Sarah Axley , LCSW

Sarah Axley is a Licensed Clinical Social Worker who helps people manage stress, anxiety, grief, addiction, and changes in life. She focuses on practical support and clear steps. She also works with concerns related to self-esteem, depression, trauma and abuse, sleeping problems, parenting strain, anger, bipolar symptoms, and LGBT issues.

She trained at Virginia Commonwealth University and holds a Master of Social Work and a Post Baccalaureate Certificate in Aging Studies. Sarah has provided psychotherapy since 2009 in outpatient clinics, community-based settings, and in a hospital setting where she currently works. Her practice draws on 15 years of clinical experience with a wide range of diagnoses and life circumstances.

In session she takes a collaborative approach. She listens first, then helps clients set goals and try practical strategies between visits. Expect work on changing unhelpful thought patterns, building coping skills, and improving communication. Homework and short exercises are often part of the process.

Sarah describes herself as LGBTQ+ informed and has experience supporting people through grief and loss, chronic illness, caregiver stress, and issues that come with aging. She also has experience addressing substance use, isolation, and family of origin concerns.

Sessions are offered in English and can be scheduled to suit different lifestyles. People who prefer clear steps, active skill practice, and a strengths-based style may find her approach helpful.

How Sarah’s Approaches Work Online

Client-Centered Therapy focuses on building a respectful, collaborative relationship where the therapist follows the client's lead and helps clarify goals. This approach is useful when someone needs to feel heard and decide what changes matter most. Cognitive Behavioral Therapy, or CBT, looks at how thoughts, feelings, and behaviors connect and uses simple exercises to change unhelpful patterns; it can help with anxiety, depression, sleep issues, and mood swings.

Finding the right approach is part of the work. Sarah will talk with the client about goals, preferences, and what has or hasn’t helped before. Together they decide whether to use CBT tasks, mindfulness practices, narrative work, or a mix that fits the person and the situation.

Online sessions are offered as video calls, phone sessions, live chat, or text-based messaging to make therapy more flexible. Video is good for face-to-face conversation, phone can be easier when bandwidth is limited, live chat or text messaging can fit quick check-ins or when typing feels more comfortable. These options let people fit therapy around work, caregiving, or travel while still working on the same practical skills and goals they would in office-based care.