Tiffany Machia

I'm Tiffany, an LMFT with nearly a decade of experience, offering telehealth therapy in OR, CA, and AZ. I work with perinatal mental health, grief and loss, anxiety, low mood, therapy for dads, women's issues, confidence and self-worth, and relationship or interpersonal patterns. My focus is on what often goes unaddressed: new mothers struggling beyond the baby blues, dads who feel lost, grief that others have stopped acknowledging, anxiety or low mood that won't lift, repeating relationship patterns, or self-criticism that's hard to shake. If something feels off, that's reason enough to start.

I use a directive, skills-based approach so you leave sessions with practical tools you can actually use — not just in our conversations, but in your day-to-day life and relationships. I primarily draw on CBT to help identify and shift the thought patterns keeping you stuck, and I bring in Gottman Method, Narrative Therapy, Motivational Interviewing, or Solution-Focused Brief Therapy depending on what fits you best. I'm warm, but I'm also direct — I'll be honest with you about what I'm noticing, and I'll hold you to the goals you set for yourself.

Reaching out can feel like a big step, especially if you're used to holding things together for everyone else. In our first session, we'll take time to get to know each other — I'll ask about what's bringing you to therapy now and what you've tried before, and we'll start sketching out what you want things to look like going forward. You don't need it all figured out before we talk. Some curiosity about doing things differently is enough to begin.