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.

Comparison · 8 min read

Sexologist vs. sex therapist vs. sex coach: what is the difference?

Three titles, wildly different levels of accountability. Here is exactly what each one requires, what each can legally do, and how to check before you hand someone your sexual history.

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

The short answer

A sex therapist is a state-licensed mental health clinician with sexuality training who can diagnose and treat. A sexologist studies sexuality — the title is unregulated and may or may not include clinical licensure. A sex coach is unlicensed, cannot diagnose, and has no board oversight.

Side by side

	Sex therapist	Sexologist	Sex coach
Required credential	State clinical license + sexuality training; AASECT certification is the US standard	None — an academic descriptor, sometimes attached to a PhD, sometimes to nothing	None — anyone may use the title today
Can diagnose and treat	Yes, within scope of license	Only if separately licensed	No
Confidentiality protection	HIPAA and state law	Depends entirely on licensure	Contractual at best
If something goes wrong	State licensing board complaint; certification can be revoked	Depends on licensure	No regulatory recourse
Insurance / superbill	Often available	Only if licensed	No
Best used for	Clinical concerns: pain, dysfunction, trauma, diagnosable distress	Research, education, writing, teaching	Skills, confidence, exploration in the absence of clinical concerns

Why the distinction matters clinically

Sexual complaints have a high rate of medical contribution. Erectile difficulty can be the first presentation of cardiovascular disease or diabetes. New-onset painful sex can reflect a dermatologic condition, an infection, hormonal change, or pelvic floor hypertonicity. Sudden loss of orgasm frequently follows an SSRI change. A licensed clinician is trained to recognize when to stop and refer; an unlicensed practitioner is not, and has no obligation to.

The second issue is trauma. Sexual concerns and trauma histories overlap heavily. Techniques that are harmless in a coaching frame — pushing exposure, prescribing frequency, assigning explicit homework — can retraumatize someone whose history has not been assessed. Assessment is licensed work.

When a coach is a reasonable choice

This is not an argument that coaching is worthless. For a person with no clinical distress, no pain, no trauma history, and no functional complaint — someone who simply wants to communicate desires more confidently or expand a repertoire — a skilled coach can be genuinely useful and often more affordable.

The line is clinical distress. If the concern involves pain, loss of function, compulsion, trauma, or persistent distress that is affecting your mood or your relationship, that is treatment, and treatment requires a license.

How to verify anyone in four minutes

Search the state licensing board site for their name and license number. Every state publishes a free look-up. No result means no license.
Search the AASECT public referral directory. Certification is listed publicly and expires if continuing education lapses.
Ask directly: 'What license do you hold, in which states, and what is your license number?' A licensed clinician answers this instantly and without defensiveness.
Check the intake paperwork. Licensed clinicians provide a HIPAA notice of privacy practices and informed consent. Their absence is diagnostic.

Frequently asked questions

Is a sexologist a real doctor?

Not necessarily. 'Sexologist' is an unregulated descriptor for someone who studies sexuality. Some hold a doctorate and a clinical license; others hold a weekend certificate. The title alone tells you nothing about training, and it does not confer the ability to diagnose or treat.

Can a sex coach diagnose sexual dysfunction?

No. Diagnosis is a licensed clinical activity. A coach who offers a diagnosis, treats a pain condition, or works with trauma is operating outside any legal scope of practice, and there is no licensing board to hold them accountable.

Which one should I see for erectile dysfunction or painful sex?

A licensed sex therapist, and often a physician alongside. Both conditions have meaningful medical differentials — cardiovascular, endocrine, dermatologic, neurologic, or pelvic floor — that need to be assessed or ruled out before or during behavioral treatment.

Do sex coaches ever have physical contact with clients?

Some unlicensed practitioners advertise hands-on work. Licensed sex therapy never includes physical contact of any kind. If a practitioner proposes touch as part of treatment, that is a different service entirely, and the legal and safety protections you would expect are not in place.