01 · Who Sarah works with

Sarah works with stress, Anxiety, addictions and grief

Sarah lists 14 specialisms and 23 further focus areas. Specialisms are the subjects Sarah chose to list first, which is the closest a listing gets to “this is my actual practice”.

02 · In Sarah's own words

What Sarah says about the work

Reproduced in full and unedited - not summarised, not tightened, not rewritten in a house voice.

Hello! First of all, take a second and give yourself a ton of praise for recognizing that you are having difficulties and reaching out for help! You have already conquered one of the most difficult steps in the process!

So a little about me…My name is Sarah Axley and I am a Licensed Clinical Social Worker. I obtained my education at Virginia Commonwealth University in psychology and social work. In addition to my Master's Degree in Social Work, I also completed a Post Baccalaureate Certificate in Aging Studies with VCU’s Department of Gerontology. I have provided psychotherapy since 2009 in an outpatient mental health clinic, an intensive community-based setting and now in a hospital, where I am currently employed full time. I obtained my License in Clinical Social Work in 2012 while doing my clinical work in an outpatient mental health service where I worked with individuals of all ages, backgrounds and with various diagnosis, to include Depressive Disorders, Bipolar Spectrum Disorders, Anxiety Disorders, Trauma Related Disorders, Substance Use Disorders, Schizophrenia Spectrum Disorders and Autism Spectrum Disorders. I am considered to be an LGBTQ+ informed psychotherapist. I have experience working with clients dealing with grief/loss. I have also provided psychotherapy services to help clients better manage stressors due to COVID and the current social and political climate. I believe that the therapeutic relationship is a collaborative one. Whether it is to process/gain insight, to build on skills to manage symptoms, to change thinking patterns to better serve you, to improve communication, etc., we can work together to help you to better understand yourself and to help achieve your goals. I use a combination of evidence-based therapeutic approaches (cognitive behavioral therapy, motivational enhancement therapy, mindfulness training, etc.), based on your needs and preferences. I operate from a strength’s perspective. You are more resilient than you realize. With the right and knowledge and tools, you can manage anything! I see clients Monday and Wednesday evenings and Saturday late morning/afternoons. In between sessions, you will likely be completing tasks to help you work to achieve your goals. That is where a lot of the work happens!

If I sound like I could be a good fit for you and what you’re looking for in a psychotherapist, let’s do this!

Warm regards and well wishes,

Sarah Axley, LCSW

Sarah Axley, on the BetterHelp listing · read 9 Oct 2026

03 · How Sarah works

The 6 approaches Sarah lists, in plain English

These are the clinical methods Sarah lists. The descriptions are Maker Therapy's, not Sarah's - a general explanation of what each method is, so the list means something before you have spoken to anybody. They are not a claim about how Sarah runs a session.

Client-Centred TherapyPerson-centred · Rogerian

The therapist does not steer toward a technique or a diagnosis. They offer sustained, non-judgemental attention and reflect back what they hear, on the premise that people find their own direction when they are genuinely listened to. Often what people mean by “someone who just gets it”.

Cognitive Behavioural TherapyCBT

Structured, present-focused work on the loop between what you think, how you feel and what you then do. Usually means noticing a thought pattern in the room, testing it against evidence, and practising something different between sessions. Among the most heavily researched talking therapies for depression and anxiety.

Mindfulness-Based TherapyMBCT

Trains attention on what is happening right now - body, breath, the thought as it arrives - so distress can be observed rather than automatically acted on. Strongest evidence is in preventing depression from recurring, and it is usually taught as a practice you keep doing outside the session.

Motivational InterviewingMI

A way of talking about change with somebody who is genuinely in two minds about it. The therapist does not argue for the change; they help you say your own reasons out loud, which is the part that predicts whether it happens. Common around substance use and health behaviour.

Narrative Therapy

Treats the story you tell about your life as something that can be examined and retold rather than as the plain facts. Separates the person from the problem - “the anxiety” rather than “your anxiety” - to make room for the parts the current story leaves out.

Solution-Focused Brief TherapySFBT

Starts from where you want to end up rather than from how you got here. Sessions look for the times the problem is already smaller and work out what is different about those, so the number of sessions tends to be short and the work concrete.

04 · What happens next

From this page to a first session

Sarah practises through BetterHelp, so the route in is BetterHelp's. This is that sequence, written by Maker Therapy from the platform's published process - not a description of Sarah's own practice, and not a promise about how quickly anything happens.

1. A questionnaire, not a booking form

   BetterHelp opens with a set of questions about what you are dealing with, what you want from therapy, and any preferences on the therapist. You are not booking Sarah at this point.

2. Naming Sarah specifically

   BetterHelp matches algorithmically by default, so asking for Sarah is a step you have to take. There is a field for requesting a specific therapist during sign-up, and you can switch afterwards from your account. Starting from a link on this page does not by itself assign you to Sarah.

3. If the caseload is full

   You will be offered somebody else rather than put on a waitlist. Worth knowing, because it is easy to assume a match is the person you asked for.

4. The first conversation

   A first session is typically history and orientation: what brought you, what has been tried, what you want to be different. It is also where the questions in the next section belong.

5. If the fit is wrong

   Changing therapist on BetterHelp does not need a reason. A first session that does not click is common and is not a verdict on therapy. That option existing is the main practical difference between a platform and a private practice.

05 · Before you commit

4 questions worth asking Sarah

Built from what Sarah actually lists, so they are answerable and specific rather than generic. Maker Therapy's, not Sarah's - Sarah has not seen them and is under no obligation to answer any of them.

• “You list both Cognitive Behavioural Therapy and Client-Centred Therapy. Which do you lean on with someone like me?”

  Those two point in different directions - one structured and led by the therapist, the other led by you. The answer tells you what the sessions will actually feel like.

• “How do you decide when someone is ready to work on a traumatic memory itself?”

  Pacing is the biggest safety question in trauma work. A clear, unhurried answer here matters more than any credential.

• “With 15 years in, what has changed most in how you work?”

  Long experience is only an advantage if it has been examined. This tends to surface whether it has.

• “How do you handle the gap between sessions if something comes up?”

  On BetterHelp this varies a great deal by therapist. Better to know the rhythm now than to discover it on a bad week.

06 · Practical details

Credentials and licensing

Credential

LCSW

Licensed in

Virginia

Licence

VA LCSW 0904008055

Licence number

0904008055

Licence expires

30 Jun 2027

NPI

1457604597

Years in practice

15

Gender

Female

Languages

English

International clients

Accepted

Listed since

15 May 2026

07 · Provenance

Where every line on this page came from

Sarah's name, credential, state, subjects, approaches and biography are read from BetterHelp's therapist roster, which Maker Therapy re-reads once a day; this page reflects the reading taken on 9 Oct 2026. The licence number and NPI are cross-checked against public registers.

The plain-English method descriptions, the first-session walkthrough and the questions are written by Maker Therapy and labelled as such wherever they appear.

Maker Therapy is not BetterHelp, does not take bookings, and has not met Sarah. There are no reviews or ratings on this page because we have no way to verify one. If you start therapy through a link here, we may be paid a commission - it does not change your price and it does not affect who appears here or in what order.

Something on this page wrong or out of date? Report it and it will be checked against the source.