Sianna Nacoste-Caldwell

Sometimes stress is not coming from one place—it is the pressure of trying to manage work, family, relationships, culture, expectations, and your own emotions all at once. You may be dealing with anxiety that is difficult to quiet, depression that makes it harder to feel like yourself, or a major transition such as pregnancy, motherhood, or changes within your family that has left you feeling overwhelmed. I work with children, adolescents, adults, and older adults throughout Louisiana, with a focus on anxiety, depression, stress management, cultural and ethnic concerns, and maternal mental health.

I also support ADHD, family and relationship issues, anger, women’s issues, and PTSD when those challenges are connected to the bigger picture of what you are experiencing. I have worked in social work for more than a decade across a variety of settings, and my goal is to create a warm, open-minded space where you feel understood in context—not reduced to a diagnosis—and empowered to move toward meaningful change.

I believe therapy works best when we understand both what you are feeling and what has shaped the way you respond to life. Your relationships, family system, culture, past experiences, current stressors, and even the way your body responds under pressure can all influence what is happening emotionally. Anxiety, depression, overwhelming stress, or maternal mental health concerns may be what brings you in, while ADHD, anger, PTSD, or relationship difficulties can add additional layers that deserve attention.

Rather than treating each concern as a separate problem, we’ll look at how they connect while keeping your goals at the center of our work. I draw from Cognitive Behavioral Therapy to help identify patterns in thoughts and behaviors, Trauma-Focused CBT when difficult experiences continue affecting the present, Motivational Interviewing to explore change without pressure, and Strength-Based and Behavioral approaches to build practical skills while recognizing the resilience you already have. My work is evidence-based, collaborative, and grounded in the connection between mind, body, and lived experience.

You do not have to arrive with the perfect explanation for what is wrong. We can start with what life feels like for you right now. During our first few sessions, we’ll talk about what brought you to therapy, what has been most difficult, what may be contributing to those challenges, and what you would genuinely like to be different. From there, we’ll clarify goals together and create a plan that feels realistic for your needs, circumstances, and pace. You can expect me to meet you where you are with warmth and respect while also helping you recognize patterns, build on your strengths, and identify practical ways to move forward. Progress may look like feeling less consumed by anxiety, reconnecting with yourself during depression, handling stress or anger more effectively, navigating motherhood with greater support, improving family relationships, or processing trauma in a way that helps you feel safer in the present.

My hope is that therapy helps you feel more grounded in who you are and more confident in your ability to handle what comes next.