Dr. Trillion Small

I work with high-functioning, driven adults who are successful on the outside but often carrying pressure, over-responsibility, or internal strain on the inside. Many of my clients are executives, entrepreneurs, professionals, and leaders who are accustomed to performing at a high level and want therapy that matches their pace, depth, and intellect.

I hold a PhD in Clinical Counseling and a Global Executive MBA from Duke University. I have extensive experience working with high achievers navigating stress, identity shifts, relationships, leadership demands, and major life transitions. Clients often come to me when traditional therapy has felt too surface-level or when they want a space that allows for both emotional depth and strategic thinking.

My style is warm, direct, and grounded. I value clarity, insight, and meaningful progress, and I work collaboratively with clients who are ready to engage honestly with themselves and their growth.

At this time, my practice is accepting new clients for individual therapy only. I am not accepting new couples therapy clients. Please ensure you are seeking individual therapy before scheduling an initial appointment. Thank you for your understanding.

My approach is integrative, insight-oriented, and practical. I help clients understand why patterns exist while also focusing on how to create sustainable change. Sessions often blend emotional processing with cognitive clarity, nervous system regulation, and intentional skill-building.

I don’t believe in pathologizing high achievement, however, I do believe in addressing the costs that often come with it: burnout, emotional suppression, relationship strain, over-functioning, or difficulty slowing down. Therapy with me is thoughtful and engaging, with space for both reflection and forward movement.

Clients who work well with me appreciate depth, honesty, and a therapist who can hold complexity without oversimplifying their experience.

The first session is a collaborative conversation focused on understanding what brings you in, what matters most to you, and what you want therapy to support or shift in your life. We’ll explore your current challenges, patterns, and goals while also getting a feel for how we work together.

You can expect a calm, professional, and thoughtful space. One where you don’t need to perform, explain yourself excessively, or have everything figured out. By the end of the session, most clients leave with greater clarity, a sense of direction, a grounded awareness of self-agency, and a clear understanding of how therapy can support them moving forward.

To learn more about me please visit: https://trillioninstitute.com/