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My approach to therapy consists of two core principles: Creating a strong and safe therapeutic relationship and utilizing research-supported therapy techniques to achieve therapy goals in a timely manner. In my first few sessions, I focus on understanding presenting concerns, getting to know one another, providing a detailed diagnostic assessment, and collaboratively creating a treatment plan that will be referred back to and modified as treatment progresses. I typically meet with clients for around a year (more or less depending on severity) and expect to see signs of symptom improvement within the first 1-2 months of weekly meetings.
I have been trained extensively in Cognitive Behavioral Therapy (CBT) principles and I utilize many research-supported techniques from CBT and third-wave CBT therapies, specifically Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy (DBT), Mindfulness Therapy, Compassion-Focused Therapy, and Schema Therapy. I also incorporate elements from Interpersonal Psychotherapy (IPT) and Emotion Focused Therapy (EFT). With certain client issues, I primarily use “gold standard” techniques that have been found to produce the best outcomes, like Cognitive Processing Therapy (CPT) for PTSD/trauma, Exposure and Response Prevention (ERP) for obsessive compulsive disorder (OCD), and exposure therapies for phobias and social anxiety. While I greatly value research-supported techniques, I also believe they are most effective delivered in a client-centered and humanistic manner drawn from multicultural and feminist therapy perspectives. My approach has been described as kind, caring, transparent, and invested in my client’s wellbeing. I am not a therapist with a detached and clinical approach for my clients, and I believe every client deserves a tailored experience to their specific needs.
If I am lacking expertise to address a specific concern, am not seeing expected symptom reduction, or there are misalignments in my approach and client’s expectations, I aim to address these concerns early in the therapeutic relationship. I invite honest feedback throughout therapy regarding what each client feels is helpful or unhelpful in our meetings, and we’ll work together to find the right adjustments or possibly a better fitting referral. I love working with my clients, and part of that is ensuring each client receives what they deserve from their hard work and time committed to therapy.
I’ve lived in Washington for most of my life, completing my PhD in Clinical Psychology at Washington State University in 2023 after earning my B.S. in psychology and B.A. in anthropology there as well. I left for Minneapolis to complete my predoctoral internship at the University of Minnesota’s Student Counseling Services and then joined a local private practice in the Minneapolis suburbs for my postdoctoral fellowship. Shortly after returning to the Pacific Northwest, I became licensed as a clinical psychologist in Washington State and opened my private practice, Sierra Paup Psychology, alongside Associates in Behavioral Health.
I believe in bringing my genuine self to the therapy room. I am a queer, transgender woman who embraces her nerdiness and practices a variety of creative outlets. In my free time, I enjoy exploring restaurants across the country with my wife, spending time with my two cats, building, painting, sewing, or writing, and playing increasingly complex board games. One of my most essential goals is creating a welcoming environment where clients can also be their authentic selves, so we can work together to understand and achieve their goals.
I am not in-network with any insurance companies and do not plan to be in the future. I will provide superbills for any client who would like to seek out-of-network reimbursement from their insurance.
70% of my clients pay on a sliding scale, in which costs for services are discounted based on expressed client need. I further explain my sliding-scale system and determine appropriate payment amounts with clients during a free phone consultation before starting services.