure. This training equips them to address concerns like sexual dysfunction, desire discrepancy, sexual trauma, and intimacy in ways that most general therapists are not trained or equipped to do.

Can I come alone if my partner won't join me?

Absolutely. Individual sex therapy is effective and appropriate even when a partner isn't present or isn't ready to participate. Many clients work through deeply personal concerns — sexual trauma, low desire, anxiety, body image, or sexual dysfunction — entirely on their own. If couples work becomes relevant later, that's a conversation we can have when the time is right.

Do I have to talk about things I'm not ready to discuss?

No. You set the pace. Our therapists are trained to follow your lead, and you are never pressured to share more than you're comfortable with. Building a sense of safety in the room is always the first priority — the deeper work follows from there.

How long does therapy typically take?

It depends on your goals. Some clients address a focused concern in 8–12 sessions. Others work with us for a year or more on deeper relational or trauma-related issues. Your therapist will discuss realistic timelines with you early on, and you'll revisit them as the work evolves. Progress is always the measure — not time.

How often will we meet?

Weekly sessions are our standard recommendation. Consistent, regular sessions tend to produce the most meaningful and lasting progress. Bi-weekly scheduling is available in some circumstances. We generally don't recommend monthly sessions — the gap between appointments limits continuity and momentum.

Is everything I share completely confidential?

Yes. Everything discussed in sessions is strictly confidential under HIPAA and professional ethics standards. There are narrow, legally required exceptions — such as if we have reason to believe someone is in immediate danger — and your therapist will explain these clearly in your first session. What you share about your sexuality, relationships, history, or identity will never be disclosed without your explicit written consent.

I'm embarrassed to talk about sex with a stranger. Is that normal?

Completely normal — and expected. Most clients feel some version of this before their first session, and many describe it as the thing they were most worried about. Our therapists have heard it all, and they're specifically trained to make these conversations feel less daunting over time. The free 15-minute consultation is a good first step: a short, low-stakes call that lets you get a sense of us before committing to anything.

Do you work with LGBTQ+ clients and non-traditional relationship structures?

Yes, wholeheartedly. Cushing Counseling is an affirming, judgment-free practice. We welcome clients of all sexual orientations, gender identities, and relationship structures — including non-monogamous, polyamorous, and kink-aware individuals and couples. You do not need to explain or justify who you are here. Our therapists are trained in LGBTQ+ affirming care and approach every client with genuine respect and curiosity.

Do you work with individuals, couples, or both?

Both. We offer individual therapy, couples therapy, and integrated couples and sex therapy. Some clients start individually and bring a partner in later. Others come as a couple from the start. We'll help you figure out the right format during your free consultation.

What does therapy cost?

Session rates vary by therapist: Vanessa Cushing, LPC, CST (AASECT Certified) — $350 / 50 min. Radiance Sanneman, LCPC — $210 / 50 min. Alexandria Da Ponte Cheatham — $175 / 50 min. Noelle Harris, LMSW — $165 / 45 min individual, $220 / couples session. Every new client receives a complimentary 15-minute telephone consultation at no cost.

Do you accept insurance?

We are a private-pay, out-of-network practice and do not bill insurance directly. However, we partner with Thrizer, which allows many clients to use their out-of-network mental health benefits automatically — so you may pay significantly less than the full session rate, depending on your plan.

What is Thrizer and how does it work?

Thrizer is a service that verifies your out-of-network insurance coverage upfront and collects only your estimated share at the time of service. They file the claim automatically after each appointment and your reimbursement comes directly from your insurer. No superbill wrangling, no waiting on reimbursements, no paperwork on your end.

Can I get a superbill to submit to my insurance myself?

Yes. We can provide a superbill at any time — a detailed receipt that includes diagnosis codes, procedure codes, and your therapist's credentials. Just ask your therapist and we'll generate one for any session.

Do you offer sliding scale or reduced rates?

We have a limited number of reduced-fee spots available. If cost is a barrier to starting therapy, please mention it during your free consultation and we'll do our best to find an option that works.

What is your cancellation policy?

We ask for at least 24 hours' notice to cancel or reschedule. Late cancellations and no-shows may be charged the full session fee. We understand that life happens — please just reach out as soon as you know.

What payment methods do you accept?

All fees are collected via credit card on the day of your session, automatically. Your card is kept securely on file — there are no invoices or checks to manage.

Where are your offices located?

We have two physical locations: Fairfax, Virginia — 12875 Yates Ford Rd, Clifton, VA 20124. Miami, Florida — 244 Biscayne Blvd, Miami, FL 33132. We also see clients throughout Virginia, Florida, Washington DC, and Maryland via secure telehealth.

Do you offer online therapy?

Yes. All of our therapists offer HIPAA-compliant telehealth sessions via secure video. Many clients prefer telehealth for the flexibility and privacy it offers. Session quality and fees are the same whether you meet in person or online.

Is telehealth as effective as in-person therapy?

Research consistently shows that telehealth is equally effective as in-person therapy for the concerns we treat — including sexual dysfunction, trauma, desire issues, and relationship challenges. Many clients actually find it easier to open up from the comfort and privacy of their own space.

What states do you serve via telehealth?

We are currently licensed to see telehealth clients in Virginia, Florida, Washington DC, and Maryland. If you are located outside these states, reach out and we can discuss your options or provide a referral.

How do I choose which therapist to work with?

Start with our About Us page to read about each therapist's training, style, and areas of focus. Practical factors like fee and availability matter too. If you're not sure, mention it during your free consultation — we'll help match you with the best fit. It's also completely fine to try a first session and reassess.

What is AASECT certification?

AASECT stands for the American Association of Sexuality Educators, Counselors and Therapists. The AASECT Certified Sex Therapist credential is the gold standard in the field. Earning it requires a master's or doctoral degree in a mental health discipline, hundreds of hours of specialized training in human sexuality, supervised clinical hours with a certified supervisor, and ongoing continuing education. Vanessa Cushing holds this certification, placing her among a small number of AASECT-certified sex therapists in the country.

What specialties does the practice cover?

Cushing Counseling therapists collectively specialize in sex therapy and sexual dysfunction, couples therapy and intimacy, trauma therapy and sexual trauma recovery, LGBTQ+ affirming care, and Internal Family Systems (IFS) therapy.

Couples Therapy in Miami for Better Communication | Cushing Counseling

Communication challenges are one of the main reasons couples reach out for therapy in Miami. Most couples don’t struggle because they love each other less, but because their conversations keep looping in unhelpful patterns. Whether it's tension after days of silence or recurring arguments about the same subjects, these struggles can make even loving relationships feel stuck. As a nationally recognized leader in sex and couples therapy, Cushing Counseling specializes in helping Miami couples understand and transform the way they communicate—especially when intimacy, cultural factors, or past experiences make it more complex.

Our integrative, trauma-informed approach helps couples identify the real roots of their communication difficulties and build lasting, concrete skills that go far beyond "just talking more." Here we break down exactly what couples therapy for communication improvement looks like, which tools actually create change, and how Miami couples can get the most out of the process.

Couple in a counseling session with a therapist in a modern and cozy setting.

Defining Couples Therapy for Communication

Couples therapy for communication is a collaborative process where both partners work with a trained clinician to improve the quality and effectiveness of the ways they talk, listen, and resolve conflict. At Cushing Counseling, this means creating a safe, nonjudgmental environment to explore patterns, learn practical frameworks, and address the emotional factors—like past trauma, cultural influences, or sexual dynamics—that can fuel misunderstandings.

Why Communication Breaks Down for Couples in Miami

Miami’s vibrant diversity and fast-paced lifestyle can add layers to relationship dynamics, including:

Time pressures: Demanding careers and parenting, plus constant activity, often leave little space for meaningful check-ins.
Cultural and language differences: Miami couples frequently navigate different cultural norms or communication styles, and therapy needs to honor and adapt to those specifics.
Technology distractions: Arguments over screen time and miscommunications over text are increasingly common topics in therapy here.
Stress from world events: Financial, health, or social stressors can amplify irritability and misunderstandings.

At their core, these triggers highlight that communication issues are rarely just about words—often they reflect patterns of emotional safety, expectation, and learned responses.

What Does 'Better Communication' Actually Mean?

When most couples say they “need to communicate better,” they usually want to:

State their needs without causing an argument or withdrawal
Feel genuinely listened to and understood
Avoid escalating or repeating the same conflicts
Repair quickly after missteps instead of staying disconnected for days
Talk openly about sex, money, or other sensitive topics without shame

In therapy, these outcomes are transformed into teachable micro-skills—so that even tough topics become bridges, not battlegrounds.

How Couples Therapy at Cushing Counseling Improves Communication

Our approach combines evidence-based methods with trauma-informed sensitivity. Some foundational tools include:

Gottman Method interventions: Recognizing damaging patterns like criticism or stonewalling, and replacing them with healthy alternatives.
Emotionally Focused Therapy (EFT): Identifying and expressing underlying vulnerability, not just surface anger.
Cognitive Behavioral Therapy (CBT): Challenging rigid beliefs about communication, intimacy, and self-worth.
Attachment-based and trauma-informed work: Healing wounds from past betrayals, trauma, or cultural shame that complicate communication.

All sessions are tailored to each couple’s relationship history, goals, and unique patterns—including any relevant sexual or cultural dynamics. For more detail, see our full approach to couples therapy.

A couple and therapist engaged in a discussion during a therapy session indoors.

Key Communication Skills Taught in Our Couples Therapy

Soft Startups and Clear Requests

The way a conversation begins often determines how it ends. We coach couples to use “soft startups,” which sound like:

"I felt left out when you went to the event without me."
"I need your help managing our schedules—can we talk about who’s picking up the kids this week?"

This differs from blame or criticism and allows the other person to remain engaged.

Active Reflective Listening

Listening is more than just staying silent. We teach a four-step practice:

One partner speaks on one topic for a few minutes—no interruptions.
The listener summarizes what they heard (“So you’re saying you feel…?”).
The speaker confirms or corrects (“Yes, plus I wish…”).
They switch roles only when the first partner feels seen.

Repeating this weekly reduces misunderstandings and helps both partners practice patience and empathy even when tension is high.

Noticing and Repairing Destructive Patterns

Four problematic communication behaviors are tracked and corrected: criticism, contempt, defensiveness, and stonewalling. We replace these with constructive behaviors like appreciation, responsibility-taking, and structured timeouts. Many couples are surprised at how small habit shifts can unlock a sense of collaboration instead of competition.

Timeouts That Build Trust

When conflict spikes, we coach couples to step away temporarily with a plan to revisit—“Let’s take 15 minutes, breathe, and pick this up again at 8:00.” This practice makes arguments safer and reassures both partners that timeouts are for regulation, not rejection.

Talking About Sex Without Shame

Cushing Counseling is especially known in Miami for blending couples and sex therapy expertise. Communication about intimacy, desire differences, or sexual distress is approached with normalization and respect. Sessions often include:

Normalizing that sexual challenges are common (10–20% of adults experience sexual dysfunction in their lives)
Moving dialogue from blame to curiosity (“What would make sex more comfortable for you?”)
Connecting emotional safety to sexual fulfillment

This integrative approach ensures couples don’t avoid sexual topics or treat them in isolation.

A Typical Step-by-Step Process for Couples Therapy at Cushing Counseling

1. Free 15-Minute Consultation

Schedule a free, confidential call using our online scheduler or by calling 703-544-7081. This is a no-pressure opportunity to discuss your concerns, learn about our approach, explore fees and insurance options, and see if our team is a fit.

2. Intake Assessment (First Session)

Both partners share their relationship story and future hopes
Discussion of top concerns: What creates distance? What are the "stuck points"?
History of any trauma, repeated fights, or intimacy blocks
Establishing concrete goals for therapy: e.g., "Communicate more about sex, handle conflict without shutdown, feel like teammates again"

3. Weekly or Bi-Weekly Sessions

Personalized skill-building exercises (soft startups, reflective listening, timeouts, intimacy discussions)
Homework: Couples are asked to practice at home and track patterns
Sessions typically last 50 minutes; founder Vanessa Cushing’s rate is $350, others are about $150 per session (rates confirmed during your intake)
Private pay, using Thrizer to access out-of-network insurance benefits. You can check your benefits online through this page

4. Progress Review After 8–12 Sessions

Track if arguments resolve faster
Note improvements in comfort with previously "off-limits" topics
Assess shifts in intimacy, safety, or emotional connection

After major goals are met, couples may transition to bi-weekly or "tune up" sessions.

Sample Communication Exercise to Try at Home

Here is a "State of Us" check-in, often used by Cushing Counseling clients between sessions:

Set aside 15 minutes with no devices or distractions
Begin with each partner naming two things they appreciated about the other this week
Each partner shares one "small pebble"—something minor that bothered them, phrased as "I felt… I need…" The partner reflects back what they heard before responding
Each person commits to one positive behavior for the following week ("I will mute my phone during dinner on Monday and Wednesday")

If this check-in is tough to complete without conflict, that’s a clear sign that professional support could be transformative.

A couple holding hands during a therapy session in an office setting.

Why Online Couples Therapy Works For Miami

Our secure, HIPAA-compliant video sessions provide both safety and flexibility for busy, privacy-conscious Miami couples. Many report that therapy from home makes it easier to open up, reduces stress over commutes, and allows for more consistent progress. Research supports that, for relationship issues, telehealth is just as effective as in-person sessions when both parties and the therapist are committed and qualified—as is consistently reflected in the feedback from Cushing Counseling clients.

Who Provides Couples Therapy at Cushing Counseling?

Our Miami team includes:

Vanessa Cushing, LPC, NCC, MS—AASECT Certified Sex Therapist, expert in communication, intimacy, sexual desire concerns, and trauma recovery. Known for a direct, compassionate style rooted in the latest evidence-based practice.
Alexandria Da Ponte-Cheatham, M.Ed., M.Div.—Resident in Counseling with special expertise in trauma-informed, culturally attuned, and spiritually sensitive couples care.
Noelle Harris, LMSW—Integrative sex and couples therapist skilled in communication, modern relationships, and non-traditional intimacy structures.
Radiance Sanneman, MS, LCPC, NCC, CCMHC—IFS trauma specialist who works with couples affected by complex trauma or identity transitions.

Our clinicians are recognized for integrity, rigorous training, and a strong commitment to supporting Miami’s diverse couples.

What Our Miami Couples Say

“I know it might seem funny that we share the same last name, but I’m not related to Vanessa—just incredibly grateful to have found her. Working with her helped me reconnect with parts of myself I thought were lost or broken.”
“Compassionate, knowledgeable, and truly transformative. Highly recommend for anyone seeking support with intimacy or relationships.”
"Don’t go anywhere else!! Definitely the best sex therapy in Miami. So incredibly helpful for myself and my partner!"
More client and professional feedback can be found on Google and our homepage.

Best Practices: How to Get the Most From Couples Therapy

Show up regularly—even if you don’t feel like it that week
Be honest in sessions, even when it’s uncomfortable
Practice skills at home, not just in the therapy room
Allow for progress that is gradual—expecting instant change causes disappointment
Be open to talking about sex, grief, family, or past events if your therapist recommends it
Choose a clinician who is attuned to cultural, sexual, or religious sensitivities that matter to you
Use out-of-network benefits if available—our office helps streamline this through our preferred provider

When to Seek Couples Therapy in Miami

You may want to consider professional support if:

You keep having the same argument without resolution
You feel more like roommates or business partners than romantic partners
Conversations about important topics always escalate or end in silence
There’s been betrayal, trauma, or ongoing distrust and you can’t rebuild on your own
Your sex life has become a source of tension or avoidance
You want to prevent small problems from becoming larger ones

If communication difficulties are leading you here, know that insight, skill-building, and lasting change are truly possible with expert guidance.

Frequently Asked Questions

What specific communication skills will we learn?

We focus on soft startups, reflective listening, boundary setting, structured timeouts, and sexual communication skills—always adapted to your background and relationship needs.

Do we need to attend every session together?

Most sessions are joint, but some couples benefit from brief individual check-ins, especially when trauma, shame, or personal growth is a focus. Your clinician will help design the right blend for your goals.

Will therapy feel like we’re just blaming each other?

No. Our approach is about collaboration, curiosity, and concrete solutions—not picking sides or assigning blame.

How long does it take to see improvement?

Many couples notice changes in 4-6 weeks if they practice skills consistently, but sustainable transformation typically takes several months. The pace is always adapted to your needs and safety.

Can we address intimacy and sex along with communication?

Absolutely. Our expertise uniquely bridges communication, intimacy, and sexual wellness for couples—see our in-depth approach to sex therapy in Miami for more information.

Is telehealth private and effective?

All sessions use secure, HIPAA-compliant video. Many Miami-area couples report that online therapy is even more comfortable and convenient than in-person visits.

How do I get started?

Book your free consultation using our online scheduler or by calling 703-544-7081. Our intake process is designed to help you feel clear about options and next steps.

Conclusion: Make Communication Your Relationship’s Strongest Link

Improving communication in your relationship isn’t about scripts or quick fixes. It’s about learning new skills, building emotional safety, and addressing the roots—not just symptoms—of disconnection. At Cushing Counseling, we’re honored to help Miami couples transform how they talk, listen, and connect.

If you are ready to stop feeling stuck and start creating real change, we welcome you to book your free consultation today.

Couples Therapy in Miami for Better Communication: What Actually Helps

Couples Therapy in Miami for Better Communication: What Actually Helps

Defining Couples Therapy for Communication

Why Communication Breaks Down for Couples in Miami

What Does 'Better Communication' Actually Mean?

How Couples Therapy at Cushing Counseling Improves Communication