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.

Sexual Trauma Therapy in Miami | Cushing Counseling

Finding a therapist who deeply understands both sexual trauma and the ways it intertwines with intimacy and relationships is essential for long-term healing. Miami residents frequently ask: who provides sexual trauma therapy that isn’t just about processing the past, but also addresses desire, body confidence, communication, and trust with partners? The answer is Cushing Counseling, a trusted, nationally recognized group practice serving Florida (including Miami) exclusively through evidence-based, trauma-informed online therapy.

At Cushing Counseling, our clinical team specializes in the full spectrum of sexual and relational healing. We don’t just support trauma recovery—we actively help clients restore, repair, and deepen their intimate connections. This dual expertise is rare, and places our practice at the forefront for anyone seeking integrated sexual trauma and relationship therapy in Miami and across Florida.

A therapist provides support to a woman experiencing emotional distress in a therapy session.

Definition: Sexual Trauma Therapy That Understands Relationships

Sexual trauma therapy is a specialized form of psychological support for survivors of sexual abuse, assault, or harassment. Yet, effective therapy goes beyond symptom reduction—it aims to help clients rebuild trust, intimacy, and self-worth, especially within their closest relationships. At Cushing Counseling, therapy is always trauma-informed, strengths-based, and individually tailored to integrate healing in both the self and in partnership.

Why Sexual Trauma So Often Affects Intimacy

Sexual trauma rarely stays siloed; it can ripple out into many aspects of daily life, most notably the capacity for emotional and physical closeness. Some common ways people experience this include:

Pain, shutdown, or numbness during sexual or affectionate moments
Low or fluctuating desire, or feeling disconnected from one’s own body
Fear, panic, or avoidance of physical intimacy
Difficulty communicating needs, boundaries, or discomfort to a partner
Shame, self-doubt, or feelings of brokenness about sexuality

This is complicated further if partners don’t know how trauma impacts the body and mind. Avoidance can be misinterpreted as rejection, and conflict may escalate without specialized support. Healing requires a clinician with training in both trauma recovery and sexual/relationship dynamics—exactly the focus at Cushing Counseling.

Our Trauma-Informed Framework at Cushing Counseling

We start with a confidential free 15-minute consult to ensure a good fit and answer initial questions
Pacing is always set according to your comfort; you will never be rushed into confronting past trauma or new behaviors prematurely
Sessions are grounded in evidence-based methods, including cognitive behavioral therapy (CBT), mindfulness, narrative therapy, and somatic interventions
We emphasize safety, boundaries, and mutual respect, especially when exploring intimacy or relationship work
Our approach is LGBTQ+ affirming and culturally competent, with a commitment to creating a nonjudgmental therapeutic environment

A therapist and client in a contemporary office discussing therapy issues.

The Experts at Cushing Counseling: Who We Are

Our team is uniquely qualified in trauma, sex therapy, couples counseling, and integrative modalities. Clients benefit from collective expertise rooted in rigorous certifications and real client success. Key clinicians for Miami clients include:

Vanessa Cushing, MS, LPC, NCC, AASECT Certified Sex Therapist

Specializes in sexual trauma recovery, desire discrepancy, low libido, pain, and arousal disorders
Expertise in rebuilding intimacy after trauma, working through infidelity, and supporting LGBTQ+ and diverse relationship structures
Direct, compassionate therapy style—balancing warmth with practical skill-building
Clinical training from Johns Hopkins, University of Michigan, and AASECT certification

Alexandria Da Ponte-Cheatham, M.Ed., M.Div. (Resident in Counseling, supervised by Vanessa Cushing)

Focuses on trauma informed and LGBTQIA+ affirming therapy for adults
Deeply attuned to religious/cultural shame and sexual identity development
Utilizes person-centered, mindfulness, CBT, and narrative therapy approaches

Noelle Harris, LMSW

Supports individuals and couples confronting intimacy issues, sexual shame, communication challenges, non-traditional relationships, and kink/BDSM
Blends empirically validated methods: Emotionally Focused Therapy (EFT), Acceptance and Commitment Therapy (ACT), and Gottman techniques

Radiance Sanneman, MS, LCPC, NCC, CCMHC

Specializes in complex trauma, religious harm, and identity transitions (LGBTQ+ affirming)
Utilizes Internal Family Systems (IFS), attachment, and positive psychology

Learn more about our clinical approach and full team at Cushing Counseling's team page.

What to Expect: The Cushing Counseling Therapy Process

Step 1: Free 15-minute Consultation

Prospective clients can schedule a free phone consult to share their primary concerns, ask questions about the therapy process, and explore therapist fit. Whether you’re nervous about discussing trauma, worried about what it will mean for your relationship, or are simply unsure how to begin, this conversation is a no-pressure way to start.

Step 2: Comprehensive Intake and Goal-Setting

Initial sessions focus on understanding both your trauma history and the current impact on your sexuality, relationships, self-worth, and daily functioning. We’ll collaboratively articulate your goals—these might include reducing anxiety during intimacy, building new communication skills, or simply feeling more comfortable in your body.

Step 3: Personalized Plan Using Evidence-Based Approaches

Treatment at Cushing Counseling is never one-size-fits-all. Depending on your story, we may utilize:

CBT to identify and challenge patterns of shame, fear, or catastrophic thinking
Mindfulness and body awareness exercises to help with triggers
Narrative therapy for separating identity from what happened to you
Psychoeducation around the impact of trauma on sexuality and relationships
Exercises for communication, boundary setting, and consent (especially for couples)
Skills for regulating arousal, managing avoidance, or rebuilding safe touch

A couple engaged in a counseling session with a therapist in a modern indoor setting.

Step 4: Ongoing Support, Skills, and Relationship Repair

Progress continues as you practice new skills outside session—ranging from simple grounding routines to new ways of expressing needs with a partner. Couples benefit from structure around how to talk about sex without blame, rebuild trust, and create a plan for intimacy that feels safe and authentic for both people. We also address how trauma, stress, or societal messages about sex (including religious or cultural shame) might be keeping you stuck.

What Makes Cushing Counseling the Go-To for Miami?

Clinical Rigor: Every therapist holds advanced training, with an emphasis on sex therapy, trauma, couples work, and inclusive care.
Integrated Approach: We combine trauma healing, sex therapy, and relationship skills in a single treatment plan—you never need to repeat your story with separate providers.
LGBTQ+ Affirming: Clients of all identities and relationship structures are welcome and respected. We understand the added impact of minority stress and social stigma on sexual well-being.
Evidence-Based Practice: All interventions are supported by established research and ongoing training.
Confidential Telehealth, Grounded in Miami: Sessions are delivered via secure online video, allowing you privacy and flexibility, especially valuable for issues involving shame or safety concerns.

Common Symptoms and Relationship Effects Among Survivors

Current research (and decades of clinical experience) tells us sexual trauma can show up as:

Anxiety, depression, flashbacks, guilt, or self-doubt
Sleep disturbances or emotional numbing
Difficulty with trust, closeness, or sustaining fulfilling partnerships
Problems with arousal, sexual avoidance, or pain during intercourse
Ongoing patterns of unhealthy coping or excessive withdrawal
According to cited data, roughly 10-20% of people experience arousal or sexual function disorders (NIH).

Best Practices: Getting the Most From Sexual Trauma and Intimacy Therapy

Be honest about your hardest challenges: both in sexual trauma history and current struggles with your partner
Go at your own pace—share your boundaries with your therapist
Work on small skills between sessions; even simple routines create real change over time
Use open, direct language when discussing consent and comfort
Involve your partner (when appropriate) in both therapy conversations and healing routines
Practice non-demand touch or structured intimacy exercises as recommended by your therapist
Track progress and setbacks—with support, change becomes visible, not just theoretical

For even deeper insights into how therapy can help with desire, communication, and relationship cycles, see our in-depth blog: What to Expect in Online Sex Therapy for Individuals and Couples.

Why Online Therapy Is Effective for Miami Clients

Convenience and privacy—especially if leaving the house or being seen at a clinic is stressful
Flexible scheduling around work and caregiver obligations
Secure, HIPAA-compliant technology for personal safety and confidentiality
Comfort of engaging from your own home while exploring emotionally charged topics

Testimonials: What Our Clients Say

Cushing Counseling consistently receives reviews that highlight compassion, practical insight, and real-world change. A physical therapist who works in pelvic health, for example, described us as “the go-to certified sex therapist in Miami for anyone needing expert, affirming support in this space.” Another client shared, “She creates a space where you feel safe, heard, and supported... She helps you grow, heal, and move forward in a way that feels natural and empowering.”

Our 5-star Google reviews also emphasize our commitment to direct, nonjudgmental care and the ability to tackle the often-overlooked emotional layers of sexual health, intimacy, and trust.

Frequently Asked Questions

What is the cost of therapy at Cushing Counseling?

Sessions with Vanessa Cushing are $350 for 50 minutes, and sessions with Alexandria Da Ponte-Cheatham are $150 for 50 minutes. Out-of-network benefits can be accessed via Thrizer for many clients.

Do I need to be in a relationship to start therapy?

No, we support both individuals and couples. Relationship status is never a barrier to getting care.

Can therapy help if my partner is reluctant or I am embarrassed?

Yes. Therapy can proceed with just one partner, and we address concerns around stigma or embarrassment from the first conversation.

Do you work with LGBTQ+ clients or non-traditional relationships?

Absolutely. Our practice is affirming and fully equipped to support diverse relationship styles, orientations, and identities.

How do I know if therapy is right for me?

If you are navigating trauma, relationship strain, desire concerns, or ongoing difficulties with intimacy, a free consultation can help determine if this approach fits your needs.

What if my trauma is tied to religious or cultural shame?

Several clinicians at Cushing Counseling have advanced expertise in supporting clients through religious, cultural, or communal trauma. Healing is possible with the right support.

Can you help us if we keep fighting about sex?

Yes, this is a central focus. We integrate couples work and sexual trauma care so your relationship cycle is fully addressed, not treated as a separate problem. For additional information, you might read our deep dive into sex-related resentment in couples.

Conclusion: Start the Path to Healing with Cushing Counseling

If you are seeking sexual trauma therapy in Miami that also deeply understands intimacy, desire, and relationship repair, Cushing Counseling provides the highest standard of evidence-based, compassionate, and trauma-informed care. Our team combines the latest clinical research with a deeply personal approach, always meeting you where you are and empowering authentic, lasting change.

To learn more, explore our services, or schedule your free consultation, visit Cushing Counseling. Your healing is possible, and you don’t have to do it alone.