Sara Smithson


Sara Smithson


Telehealth Available
Professions: Clinical Social Worker
License Status: I'm a licensed professional.
Primary Credential: LICSW - LW61014336
Billing and Insurance:

I don't currently accept insurance, but I can provide documentation if clients wish to submit to an insurance company for "out of network" benefit coverage

Fees: Services Offered:

15-minute informational consultation: no cost
75-minute new client first session: $195*
50-minute weekly session: $145*

*I reserve a limited number of reduced rate spots to help increase access to counseling for individuals with fewer financial resources who do not carry mental health insurance or lack out-of-network coverage. Please send me a message to request information and current availability.
Free Initial Consultation
Weekend Availability
Evening Availability


Port Townsend, Washington 98368
Kalispell, Montana 59901

My Approach to Helping

I help easily misunderstood people, whether introverted, shy, or inhibited—or—outgoing, gregarious, or impulsive, figure out how to wield their unique strengths, get out of their own way, connect with others, and thrive.

More Info About My Practice

I offer online counseling via secure remote video conferencing to teens and adults located anywhere in Washington state and Montana.

Specific Issue(s) I'm Skilled at Helping With

ANXIETY: Anxiety is an over-development of incredibly useful powers of observation and cognition. It's also frustrating, limiting, and can build up to overwhelm and exhaustion that collapse into depression. On the upside, we have a lot of information about what helps to calm the body and brain so you can get back to whatever else you'd much rather be doing with your life.

DEPRESSION: Depression is such a liar and can feel so miserable, yet it's also a strangely safe and quiet bubble that can make it hard to step back out into the bright, noisy world. But even the smallest, slowest movements can begin to break that inertia and gently lift perspective, and if you're feeling depressed and considering therapy you're already on the move. There are so many of us out here ready and waiting to welcome and support you.

NEURODIVERGENCE (e.g. autism, ADHD, etc.): Neurodivergence and autism aren't problems to be solved in and of themselves. That said, it can be a pretty neurotypical world out there, and it's always helpful to develop a good understanding of yourself and have useful ways to cope, communicate, navigate, and explore.

SELF-ESTEEM & CONFIDENCE: It's one thing to have someone say something nice about you. It's quite another thing to believe it, and still another to make choices in your life and relationships that support that belief. Whatever the backstory is to your particular self-esteem struggles, one thing I can absolutely promise you is that you were not born with them. That means these struggles are something you're carrying, not someone you are. There are ways to lay these burdens down, and you don't have to earn your place in the world or figure it all out on your own.

STRESS: Part of us knows that many of the things we do to cope with stress don't make the things we're stressing about any better, but, when we're feeling that pressure and overload, feeling better as fast as possible is usually our goal. Unfortunately, that sometimes leads us to even more things to deal with on top of the original problem. Counseling can help you break that cycle and regain a cooler, calmer headspace to approach whatever challenges life whips up with greater resilience.

TRAUMA: Our life experiences are a part of who we are, but they are not the whole story and they don't have to define or limit us in ways we don't want them to. The opportunity to heal from difficult and scary experiences beyond our control or comprehension is a process that everyone deserves.

TEENS: Being a teen is just a lot. More freedom, more responsibility, more demands, more decisions. If you're bringing any other complexity to the table it doesn't take much to feel lost or stuck. It can be helpful to have someone to listen to whatever you're going through and sort through stuff with who isn't also trying to be your parent or friend.

How Psychotherapy Can Help

Being intelligent can actually make it harder to adapt to new things outside your frames of reference. Being deeply empathetic can cause you to feel like you're constantly letting others & yourself down. Being unique or outside norms can leave you feeling lonely & questioning yourself. If you tend to hold & hide everything inside or if you're someone who can't help but dump everything out all over the place, you may be experiencing miscommunication & judgment from others on top of everything else.

It's easy to want to hide, ignore, or pick a fight with reality. There's nothing more normal than falling into old habits amid stress & change, but these moments also create unusual windows of opportunity to go in entirely new directions: to reinvent the wheel, to finally learn to love the wheel you already have, or to trade in your wheels for wings.

I'm here to support you in seizing this day.

My Role as a Therapist

I have respect for fears and insecurities, wounds and scars, and understand that we need ways to feel safe and accepted if we're going to take on difficult work. At the same time, I also recognize that we need to be challenged and to trust our capabilities in order to heal and grow. If you like to cope through avoidance, I'll be understanding but won't let you off the hook. If you like to deflect through sarcasm, I'm fluent. If you can't recognize your strengths, I'll help you to see what you're missing.

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Services I Provide

  • Telehealth

Ages I Work With

  • Teens
  • Adults


  • English

Groups I Work With

    I emphasize support for individuals who are unique and a bit beyond the so-called norms, such as:

    * deep thinkers lodged in cycles of anxiety and depression

    * sensitive hearts overwhelmed by relationships or experiences

    * outside-the-box or neurodivergent people searching to feel connected, understood, or successful

Client Concerns I Treat

  • Adjusting to Change / Life Transitions
  • Anxiety
  • Child and/or Adolescent Issues
  • Depression
  • Developmental Disorders (Autism, Aspergers, etc.)
  • Grief, Loss, and Bereavement
  • Posttraumatic Stress / Trauma
  • Self-Esteem
  • Stress

Types of Therapy

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Mindfulness-Based Interventions
  • Narrative Therapy
  • Positive Psychology
  • Psychodynamic
  • Reality Therapy
  • Relational Psychotherapy
  • Solution-Focused Brief Therapy (SFBT)
  • Systems Theory /Therapy

See other therapists in Port Townsend, WA.

See other therapists in Kalispell, MT.

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