Questions about what it’s like to work together?

I’m physically located in Tacoma, Washington but can provide online therapy to anyone in Washington or Utah.

Yes, I see clients for weekly and biweekly therapy appointments in person at my office in Tacoma at 4041 Ruston Way Suite 202, Tacoma, WA 98407. I also see couples for therapy intensives at my office on the weekends.

My hourly rate breaks down to $300/50 minutes for individuals and couples/families. I typically see individuals and couples for 75 minutes weekly or biweekly, no less. Your session fee will be $450/75 minutes, unless we agree to a longer session—2 hours is an option (or 110 minutes).

My practice is designed both for my benefit and yours—I have considered what facilitates the deepest, most profound change the most quickly, and a lot of therapy frequently is the answer. I notice a significant difference in the impact of therapy with a longer session length and prefer to work with clients for a longer amount of time to help achieve more depth and more immediate character change. Intake sessions are 75 minutes long, sometimes longer.

Weekend hourly rates are higher. Please see my Intensives specialty page.

Payments will be collected at the start of the session. You can pay by credit or HSA.

No. I am private pay only. I do not send clients superbills or deal with insurance companies in any aspect. Your treatment will be entirely out of pocket.

Click here to view my online calendar and schedule an intake appointment. Your first appointment will be longer (1.5-2 hours) so that we can discuss what you would like help with in therapy and you can get a feel for what therapy feels like with me. The best way to determine fit is to do trial therapy. You will get help immediately and be able to decide if it's right for you. Please make sure my openings work with you for ongoing therapy.

I have a limited cancellation policy of 4 “free” cancellations per calendar year. Once you have missed or canceled 4 appointments in a calendar year—for any reason—you will be charged for any additional appointments you are not able to reschedule (as my schedule allows). Once you start treatment with me, you have a regular spot on my calendar, so you are paying for that spot, whether you are able to make it or not—I cannot take on additional clients to make up for times when you are not able to attend.

This policy is also designed to encourage you to commit to therapy once you begin. A very important and fundamental aspect to successful treatment is maintaining a frequency until the work is complete. Like with any medication, you must take a certain dosage with a certain frequency in order for it to take effect. Do not minimize the importance of this—it is the reason for treatment failure in many cases. Therapy is a serious and deeply healing experience if you fully commit.

Please evaluate whether my policy will work for you and consider how important therapy is to you before reaching out—I stick to my policies and commitments and I would hate for you to be unhappy working with me because you did not seriously evaluate if this would work for you.

For ongoing couples therapy, I meet with both partners together for most appointments. Since my client is the relationship, the majority of relationship therapy will have both people in the room. As treatment progresses, I may ask to meet 1:1 with each partner. For some relationships with increased distress, meeting 1:1 may happen more often. For couples with a past or current history with IPV/DV, I do 1:1 assessments before beginning couples therapy. For couples therapy intensives, I do see partners 1:1 for one portion of the intensive.

For couples, yes! It is imperative that couples join their online session with me from the same physical location. I do not meet with couples online who are joining from different locations. For family therapy, especially adult family therapy, parties do not need to join from the same physical location, although it is best if they can.

For family therapy, all parties do not need to be present for every session. Depending on how many family members there are and what their goals are with each other, sometimes we may meet in smaller groups of two or three instead of the entire family of five, for example.

I work with heterosexual couples, LGBTQ+ couples and nonbinary or gender nonconforming people and relationships. I also work with polyamorous relationships—typically those that are already established. I welcome any person looking for help with their relationship into my office. Although sex therapy is not my specialty, I do help couples with their sex life and am sex positive and kink friendly. However, if sex therapy is primarily what you are looking for, I will happily recommend you to a colleague who specializes in this work.

I don’t do parent coaching with divorced couples or divorce/separation therapy. Once a couple I am seeing for therapy has decided to divorce, I will find them a recommendation for a therapist specializing in whatever they need, whether it’s divorce/separation therapy or co-parenting therapy. I am happy to recommend professionals to help guide them in their next step. I am happy to work with separated couples who could like to come back together or couples who are unsure. Once a decision to separate leading to divorce has been made, I refer them to their next guide.

Yes, please email me at sandra@ctr4excelmft.com to get on a waitlist for weekly/biweekly therapy. If you would like to work with me, but my calendar is currently full, I do offer couples therapy intensives, which are a great option for couples wanting help now. They can lead to breakthroughs, a decrease in tension, and an increase in connection. These are as short as 4 hours and as long as 2 days.

If these options don’t appeal to you, here are a few local relationship therapists I refer to:

Tacoma:
Allie Peyton
Jenn Parretta
Maria Carrington

Seattle:
Seattle Clarity Counseling
Lia Schaefer
Ben Trelease

If you are specifically looking to do individual therapy with an ISTDP therapist licensed in WA or UT, I am happy to put you on a waitlist.

I do not offer consultations to prospective clients. I find that talking about what might happen in therapy or about how I work is not an accurate measure for whether or not therapy will work for you--it is simply a sales pitch, which is only an accurate representation of my ability to sell my services, rather than a measure of my therapy skills. The only way to know if therapy works for you is to try it out and see. Our first appointment together is longer for a few reasons, a) to help me assess what you're struggling with and whether I can help; b) to help you experience therapy with me and know by the end if it has helped or not. How you feel will speak for itself. If it has not been helpful for you or I determine I won't be able to help you, I can give you the best referrals because we've spent some time together and I have a good idea of what would be most helpful. It's a win-win.