Sarah Axley, LCSW

Sarah Axley is a Licensed Clinical Social Worker with 15 years of clinical practice. She welcomes people who are feeling overwhelmed by stress, anxiety, addiction, grief, or changes in life. She emphasizes a collaborative relationship and helps clients set clear goals and learn practical skills. Sarah offers honest, down-to-earth care and meets people where they are in the moment.

Sarah trained in psychology and social work at Virginia Commonwealth University and completed a postbaccalaureate certificate in Aging Studies. She has provided psychotherapy since 2009 in outpatient clinics, intensive community settings, and in a hospital where she currently works full time. Her experience includes working with a wide range of concerns, including depressive and bipolar spectrum disorders, anxiety, trauma, substance use, autism spectrum conditions, and grief.

In sessions she blends Client-Centered Therapy, Cognitive Behavioral Therapy, Motivational Interviewing, Mindfulness Therapy, and Narrative Therapy depending on each person’s needs. Much of the work focuses on changing unhelpful thinking, building skills to manage symptoms, and strengthening everyday coping. She also uses a strengths perspective to highlight resilience and practical progress.

Sarah is knowledgeable about aging and caregiver stress, chronic illness and disability, and issues related to family of origin. She is LGBTQ+ informed and has supported people facing social stressors, pandemic-related worries, and workplace stressors such as first responder concerns. Her approach is solution-focused and aim-oriented.

Between sessions clients often practice short tasks or exercises to build momentum toward goals. Sarah sees clients in the evenings and on Saturdays, and she encourages people to reach out when they feel ready to begin.

How her approaches translate to online therapy

Client-Centered Therapy focuses on listening, empathy, and following the client’s priorities. Online work using this approach means sessions concentrate on what matters most to the person and on building a trusting collaborative relationship.

Cognitive Behavioral Therapy (CBT) targets unhelpful thoughts and behaviors with practical strategies. In an online setting CBT can include brief exercises, thought records, and homework to practice new skills between sessions, which helps with anxiety, depression, and addictive behaviors.

Motivational Interviewing helps people clarify their own reasons for change and build internal motivation. Used online, it supports difficult decisions about substance use or other life changes by exploring ambivalence in a respectful way.

Finding the right approach is part of the work. The therapist will discuss goals, preferences, and what has helped or not helped in the past. Together they will try methods that fit the client’s needs and adjust the plan over time.

For practical matters, confirm the available session formats before booking since the biography does not list them. Online therapy can make it easier to fit sessions into a busy life, reduce travel time, and allow for shorter check-ins when needed. It also makes it possible to continue work during life transitions and across geographic boundaries, with the therapist helping clients choose the best way to meet their needs.