Couples Therapy · San Francisco
Couples therapy
for San Francisco.
You built a life in San Francisco on purpose. You love it, or you used to, or you're not sure anymore. What you do know is that the two of you have been running at 110% for years, and the relationship is the first thing that got quietly cut from the budget. The pattern is a common one, and there's a way back.
Evidence-based couples work for San Francisco. Gottman Method, Emotionally Focused Therapy, attachment-based. Explicitly LGBTQ+, ENM, and BIPOC-affirming. Secure telehealth across California.
Who we see in San Francisco
The city and the couple.
San Francisco couples who walk in tend to share a profile, regardless of whether you work in tech, the arts, healthcare, public service, or are raising kids in a city that's gotten harder to raise kids in. Both of you are competent, both of you are tired, and the relationship has been operating on maintenance mode for so long you're not sure what attention would even look like.
The specifics vary: couples who see each other mostly through childcare logistics, partners whose careers took off at different times and never quite rebuilt the relationship around this new change, couples in a stretch where one person's crisis has been the household's main story for months or years. What these couples share: the relationship didn't get the attention it needed, and you've stopped arguing because arguing took energy you didn't have.
We work with SF couples across all neighborhoods (Mission, Castro, Bernal Heights, Noe Valley, Richmond, Sunset, the east side, the hills) and anywhere else in California via telehealth.
How the work goes
Structured and collaborative.
We start with a full intake: the story of the relationship, what's actually happening now, what each of you most wants from the work. Some couples do this together. Others start with a brief individual session each so we can hear both sides without one partner managing the other's reaction.
From there, the backbone is the Gottman Method. A structured framework with 40+ years of research behind it on what actually predicts whether couples make it. We integrate Emotionally Focused Therapy (EFT) to work the emotional pattern underneath the content of your fights, and narrative work when the story you've been inside of needs to get named before it can be rewritten.
If you're queer, ENM, or polyamorous, the structure of your relationship isn't what we're trying to fix. We work the actual dynamics inside it: communication, attachment, conflict, intimacy. If you're a BIPOC client, cultural context is clinically relevant, and we work with it directly.
Who you'd work with
The team for SF couples.
Christina Mathieson
Licensed Marriage and Family Therapist (LMFT) #115093
Founder and lead clinician. Gottman Method Level 2, with comprehensive sex therapy training. Couples work and sexual connection get held in the same room.
Full bio
Michelle Cortez
Registered Associate Marriage and Family Therapist (AMFT) #146795
Supervised by Christina Mathieson, LMFT #115093
Couples work grounded in EFT and attachment theory. Particular experience with ethical non-monogamy, queer relationships, and cultural identity work.
Full bio
Jalyse Stewart
Registered Associate Marriage and Family Therapist (AMFT) #153712
Supervised by Christina Mathieson, LMFT #115093
Trauma-informed couples work, with particular care for BIPOC couples and partners holding what hasn't been named at home yet.
Full bioFAQ
Common questions from San Francisco couples.
Do you see same-sex and queer couples in San Francisco?
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Yes, affirmingly. Queer and same-sex couples are a real part of our San Francisco client base. The work follows the same evidence-based frameworks as any couples therapy. We won't expect you to teach us LGBTQ+ 101 or defend your relationship's structure. We will expect you to share your own lived experience, because every relationship is its own.
Are you experienced with non-monogamous and polyamorous couples?
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Yes. Michelle Cortez, AMFT #146795 (supervised by Christina Mathieson, LMFT #115093), specializes in this work. We're familiar with the patterns that come up: jealousy and compersion, scheduling and capacity, metamour dynamics, hierarchy negotiations, NRE. We can go deep on the structure when it's relevant to what you're working on, and leave it alone when the actual issue is something else entirely.
How long does couples therapy take?
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Most couples we see start to feel something shift within four or five sessions. Not 'we're fixed,' but 'oh, that's what's happening between us.' Real change tends to land somewhere between session 8 and 12. Affair recovery and long-standing avoidance often take longer. If nothing's moving by week six, we'll say so out loud.
Do you offer sliding scale or take insurance?
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We have sliding scale spots that vary by therapist and availability, and we're in-network with Lyra (employer-sponsored). Most PPO plans cover a portion of our fee through out-of-network benefits, and we provide the superbill. Mention cost during your free consult and we'll talk through what's actually possible.
Is couples therapy effective over telehealth?
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Yes. The research is now solid that telehealth couples work matches in-person outcomes for most presentations. For San Francisco couples, video also removes the logistical friction (cross-city traffic, finding the same 90-minute window in two busy schedules) that often kept therapy from happening at all.
References & further reading
- Gottman Method — research overview — The Gottman Institute
- Brené Brown on Empathy (RSA Short) — Brené Brown / RSA
- Brené Brown on Blame (RSA Short) — Brené Brown / RSA
- Come Together — Emily Nagoski, PhD — Emily Nagoski, PhD
Ready to talk it through?
Free 15-minute call. Secure telehealth, therapist-matched to what you're actually working on.
Book a Free Consult