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.

Where we can see you · 4 min read

Online sex therapy across 40+ states

A certified sex therapist you can actually be seen by — wherever in the country you are sitting when the session starts.

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

Therapy licences are state-by-state, so what matters is which clinician is authorized where you are physically sitting. Cushing Counseling now covers Virginia and Florida through its counseling licences, plus more than forty jurisdictions — including Texas, Ohio, Georgia, Arizona and Pennsylvania — through a psychologist on the team authorized under the PSYPACT compact.

Book a free 15-minute consultation

Name the state you will be in, and the consultation call tells you in two minutes whether you can be seen.

Why finding a sex therapist in your state is so hard

Two things stack up against you. Certified sex therapists are genuinely rare — the specialist certifications require supervised clinical hours in sexual health on top of a full licence, and most states have a handful of holders. Then licensure cuts whoever is left down to the ones authorized in your state specifically.

That is why the search so often ends with a general therapist who lists intimacy as one interest among twenty. The specialty problem does not get treated; it gets politely stepped around.

How the coverage works

A psychologist licensed in a state that has joined the Psychology Interjurisdictional Compact can provide telepsychology to clients located in any other member jurisdiction, without holding a separate licence in each one. Just over forty jurisdictions have joined. That compact is open to doctoral-level psychologists only, which is why most therapy practices cannot offer this.

Cushing Counseling's counselors are licensed in Virginia and Florida. Dr. Elizabeth Wolfe, PsyD, is a licensed clinical psychologist and certified couples and sex therapist, and her compact authority is what extends the practice to the rest of the list.

Jurisdictions currently in the compact

The roster grows as legislatures opt in, so it is confirmed for your state on the consultation call rather than taken from a page. What counts is where you are physically located during the session.

Alabama
Arizona
Arkansas
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Idaho
Illinois
Indiana
Kansas
Kentucky
Maine
Maryland
Michigan
Minnesota
Mississippi
Missouri
Nebraska
Nevada
New Hampshire
New Jersey
North Carolina
North Dakota
Ohio
Oklahoma
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

What you can be seen for

Sex therapy is talk therapy plus structured exercises done privately at home. No examination, no touching, no observation of sexual activity — anywhere, ever.

Low desire and desire discrepancy between partners
Erectile difficulty, early or delayed ejaculation
Arousal and orgasm difficulty
Pain with sex, including where the medical workup came back normal
Performance anxiety and the avoidance cycle it creates
Sex after sexual trauma
Infidelity, disclosure and repair
Communication and conflict that repeats regardless of the subject

If your state is not on the list

Say so anyway on the consultation call. The compact roster changes, some concerns are better served by a referral than by waiting, and this practice keeps a vetted referral network of pelvic-health and specialist colleagues around the country rather than leaving you to start the search over.

Frequently asked questions

Does it matter which state I live in, or which state I am in during the session?

The session. Licensure follows your physical location at the time you are seen, which is why a client who lives in one state and works in another, or who travels regularly, should mention it before booking rather than after.

How do I know whether my state is covered?

Ask in the free consultation, and say where you will physically be during sessions — that is what determines which clinician can see you, not where you live on paper. The compact roster grows as legislatures opt in, so it is confirmed for your state at the time you book rather than assumed from a list on a page.

Is online sex therapy as effective as in person?

This work translates unusually well to video, because the substance of it is conversation plus exercises you practise privately at home — where they belong anyway. The majority of this practice's clients are seen by video by preference rather than necessity.

Is it private?

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.

How do I start?

Book a free 15-minute consultation and say where you will be located during sessions. You will be matched with the clinician authorized to see you there, and you decide afterwards whether to continue.

Keep reading

Sex Therapy — Desire, arousal, pain and mismatched libido, in plain terms.
Couples Therapy — Conflict cycles, disconnection and repair after betrayal.
Dr. Elizabeth Wolfe, PsyD — The psychologist whose compact authority makes this coverage possible.

Also on this site

Meet the team — Every clinician, what they treat and where they are licensed.
Fees & Insurance — Per-clinician fees, superbills and out-of-network benefits.
Book a free consultation — Fifteen minutes, by video, with no obligation to continue.
Contact us — Questions about state coverage, scheduling or fit.

Next step

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