Sarah Axley , LCSW

Sarah Axley is a Licensed Clinical Social Worker (LCSW) with a background in psychology and social work from Virginia Commonwealth University. She also completed a Post Baccalaureate Certificate in Aging Studies through VCU's Department of Gerontology. Since 2009 she has provided psychotherapy across outpatient mental health clinics, intensive community-based programs, and currently works full time in a hospital setting. She earned her clinical social work license in 2012 after developing experience with clients of all ages and diverse backgrounds and with diagnoses that include depressive and bipolar spectrum disorders, anxiety and trauma-related disorders, substance use conditions, schizophrenia spectrum disorders, and autism spectrum disorders.

Sarah approaches therapy from a strengths-based, collaborative stance, emphasizing the therapeutic relationship as a partnership. She is informed in working with LGBTQ+ clients and has experience supporting people through grief and loss and managing stressors related to the COVID pandemic and the broader social and political climate. Her clinical work draws on evidence-based techniques such as cognitive behavioral therapy, motivational enhancement strategies, and mindfulness training, tailored to each person’s needs and preferences. She frames treatment around building insight, developing practical skills to manage symptoms, and improving communication so clients can better understand themselves and pursue their goals.

Sarah communicates a belief in client resilience and in the importance of between-session practice to reinforce progress and apply new skills to everyday life.

Approaches for Online Care and Therapeutic Support

Sarah Axley draws from several well-established approaches to meet clients where they are. Client-centered therapy focuses on building a respectful, nonjudgmental relationship in which the client leads the pace and direction of work while the therapist provides empathy and support - this approach is often helpful for improving self-esteem and navigating life changes.

Cognitive behavioral therapy (CBT) offers practical strategies to identify and shift unhelpful thoughts and behaviors, commonly used for anxiety, depression, stress management, and patterns that interfere with daily functioning. Mindfulness therapy teaches present-moment awareness and simple practices to reduce reactivity and improve coping for stress, sleep difficulties, and emotional regulation.

Finding the right therapeutic approach is part of the process, and Sarah works collaboratively with clients to determine which methods fit their needs, goals, and preferences. Licensed professionals and therapists tailor interventions and adapt techniques as progress is made so treatment remains relevant and effective for each person.

Online therapy through video calls, phone sessions, live chat, or text-based messaging offers flexibility and accessibility for different schedules, caregiving demands, or geographic limitations. These options allow ongoing contact and continuity of care while supporting practical access to therapy from home or other convenient locations.