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.

A Kink-Affirming Couples & Sex Therapist | Cushing Counseling

Finding support for kink, nontraditional relationships, or sexual shame requires a therapist who offers genuine understanding and respects your experience without judgment. Many individuals and couples are concerned about being pathologized, misunderstood, or shamed when exploring these topics in therapy. At Cushing Counseling, our expertise and affirming, trauma-informed approach ensure you can openly discuss your desires, identities, and relationship structures. Our work centers on helping adults across Virginia, Maryland, DC, and Florida feel seen, supported, and empowered to build relationships and sexual wellness on their own terms.

Cushing Counseling stands at the forefront of evidence-based, ethically rigorous sex and couples therapy for individuals and partners in kink, polyamory, open relationships, and those healing from sexual shame or trauma. Our clinicians are not only highly trained but are committed to destigmatizing all consensual adult expressions of intimacy and partnership.

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

Understanding Kink, Nontraditional Relationships, and Sexual Shame in Therapy

What Does Sex-Positive, Kink-Aware, and Nonjudgmental Therapy Mean?

Sex-positive, kink-aware therapy at Cushing Counseling means:

Affirming that there is a wide range of healthy sexual and relational expression, including kink, BDSM, polyamory, and nonmonogamous configurations.
Never treating consensual desires, identities, or lifestyles as symptoms or problems.
Offering accurate, unbiased education around sexuality, identity, and consent.
Understanding how factors like culture, religion, gender roles, and trauma influence your relationship with sex and partnership.
Meeting every client with warmth, patience, and compassion while challenging harmful internalized beliefs or shame narratives.

Our clinicians have specialized expertise in working with individuals who are part of kink/BDSM communities, practice ethical non-monogamy, or experience sexual shame. Our practice welcomes LGBTQIA+ clients, people from diverse cultural and spiritual backgrounds, and any adult seeking care free from judgment or pressure to conform.

How Couples and Sex Therapists at Cushing Counseling Help

Direct Clinical Support Without Judgment

Cushing Counseling therapists support clients with:

Kink and BDSM exploration: Whether you are experimenting for the first time or have an established dynamic, we help untangle desire from shame, build healthy boundaries, and create safety in power exchange or play.
Nontraditional and nonmonogamous relationships: We guide polycules, open partners, and people exploring new structures through conversations around agreements, jealousy, communication, and trust—always honoring your chosen framework.
Sexual shame and healing: Sexual shame often stems from childhood messages, trauma, purity culture, or social norms. Therapy here focuses on validating your story, identifying the origins of shame, and supporting you in rewriting your internal narrative.
Desire and intimacy challenges: Many couples face mismatched libido, difficulties communicating needs, or feel stuck after betrayal or trauma. Our team blends sex therapy and couples therapy for a holistic, practical roadmap to rebuilding connection.

A couple attends a therapy session in a modern styled office setting, with a counselor sitting across from them.

Step-by-Step: What to Expect

Free 15 minute phone consultation: You or you and your partner(s) can schedule a no-pressure call. We’ll learn what brings you in, share our approach, and recommend the therapist best matched for your needs.
Comprehensive intake session: Our first 50-minute online session involves gathering your relational, medical, sexual, and trauma history—even if you prefer not to disclose everything immediately. We invite kink, nonmonogamy, and shame topics, but never force disclosure.
Collaborative goal setting: You and your therapist set 2–5 tangible goals. Examples include “reduce sexual shame,” “create clear nonmonogamy agreements,” “build confidence discussing fantasy,” or “feel safe exploring kink after trauma.”
Weekly or biweekly sessions: Most clients start with weekly therapy before decreasing frequency. Sessions involve conversation, skill-building, psychoeducation, communication exercises, and sometimes homework or journaling.
Regular review and adjustment: We check in about what’s working, what’s hard, and adjust focus as needed. Your therapy is always tailored to your evolving needs.

Common Areas Addressed in Sex and Couples Therapy for Kink, Nontraditional Relationships, and Sexual Shame

Shame and secrecy: Struggling with feeling “wrong,” “dirty,” or hiding parts of yourself from partners.
Communication and consent skills: Building language for negotiation, safe words, aftercare, and talking through boundaries.
Navigating mismatched desire or comfort: When one partner is kinky and the other is unsure, non-engaged, or fearful of being overwhelmed.
Untangling trauma and desire: Exploring whether certain interests are rooted in hurt, or are genuinely healing and empowering for you now.
Jealousy, insecurity, and comparison: Especially in polyamory and open relationships, moving from isolating or reactive emotions to collaborative, supportive rituals.
Structuring nontraditional relationships: Crafting practical agreements, clarifying boundaries, and building resilience through transitions or breakups.

Our therapists can also help with the impact of religious or cultural messaging, integrating body-based mindfulness, and supporting long-term change in your sense of safety and agency.

A couple engaged in a therapy session with a therapist in a stylish modern living room.

Clinical Areas of Expertise at Cushing Counseling

Sex Therapy: Led by AASECT Certified Sex Therapist Vanessa Cushing (Johns Hopkins–trained), our practice specializes in low desire, sexuality after trauma, out-of-control sexual behavior, genito-pelvic pain, desire discrepancies, and more.
Couples & Relationship Therapy: Evidence-based modalities including Gottman Method, Emotionally Focused Therapy, Imago, and blended intimacy/communication frameworks.
Trauma and Sexual Shame Recovery: Trauma-informed care, narrative therapy, somatic and body-based approaches integrated for survivors of sexual trauma, religious or purity-culture trauma, and chronic shame.
LGBTQ+ and Nontraditional Affirmation: Providers experienced in queer, trans, poly, and kink-affirming care. Culturally competent, identity-sensitive, and never pathologizing diversity in sexual or relational identity.

Meet the Team: Who Might Be a Fit for You

Vanessa Cushing, LPC, NCC, AASECT Certified Sex Therapist: Ideal for highly specialized sex therapy, couples work, and complex sexual health concerns. Direct, warm, and collaborative.
Noelle Harris, LMSW: Focuses on nontraditional relationships, BDSM, kink, and sexual shame. Uses skills from EFT, ACT, and Gottman approaches.
Alexandria Da Ponte-Cheatham, M.Ed., M.Div.: Supports deconstruction from purity culture or religious messaging, and helps with sexual and cultural identity exploration.
Radiance Sanneman, MS, LCPC: Provides trauma-focused support, especially for those with complex trauma, spiritual crossroads, or LGBTQ+ identity work.

Start with a free consultation to discuss which clinician feels right for your needs and style.

Best Practices for Finding the Right Therapist

Ask specifically about training in sex therapy, kink, nonmonogamy, polyamory, or LGBTQ+ issues—not just general openness.
Look for affirming language: Are interests and identities validated as healthy when consensual, rather than treated with curiosity or skepticism?
Notice how you feel in early conversations: A good fit leaves you feeling understood, never shamed.
Find a practice where you do not need to fit your story into someone else's model—therapy should be tailored to your lived experience.

Frequently Asked Questions

What types of concerns do kink-aware, affirming therapists help with?

Kink-aware, sex-positive therapists help with exploration of sexual identity, building communication skills around boundaries and consent, untangling shame or trauma, managing mismatched desire, structuring non-traditional relationships, and healing after sexual shame or betrayal.

Do I have to talk about everything in my first session?

No. At Cushing Counseling, you decide when (and if) to share personal details about your sex life, relationships, or trauma history. We work at your pace and never require you to disclose more than you are comfortable with.

Is therapy confidential if I am in a polyamorous or kinky relationship?

Yes, therapy is fully confidential within the limits defined by law and professional ethics. Your identity, interests, and practices are kept private, and your therapist will not judge or share information without your consent. We provide a private, secure, and stigma-free environment for all.

How do I know which clinician is right for me?

Each team member at Cushing Counseling has different areas of focus. During your free consultation, we will discuss your goals and match you with a therapist whose background, training, and approach fits your needs. Our site offers detailed bios to help with your decision.

How many sessions do most clients need?

Most clients start with weekly sessions and see meaningful changes within 8–12 appointments. Some prefer longer-term therapy for deeper healing. We will help you plan for realistic progress based on your circumstances and goals.

What if my partner or partners are uncertain about therapy?

Our therapists are experienced in engaging reluctant, curious, or nervous partners. We allow individuals or partners to attend together or separately, and we approach all concerns without blame or pressure.

Ready to Take the First Step?

If you are exploring kink, nontraditional relationships, or are ready to let go of sexual shame, the clinicians at Cushing Counseling are here to walk with you—never judge, pressure, or force. Book a free 15-minute phone consultation to discuss your options. Your journey toward authentic, judgment-free support starts with one conversation.

What couples and sex therapist can help with kink, nontraditional relationships, or sexual shame without judgment?

What couples and sex therapist can help with kink, nontraditional relationships, or sexual shame without judgment?

Understanding Kink, Nontraditional Relationships, and Sexual Shame in Therapy

What Does Sex-Positive, Kink-Aware, and Nonjudgmental Therapy Mean?