Sarah Axley , LCSW

Sarah Axley is a Licensed Clinical Social Worker (LCSW) who brings extensive clinical training and practical experience to her psychotherapy practice. She completed her studies at Virginia Commonwealth University, earning a Master of Social Work and a Post Baccalaureate Certificate in Aging Studies through VCU's Department of Gerontology. Since 2009 she has delivered psychotherapy across settings including an outpatient mental health clinic, intensive community-based programs, and hospital care where she is currently employed full time.

Sarah obtained her clinical license in 2012 while working in an outpatient mental health service and has supported people of all ages and backgrounds with a wide range of diagnoses, including depressive disorders, bipolar spectrum disorders, anxiety disorders, trauma-related disorders, substance use disorders, schizophrenia spectrum disorders, and autism spectrum disorders. She is an LGBTQ+ informed psychotherapist and has experience assisting clients with grief and loss as well as stress related to public health events and social and political challenges.

Her work is collaborative and rooted in a strengths-based perspective, helping people build insight, practice new skills, shift unhelpful thinking patterns, and improve communication. She integrates evidence-based approaches such as client-centered therapy, cognitive behavioral therapy, motivational interviewing, mindfulness therapy, and narrative techniques according to each person’s needs and preferences. Between sessions clients may work on tasks or exercises designed to support their goals, since much of the change often happens outside of meetings.

Sarah typically schedules sessions on Monday and Wednesday evenings and on Saturday late mornings and afternoons, and she frames therapy as a partnership focused on practical tools and lasting coping strategies.

Approach-Focused Online Therapy with Practical Support

Sarah draws on client-centered therapy to create a collaborative space where the person's priorities guide each session. This approach focuses on empathy, listening, and building a trusting therapeutic relationship so clients can explore their goals and values.

She also employs cognitive behavioral therapy, a structured method that helps people identify and change unhelpful thoughts and behaviors. CBT is often useful for anxiety, depression, stress, and patterns that interfere with everyday functioning.

Mindfulness therapy is used to teach attention and acceptance skills that reduce reactivity and build present-moment coping. Mindfulness practices can support people managing stress, sleep difficulties, and emotional regulation.

Finding the right approach is part of the work and is determined collaboratively. Sarah and the client review needs, goals, and preferences to select or blend strategies that fit individual circumstances and evolve them over time.

Online therapy offers flexibility in how sessions are conducted, including video calls, phone sessions, live chat, or text-based messaging. These options make it easier to fit therapy into busy schedules, allow ongoing contact between appointments when needed, and increase access for people who live far from in-person services or have mobility or caregiving constraints. Licensed professionals can adapt these modes to deliver effective, tailored care that meets each person where they are.