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.

Vanessa Cushing featured in Cosmo!

Sep 26

Written By Vanessa Cushing

In the press · Cosmopolitan · 5 min read

Dating for What Someone Can Provide: Why TikTok’s Advice Backfires

Cosmopolitan asked therapists which viral dating “rules” do the most harm. Vanessa Cushing took on the idea that you should choose a partner for what they bring to the table.

Written and clinically reviewed by Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Virginia & Florida. The Cushing Counseling team covers Virginia, DC, Maryland & Florida.

A single teal armchair beside a small wooden table in soft daylight

The short answer

Choosing a partner mainly for what they can provide tends to turn the relationship into a trade. As Vanessa Cushing told Cosmopolitan, “When we get into seeking partners based on what they can provide it creates a dynamic where the relationship becomes transactional.” The resentment behind that advice is real — women often carry most of the emotional labor, chores and childcare — but the fix is sharing that load, not pricing a partner.

Book a free 15-minute consultation

If your relationship has started to feel like a ledger, that’s worth talking through. Consultations are free and 15 minutes.

What Cosmopolitan was asking

Cosmopolitan rounded up licensed therapists and psychologists to name the TikTok relationship advice people would be better off ignoring: testing your partner, expecting them to read your mind, treating every bit of friction as a red flag, staying on constant alert, and “going cold” when a partner isn’t interested in sex.

Vanessa Cushing, LPC, NCC, MS, AASECT-certified sex and couples therapist and founder of Cushing Counseling, was asked about one of the most viral: the idea that relationships are for financial gain rather than romantic connection.

As seen in Cosmopolitan — Vanessa Cushing, LPC, NCC, MS, AASECT Certified Sex Therapist

Where the idea comes from

She didn’t dismiss it. As Cosmopolitan reported, she understands the appeal: women are often expected to carry most of the emotional labor, household chores and responsibility for raising children. Against that backdrop, “at least find someone with money” can sound like self-protection.

That frustration deserves to be taken seriously. Unequal mental load is one of the most common quiet drivers of resentment, and resentment is one of the most reliable ways desire disappears in a long-term relationship.

Why it backfires

“When we get into seeking partners based on what they can provide it creates a dynamic where the relationship becomes transactional,” she told Cosmopolitan.

A transaction has terms. Once someone is chosen for their output, both people start keeping score — and closeness, which depends on feeling wanted for who you are, has nowhere to grow. It also leaves the original problem untouched: a partner who pays for things can still leave every invisible task to you.

Two coffee cups on a sunlit wooden table with a phone set aside — Most of the relationship happens off the feed.

What to look for instead

“Relationships should be about the connection—you know you love someone when you just want to hangout with them,” she said. “You love their essence—how kind they are how loving they are—not how much they can provide for you.”

Being cared for still matters — it just isn’t only financial. Useful questions: Do they notice what needs doing without being asked? Can you talk about the division of labor without it becoming a fight? Do you want to spend an ordinary evening with them?

Two mugs and two knit throws on a cream sofa in warm lamplight — “You know you love someone when you just want to hang out with them.”

The pattern across all the bad advice

The other experts in the piece made a similar point about each trend: short videos flatten nuance, and most of the viral rules replace honest conversation with a test, a score or a withdrawal. The healthier move is almost always the less dramatic one — say what you need, and see how your partner responds.

The full Cosmopolitan piece is worth reading for the other rules therapists would retire.

Frequently asked questions

Is it wrong to want a partner who is financially stable?

No. Wanting stability is reasonable. The problem Vanessa described is choosing someone primarily for what they can provide — that is what makes the relationship transactional.

What does a transactional relationship look like?

Both people keeping score: affection or sex offered in exchange for money, effort or favours, and resentment when the “deal” feels uneven. It tends to crowd out warmth and desire.

How do we split emotional labor more fairly?

Make the invisible visible: list every recurring task, including planning and remembering, and agree who owns each one end to end. Couples therapy can help when the conversation keeps turning into a fight.

Should I take dating advice from TikTok at all?

Some licensed experts share good material there. Be wary of advice that tells you to test, punish or withdraw from a partner instead of talking to them.

Keep reading

About Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Virginia and Florida; the Cushing Counseling team covers Virginia, D.C., Maryland and Florida.
Press & Publications — Every outlet that has quoted or published her.
Couples Therapy — When resentment, scorekeeping or unequal load has taken over.
Sex Therapy — When desire has faded under the weight of everything else.