Tiffany Machia

Pregnancy, a new baby, a relationship under strain, a life that suddenly looks different than you planned. Big transitions can bring anxiety that won't settle, more conflict with your partner, and a nagging sense that you should be handling this better. I'm an LMFT with specialized perinatal mental health training through Postpartum Support International and Level 3 Gottman Method training. I help adults in Oregon, California, and Arizona find real relief through structured, skills-based therapy by video. I also support clients through grief and past trauma.

I take a directive, skills-based approach, so you leave sessions with tools you can use in your daily life and relationships. I primarily use CBT to identify and change the thought and behavior patterns keeping you stuck. If your relationship is part of what's hard, I draw on Gottman Method tools to help you communicate better, manage conflict, and rebuild connection, even if your partner isn't in the room. I also bring in Motivational Interviewing, Solution-Focused, or Narrative Therapy when they fit. I'm warm but direct. I'll be honest about what I'm noticing and help you stay on track with the goals you set.

Reaching out can feel like a big step, especially if you're used to holding everything together for everyone else. In our first session, I'll ask what's bringing you in now and what you've already tried, and we'll start mapping out what you want to feel different. By the end, you'll have a sense of how we'll work together and what to focus on first. You don't need it all figured out to start.