San Francisco + Bay Area
Telehealth therapy
for San Francisco.
Couples work, sex therapy, discernment counseling, LGBTQ+ affirmative therapy, and ADHD and neurodiversity-affirming individual work for a city that has opinions about therapy. Led by Christina Mathieson, LMFT, with a team of associate therapists across California.
SF's therapy market is saturated. That's a good thing; it means you have choices. A few things that make us different: integrated sex therapy alongside Gottman-grounded couples work, discernment counseling for couples at a decision point, and a team that's explicitly LGBTQ+ and non-monogamy affirming.
Who we see in SF
The patterns that bring SF clients in.
SF clients come to us with a specific flavor of question. Some of it is the tech-and-ambition version: burnout that doesn't lift, performance anxiety that the industry keeps rewarding, relationships calendar-locked against deadlines, the identity question of who am I without the work. Some of it is the long-timeline version: couples at year 8 or 15 reassessing whether this is still the relationship they want, people in their mid-30s or early 40s asking real questions about partnership or children or career that SF culture tends to outrun.
We also see a lot of clients from SF's queer and poly communities. The clinical challenge isn't the structure of the relationship (we'll never ask you to justify your setup); it's the real relational work inside it. Sex therapy, discernment work, and the kind of therapy that doesn't flinch at the specifics.
Geographically, we serve clients across all SF neighborhoods (Mission, SoMa, Pac Heights, Marina, Noe Valley, Richmond, Sunset, Potrero Hill, and the rest), plus anywhere else in California via telehealth.
Services for SF clients
What we work on.
Couples Therapy
Gottman Method, EFT, and attachment-based couples work, plus discernment counseling when one of you is leaning out.
Learn moreSex Therapy
Comprehensive sexology for desire, pleasure, pain, disconnect. Kink-affirming, non-monogamy-aware.
Learn moreLGBTQ+ Affirmative
Identity-aware therapy for queer individuals and couples. No teaching required.
Learn moreAnxiety Therapy
High-functioning anxiety, OCD, and the specific flavor of tech-industry stress.
Learn moreADHD and Neurodiversity-Affirming
Late-diagnosis ADHD in adults, executive function, neurodivergent-affirming work.
Learn moreIndividual Therapy
Identity, career transitions, meaning-making in a city that makes those questions louder.
Learn moreFAQ
Common questions from SF clients.
Is your practice actually in San Francisco?
+
No. We're telehealth-first and serve San Francisco clients via secure video. Our business address is in Walnut Creek (across the Bay), but the vast majority of our clients, including those in SF, meet with us online. We're fully licensed and insured to practice anywhere in California.
Do you work with tech and finance professionals?
+
Yes. A significant portion of our client load works in Bay Area tech, biotech, finance, or startup environments. We're familiar with the cultural patterns that show up in therapy: burnout that doesn't respond to vacation, performance anxiety disguised as ambition, relationships strained by stock-vest timelines, the specific identity question of "what am I doing if I'm not working."
Are you LGBTQ+ affirmative? Kink-aware? Non-monogamy friendly?
+
Yes to all three. Our practice is explicitly affirming. No teaching required, no translation needed. We work with ethical non-monogamy, polyamory, kink, and queer relationship structures as valid contexts for therapy, not problems to be fixed. See our LGBTQ+ affirmative and sex therapy pages for specifics.
What kind of couples therapy works for SF-based relationships?
+
Our couples work draws from the Gottman Method, Emotionally Focused Therapy (EFT), and attachment-based approaches, each grounded in research on what actually predicts relationship outcomes. We also offer discernment counseling for couples at a decision point (one partner leaning out, the other leaning in), which is particularly common in longer-term SF relationships where one or both partners are reassessing at 35-45.
Can sex therapy be done online?
+
Yes. Sex therapy is always talk therapy. Nothing physical happens in session regardless of format. Online sex therapy works as well as in-person for most clients, and for many it's more comfortable because they can do sessions from their own space. Our founder, Christina Mathieson, LMFT, holds the Buehler Institute's Comprehensive Sexology Program credential.
Ready to talk it through?
Free 15-minute call. Secure telehealth, no office visit required, therapist-matched to what you're actually working on.
Book a Free Consult