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 Trauma-Informed Sex Therapist for Couples | Cushing Counseling

If sexual trauma is interfering with your relationship, you are not alone, and you do not have to navigate this pain in silence. Many individuals and couples find that past or recent sexual trauma affects intimacy, communication, and overall closeness. The good news is, support from a trauma-informed sex therapist can help you break patterns of avoidance, reduce anxiety, and create a new sense of safety and connection at your pace. If you live in Virginia, Florida, Maryland, or Washington, DC, Cushing Counseling specializes in this precise intersection: sex therapy and trauma recovery, with a deeply evidence-based and inclusive approach.

Below, we outline exactly what trauma-informed sex therapy is, why it matters, how to know when it’s the right time to seek help, what to expect from the process, and how our expert clinicians at Cushing Counseling work with individuals and couples right where you are. Our goal is to offer clarity, direct answers, and immediate next steps for those who need help now.

What Is Trauma-Informed Sex Therapy?

Trauma-informed sex therapy is a specialized form of psychotherapy that integrates deep clinical understanding of both sexual wellness and trauma recovery. Unlike traditional talk therapy, which may focus more broadly on life events, trauma-informed sex therapy attends specifically to:

The ways trauma impacts your nervous system, thoughts, beliefs, relationships, and your body’s response in intimate moments
The unique challenges of sexual distress, avoidance, numbness, anxiety, shame, or painful intimacy that often follow trauma
Creating a safe, supportive, and predictable space to rebuild healthy desire, consent, and self-trust—at your own pace

At Cushing Counseling, trauma-informed sex therapy means you gain support from clinicians deeply trained in sex therapy, couples counseling, trauma frameworks (such as CBT, Internal Family Systems, somatic and mindfulness interventions), and an affirming view of all identities and relationship forms. We never rush clients into details before you are ready; safety, autonomy, and care lead every session.

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

How Sexual Trauma Shows Up in Relationships

Sexual trauma does not need to be recent to affect your relationship today. At Cushing Counseling, we often see how childhood abuse, young adult experiences, religious shame, or relationship betrayals echo into current partnerships. Key patterns include:

Shutting down or feeling numb during intimacy or sex
Avoidance of touch—even when you care about your partner
Flashbacks, panic, or body tension that arises from triggers
Saying "yes" when you want to say "no"—with resentment or guilt
Arguments over intimacy or boundaries that spiral quickly
A sense that you are "just roommates" emotionally and sexually

If these experiences feel familiar, a trauma-informed sex therapist—especially one with advanced training and ongoing supervision—can help you move toward insight and change while prioritizing your emotional (and physical) safety.

How to Identify a Trauma-Informed Sex Therapist

The intersection of trauma, sexuality, and relationships requires a therapist with specific expertise. Here’s what to look for:

1. Advanced Sex Therapy Credentials

Certification from the American Association of Sexuality Educators, Counselors and Therapists (AASECT), like founder Vanessa Cushing at Cushing Counseling
Formal graduate and post-graduate education in sex therapy, such as University of Michigan, Johns Hopkins, or similar programs
Ongoing advanced training and clinical supervision

2. Proven Trauma Frameworks

Competence in trauma-focused frameworks: Cognitive Behavioral Therapy (CBT), Internal Family Systems (IFS), EMDR, trauma-informed narrative and somatic approaches
Therapists who explicitly discuss how they prioritize safety, pacing, autonomy, and emotional regulation

3. Experience With Couples’ Dynamics and Intimacy

Clinicians who specialize in both couples therapy and sex therapy—not just generalists
Knowledge of integrative models (Gottman Method, Emotionally Focused Therapy, etc.)
Comfort facilitating open, shame-free conversations about sex and intimacy

4. Inclusivity and Affirmation

Explicit expertise in LGBTQ+ affirming therapy
Sensitivity to diverse relational, cultural, gender, and sexual backgrounds

At Cushing Counseling, these standards are not optional—they are at the heart of our practice model. For more on the rigorous background and advanced training of our team, you can see our clinicians’ bios on our About Us page.

What To Expect: Step-by-Step Framework at Cushing Counseling

Our trauma-informed sex therapy process is designed to ensure that every client feels respected, supported, and able to move forward at a sustainable pace. Here’s how the process typically unfolds:

1. Free 15-Minute Phone Consultation

No-pressure introduction to discuss what is bringing you (or you and your partner) to therapy
Chance to ask questions about our approach, logistics, and next steps
Personalized clinician match based on your concerns and goals
Discuss insurance, scheduling, and fees transparently

2. Comprehensive Intake Session

50-minute in-depth session (individual, couple, or both as needed)
Exploration of your story, history of trauma, patterns in your relationship, and your therapy goals
Building foundational emotional safety and establishing privacy boundaries

3. Personalized, Trauma-Informed Plan

Weekly sessions (recommended for momentum), with a plan crafted for your needs
Integrates psychoeducation, emotional regulation, safe communication skills, and consensual intimacy exercises
Includes mind-body and evidence-based trauma tools (CBT, IFS, somatic, mindfulness, narrative)
Always at your pace—never rushed into exposure or detail sharing before you feel ready

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

Typical Phases in the First 12 Weeks

Weeks 1–4: Safety and Insight

Mapping personal triggers and learning the basics of self-regulation
Creating nonjudgmental space for your story and current struggles
Slow, consent-based exploration of what feels tolerable in therapy and at home

Weeks 5–8: Connection and Communication

Guided conversations and structured tools for open, low-conflict discussion
Gradual rebuilding of intimacy (starting with small, no-pressure exercises)
Challenging shame, negative beliefs, and rigid scripts around sex and relationships

Weeks 9–12: Healing and Reconnection

Addressing persistent barriers (anxiety, desire mismatch, pain, avoidance)
Reframing what "good sex" and authentic connection look like for your partnership
Celebrating small but meaningful shifts in communication or emotional closeness

Many clients begin to notice changes in emotional safety, understanding, and hopefulness within 12 sessions. Full trauma recovery is unique to each person or couple and continues at your pace.

Why Clients Choose Cushing Counseling

Cushing Counseling is recognized as a national leader in sex and couples therapy, known for:

Integrity: Transparent, ethical communication and predictable follow-through
Expertise: Every clinician is rigorously trained with evidence-based methods and advanced sex therapy credentials
Compassion: We honor your story and meet you with warmth, empathy, and respect, while also challenging you to grow
LGBTQ+ inclusivity: A space safe for all identities and all forms of relationship
Telehealth flexibility: Sessions available to eligible clients across Virginia, Florida, Maryland, and DC

Clients and colleagues routinely share praise for the skill, warmth, and effectiveness of our team. For example, a Google review states: "If you're looking for a sex therapist who's both clinically sharp and truly human, Vanessa is the real deal." Others have described our approach as "compassionate, knowledgeable, and truly transformative." These are the standards we uphold in every session.

Costs and Insurance Details

Sessions are typically 50 minutes.
Vanessa Cushing: $350/session. Other clinicians: from $150/session.
Weekly cadence recommended; some clients transition to biweekly with progress.
Cushing Counseling is an out-of-network practice. Many clients use out-of-network benefits via Thrizer, which verifies insurance and files claims automatically. You can check your benefits online.

How to Get Started If You Need Help Now

Decide on the type of support you want: Individual, couples, or a mix. If unsure, start with a 15-minute call—no commitment required.
Schedule your free consultation: Book online at our Schedule page, or call (703) 544-7081. We are currently serving clients across Virginia, Florida, Maryland, and DC by telehealth.
Use the consult to ask about experience, safety, and collaborative planning: Bring your concerns about trauma, intimacy, and practical questions about therapy. Our clinicians will always answer with respect and clarity.

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

Best Practices for Healing When Sexual Trauma Affects Relationships

Prioritize safety and communication: Healing moves fastest when you feel safe with your therapist and partner.
Work with trauma and sex together: Addressing only the "relationship" or only the "trauma" leaves many couples stuck. Genuine progress often involves both areas at once.
Understand progress happens in small steps: Shifts in trust, desire, and comfort can be subtle but still deeply meaningful.
Pace yourself: True trauma-informed therapy is never about "pushing through." Honor your own timing.
Choose a therapist whose approach and training you trust: Ask about theoretical orientation, frameworks (IFS, CBT, EFT, etc.), and track record with sexual trauma and couples work.

For deeper information on how trauma and intimacy intertwine, explore our related blog: Who provides sexual trauma therapy in Miami that also understands intimacy and relationship issues?

Frequently Asked Questions (FAQ)

How do I know if sexual trauma is affecting our relationship?

Common signs include withdrawal during intimacy, avoidance of touch, arguments over sex or closeness, guilt or numbness during sex, and a persistent sense of emotional distance. Many couples also notice recurring "blocks" when trying to talk openly about sex or past experiences.

What if my partner is reluctant to join therapy?

It is common for one partner to feel hesitant, especially if there is shame, fear, or misunderstanding about sex or trauma therapy. We work with individuals, couples, or a mix. Sometimes starting alone is the best entry point, and your therapist can help navigate your partner’s involvement if and when they feel ready.

What if I don’t want to discuss trauma details right away?

You never have to share anything before you are ready. Trauma-informed therapy at Cushing Counseling is consent-based, prioritizing emotional safety in every session. Pacing and client agency are key values for our team.

How do out-of-network benefits and payment work?

We are out-of-network and partner with Thrizer, which checks your insurance, handles claims, and allows you to pay your estimated share up front. Learn more about this on our insurance benefits page.

How is trauma-informed sex therapy different from general couples therapy?

Trauma-informed sex therapy focuses equally on the impacts of trauma and sexuality. Our team is trained to work with the emotional, physical, and relational layers of sexual trauma—fusing evidence-based trauma methods and advanced sex therapy skills. This is often much more effective than seeing two separate providers.

Is therapy LGBTQ+ affirming?

Absolutely. Cushing Counseling welcomes all gender identities, sexual orientations, and relationship structures, and our clinicians are explicitly trained for LGBTQ+ support.

Conclusion

If sexual trauma is affecting your relationship now, you deserve a clinician with true expertise, empathy, and actionable methods to support healing for both you and your partner. At Cushing Counseling, trauma-informed sex and couples therapy is our deepest specialty. We provide skilled, ethical, and nonjudgmental care for clients across Virginia, Florida, Maryland, and the DC area through secure online sessions.

Your next step is simple: schedule a free consultation (by phone or online), ask your most important questions, and decide at your own pace if we are the right fit for you. You can start your journey towards safety, connection, and renewal anytime at www.cushingcounseling.com.

Where can I find a trauma-informed sex therapist if sexual trauma is affecting my relationship now?

Where can I find a trauma-informed sex therapist if sexual trauma is affecting my relationship now?

What Is Trauma-Informed Sex Therapy?

How Sexual Trauma Shows Up in Relationships