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No. This is not due to Covid – it’s to ensure that I can maximize access to services while minimizing potential barriers, especially given that I live in a relatively remote rural area in Southern Oregon. Telehealth offers greater privacy, flexibility, and convenience for most people compared to traveling to a physical office. My telehealth platform is state-of-the-art and HIPAA-compliant.

Generally speaking, we provide sessions between 8am to 6pm M-F Pacific Time (US). On occasion, we will schedule sessions earlier or later when this is the only way to support clients; this is on a case-specific basis. We do not generally work weekends.

David is licensed as an LCSW in California (LCSW 124154), Oregon (L11298), Michigan (6801121705), and Idaho (LCSW-43576). I am also able to provide teletherapy services as a registered telehealth provider in Florida and Vermont. My ability to offer telemental health in other places depends on local regulations, which vary greatly depending on the state or country. I’m willing to look into this on your behalf if you live in other parts of the US or overseas.

Nani provides coaching services worldwide. She is a Licensed Psychologist in Peru and can provide psychotherapy anywhere that license is recognized, including most of Latin America.

David is in-network with several insurance companies, including Regence BCBS, United Healthcare, Providence, Moda, and several OHP plans (Jackson Care Connect, CareOregon, HealthShare, and Trillium). David can bill some other insurance plans as an out-of-network provider, if your coverage allows it. We provide superbills upon request.

Nani is self-pay only. She can offer a sliding scale based upon geographic location and financial need.

We accept self-pay and copays/coinsurances in the form of Visa, MasterCard, American Express, Discover, Diner‘s Club, or JCB, PayPal, Venmo, or Wise.

Sometimes, depending on the situation. However, note that marriage/couple’s therapy in high-conflict situations or in the context of domestic violence or narcissistic abuse is outside our scope of practice.

We are LGBTQ+ affirming and work with relationships of all configurations.

This depends on the situation and the specific child or children in question. Young children are generally not a good fit for telehealth, in our experience, but pre-teens and teens sometimes feel comfortable with “screen-based” therapy and might even prefer it. With younger children, helping the parents/ caregivers often makes far more of a difference than any number of individual therapy sessions with the child, and virtually all children of any age benefit from improvements in family harmony (“less stress, more fun” is a good motto). We can discuss the best approach to help your unique family and situation.

Use the Request Appointment button to contact us for an initial consultation, which typically lasts 15-30 minutes and is at no charge to you. If it feels like we’d be a good fit to work together, we will make a plan that best suits your needs at that point.

There’s no way to predict this – it’s entirely dependent on your unique situation, history, personality, goals, support network, motivation, and a whole host of other factors. Some people see great gains after just a few sessions. Others will take much longer in order to tackle deeply rooted issues or especially complicated situations. Your progress and pace will depend greatly on your commitment to do the work and how dedicated you are to taking action between sessions. It’s your life, after all, and no therapist can do the work for you.

Under the regulations of the states in which I am licensed (California, Oregon, Michigan, and Idaho), I am not able to formally diagnose autism in a way that would be recognized medically or by educational institutions. This requires specialized training as well as specific qualifications - typically an MD, a PhD or PsyD in Clinical Psychology, or a neuropsychology license.

I am able to diagnose ADHD from a mental health perspective (as opposed to a medical perspective). However, I strongly recommend seeing a specialist in ADHD assessment if you are seeking an ADHD diagnosis for yourself or your child for official purposes such as educational, work, or disability accommodations.

I am happy to refer you to specialists in autism and ADHD assessment with whom I have collaborative relationships. I can also refer you to psychiatric providers if desired and appropriate.

What I can do is help those who have received a diagnosis of autism, ADHD, and/or other aspects of neurodiversity - or who suspect they might be neurodivergent but either have never been diagnosed or aren’t interested in pursuing “official” diagnosis - explore what their unique neurotype looks like for them and how to make the most of it. I recognize and honor the fact that self-diagnosis is well-respected and accepted in the neurodiversity community, and that autism and ADHD assessments can be expensive, difficult to access, and sometimes emotionally and logistically challenging.

I am happy to support you in your journey no matter where you find yourself along the path, whether you were diagnosed as a child, as an adult, or not at all.

This is one of the most common questions I get when people are exploring whether or not we’d be a good fit, particularly from potential clients who are autistic.

Yes, I (David) am neurodivergent. I was diagnosed as autistic in mid-2024. I sought the diagnosis in part because I had been working with neurodivergent clients for years and could not give a satisfactory answer to this question (whether or not I’m neurodivergent)… and also because several of my clients (laughingly) were calling me out on what they saw as clearly autistic behaviors. Receiving the diagnosis in my mid-50s was both a shock, and also not surprising at all - an experience that many late-diagnosed neurodivergent people can relate to.

By the time I was myself diagnosed, I’d already been providing neurodiversity-affirming therapy and supports to neurodivergent individuals and families for nearly my entire career. I can’t say that the diagnosis changed my approach a great deal, but it did give me a far deeper, and different, understanding of my work and its importance. It also has allowed me to explore many of the coping strategies and self-regulation and relationship tools I’ve found effective from a much more personal angle.

I’ve always followed a neurodiversity-affirming approach, long before I knew I was myself autistic. That just seemed fair and right. I do not see autism (or ADHD, for that matter) as a “disorder,” although I recognize that for many people whose support needs are higher than mine it can certainly be experienced as a disability. Each person’s experience of neurodivergence is unique. I do not make any assumptions and do not believe in stereotypes. I embrace each client exactly as they are.

The short answer is yes, unequivocally. I have clients across every part of the spectrum of gender identity, racial and ethnic background, sexual preference, and relationship status.

I do not specialize in gender-affirming care, and am not a sex therapist. If you are seeking support in deep exploration of your gender identity, sexual preference, or sexual practices, I can refer you to people who specialize in these issues.

Yes. I was officially diagnosed with autism (level 1) in 2024, at age 56, after undergoing a formal assessment with a psychologist trained to diagnose autism. As a late-diagnosed autistic adult, I am committed to and passionate about neurodiversity-affirming care. My lived experience, along with my professional training and nearly a decade of working with neurodivergent clients ranging in age from 5 to 80, deeply informs the way I practice. Post-diagnosis, autism and neurodivergence became “special interests” in themselves, which is helpful given the nature of my work.

David: Of course. In addition to my primary areas of focus, I work with clients on a broad array of issues, including mood disorders, grief and loss, life transitions, relationship issues, work and career challenges, chronic illness, aging, and many other topics.

I do not treat active addictions or substance use issues - for these challenges, you should see a specialist (CADC). I also am not a good fit for people in active crisis (suicidality, self-harm), since I do not have the resources to provide 24-hour emergency coverage or intensive outpatient treatment.

If we determine through an initial consultation that I am not a good fit for the issues you are confronting, I am happy to refer you to another therapist or group practice.

Nani: I work with a wide array of issues, and do not see “diagnoses” as especially helpful. If you have severe issues impacting safety, I might request or require that you work with other professionals (such as a psychiatrist) in conjunction with our work. I am especially passionate about helping people work with complex trauma as well as those pursuing deep spiritual growth, joy, and peace, regardless of their “diagnosis.”

Session costs vary depending on the service and staff member. David’s rates for a 55-minute session are:

• $230 (individual)

• $255 (couple/family)

These costs can be partially or fully covered by insurance in some cases.

Nani’s rates are self-pay only. She offers a sliding scale depending on geographic location and financial resources.

Nani’s base rates per hour:

• US/Canada/Europe/AusNZ: $175

• Latin America and Global South: $75

Self-pay allows us to offer care that is more flexible, personalized, and aligned with your needs — rather than insurance company requirements.

Working outside of insurance means:

• Sessions aren’t limited by diagnosis or medical necessity criteria

• We can adapt pace, structure, and approach based on your nervous system and goals

• There is more privacy, with no information shared with insurance companies

• Care can focus on long-term understanding and sustainable change, not short-term symptom management

Many clients choose self-pay because it allows therapy to be collaborative, consent-based, and responsive to how trauma, autism, and ADHD actually show up in daily life.