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.

Great Falls · Virginia

Couples therapy in Great Falls, VA

Couples therapy with an AASECT-certified specialist, for individuals and couples in Great Falls and across Great Falls and western Fairfax County.

Soft folds of warm cream linen in low raking light

Couples therapy in Great Falls is structured work with both partners on the pattern between you — conflict, distance, resentment, and the intimacy that usually goes quiet first. Sessions are held by secure video, both partners can join from different locations, and the first 15-minute consultation is free.

Who you would be working with

Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, MS from Johns Hopkins University. Fewer than one in a thousand licensed therapists in the United States hold AASECT certification.

If this is the year you deal with it, start with a conversation rather than a commitment.

Book a free consultation Call (703) 544-7081

Why Great Falls clients come here

Great Falls has almost no specialist mental-health provision inside its own boundaries, so residents either drive into Tysons or do nothing. Video removes the drive, which for a couple with children at home is usually the difference between starting and not starting.

Great Falls sits inside Great Falls and western Fairfax County, and the practical problem is supply rather than demand: there are very few AASECT-certified clinicians in the region, and most general therapists list intimacy as one interest among twenty. That gap is why this work is done by video for clients across Virginia rather than out of a single office.

What couples therapy treats

The same argument on repeat, with a different subject each time
Roommate dynamics — functional, affectionate, and no longer sexual
Recovery after infidelity, or after a discovery that broke trust
Two careers, small children, and no unhurried conversation in years
One partner considering leaving while the other did not know it was that serious
Sexual disconnection that neither of you has said out loud
Parenting, money and in-law conflict that is really a conflict about respect
LGBTQ+ couples, including open and non-monogamous relationships

Two glazed ceramic vessels standing close together, casting overlapping shadows — Most of what comes through the door is one of a small number of problems, and most of it responds to treatment.

How the work is structured

A joint first session, then usually one shorter individual conversation with each partner, so both stories are on the table before any work starts.
Naming the cycle rather than adjudicating the argument. Almost every couple has one pattern that generates most incidents; hearing it described accurately tends to lower the temperature immediately.
Between-session practice: specific, small, and assigned to both of you. Insight without practice does not survive a bad week.

Sessions are typically weekly to start, then spaced out as the pattern shifts. Where the sexual side of the relationship is part of the problem — it usually is — it gets addressed directly rather than left for later, which is the difference between this and general marriage counselling.

Sessions, privacy and location

The Virginia licence covers the whole Commonwealth, so clients in Richmond, Virginia Beach, Roanoke and Charlottesville are seen by secure video on the same terms as clients in the D.C. suburbs.

There is no in-person office in Great Falls. Sessions are held by secure, HIPAA-compliant video — which is how the majority of this practice's clients are seen, by preference rather than necessity. No waiting room, no drive across Great Falls and western Fairfax County, and the exercises get practised at home where they belong.

Also available in Great Falls

Sex therapy in Great Falls — sexual difficulty specifically
Trauma therapy in Great Falls — the lasting effects of what happened

Nearby in Virginia

Couples therapy in McLean — McLean, Great Falls and the Fairfax County corridor
Couples therapy in Vienna — Vienna, Tysons and central Fairfax County

Worth reading first

Questions Great Falls clients ask

Do you see clients in Great Falls?

Yes. Vanessa Cushing is a Licensed Professional Counselor in the Commonwealth of Virginia, so anyone physically located in Virginia at the time of the session can be seen — Great Falls included, along with McLean, Reston, Herndon. Sessions are held by secure video; there is no office in Great Falls, and that is stated plainly rather than implied otherwise.

What does the free consultation involve?

Booking is a free 15-minute consultation, held by video, with no obligation to continue. You will speak with Vanessa directly rather than an intake coordinator, and you can ask about fees, confidentiality and whether Great Falls residents are seen before committing to anything.

Can we join from two different places?

Yes. Video makes this easier than an office does — one partner travelling, or on a different schedule, is one of the most common reasons couples in this area never started. Both of you do need to be physically located in a jurisdiction where the licence applies.

Do you take sides?

No, and you would both know quickly if that were happening. The work is on the pattern between you, which neither partner invented alone. What does happen is that specific behaviour gets named plainly when it is causing damage.

Do you take insurance?

This is an out-of-network practice. Superbills are provided on request and many plans reimburse a share of the fee under out-of-network benefits; the insurance guide walks through how to check yours before your first session. Fees are discussed openly in the free consultation.

How private is this?

Sessions are held over a HIPAA-compliant video platform, records are kept to the clinical minimum, and nothing is disclosed to an employer, an insurer you have not billed, or anyone else without your written authorisation. This comes up constantly with Great Falls clients and it is a fair question to ask in detail during the consultation.

Couples therapy in Great Falls starts with a free 15-minute consultation with Vanessa — not an intake form, not a waiting list.