What It’s Like to Be a Therapist in Los Angeles: 10 Reflections from My Practice

by Courtney Killough | Jul 1, 2025 | Articles

What It’s Like to Be a Therapist in Los Angeles: 10 Reflections from My Practice

Being a therapist in Los Angeles means working in a landscape that is as multifaceted as the people who live here—sun-soaked and fast-paced, wellness-oriented yet often overstimulated. I work with adults and couples navigating career shifts, relationship challenges, creative blocks, anxiety, grief, and transitions. But before I step into the therapy room (or Zoom), I begin my day with intention. Here’s a glimpse into my life as a therapist in Calabasas—ten truths that shape my personal and professional life.

1. Mornings in The Valley Are Sacred

Before I engage with any technology, I start my mornings with my oat milk latte on the balcony, a walk with my dog, movement (either yoga or a workout), and a meditation practice. Living in The Valley in LA allows me to embrace the quiet, nature-filled mornings that center me before I serve others. Practicing what I preach—tending to my own well-being—is non-negotiable. My morning rituals are what keep me grounded and capable of holding space for others.

2. My Office in Calabasas: Evenings, Weekends & Flexibility

I work Tuesday through Saturday at my Calabasas office, including evenings on Tuesdays through Thursdays. No, evening aren’t my favorite hours, but I deeply value being accessible to clients who still work traditional 9-to-5 jobs—a group that surprisingly still exists in parts of Los Angeles. I pause mid-day for a nourishing lunch (think veggie protein and greens), a matcha, and a short meditation to reset. Working Saturdays is a breeze for me—I live a pretty mellow lifestyle and love being able to support clients when they’re most available.

3. Therapy in Los Angeles Is for Everyone

Being a therapist in Los Angeles has shown me just how diverse this city really is. My clients come from varying socioeconomic statuses (SES), and I honor that by offering sliding scale slots—over a quarter of my caseload. Therapy should be accessible, and I strive to support people facing barriers—whether they’re single parents, navigating a disability, or in a financial rough patch. Equity matters to me in this work.

4. Working With Couples Across LA

Though my license reads “Marriage and Family Therapist,” about 60% of my work is with individuals. That said, I love working with couples, especially those in Los Angeles who are coming in proactively—engaged, committed, and wanting to grow together. Not all couples wait until a breaking point. Many are curious, communicative, and working hard to deepen their connection. It’s refreshing to see how the stigma around couple therapy is fading here. Therapy is no longer a last resort—it’s a foundation.

5. It’s All About the Relationship

Each client in my California practice gets their own tailored approach. My work is person-centered and integrated—never a one-size-fits-all model. Some sessions are deep and reflective; others include laughter and moments of lightness. That balance—the full spectrum of human emotion—is a vital part of the healing process. I see each client for who they are, not just the challenges they’re navigating.

6. Spiritual Psychology Meets Clinical Therapy

With an M.A. in Spiritual Psychology, I blend holistic tools into my sessions when it feels aligned and welcome. Being a therapist in Calabasas, near wellness hubs like Topanga and Malibu, some clients are open to meditation, somatic work, or spiritual reflection. Others prefer a more traditional therapeutic path—and I honor that, too. Therapy with me is collaborative, client-led, and attuned to what feels most supportive to each person’s journey.

7. Creatives, Entrepreneurs, and Everyone In Between

Being a therapist in Los Angeles means sitting with actors, artists, personal trainers, screenwriters, wellness entrepreneurs, and techpreneurs. I also see doctors, lawyers, teachers, and people in family-run businesses. LA is eclectic. The only consistent thread? Everyone needs a safe, confidential space to be themselves. I don’t often work with folks in fields like manufacturing or construction, and I recognize that more traditional ideas of masculinity (including as a woman) in some industries can create a barrier to accessing therapy. That’s something I hope continues to shift.

8. You’re Not Broken—You’re Human

Many of my California clients are doing their best. They’re not in crisis. They just want support, clarity, or a different way of being. Maybe life looks good on the outside, but inside they’re anxious, lonely, or burned out. Maybe they’re fresh out of a breakup, grieving an identity shift, or stuck in perfectionism. Maybe they’re ready to find their voice again in love, in family, or at work. Therapy is for people like you who are ready to feel a little more free.

9. It’s Not Draining—It’s a Privilege

When people ask, “Isn’t it depressing to listen to people’s problems all day?” I smile. Because honestly—it’s not. It’s an honor. Of course, I hear heavy things, and yes, I feel deeply with my clients. But I also see real growth, resilience, and transformation. Watching someone come back to themselves, step into their voice, or finally feel less alone—that energizes me. My daily self-care and boundaries are what make this sustainable and deeply fulfilling.

10. Sundays Are Sacred (And Coffee Dates Look Different Now)

After spending most of my week sitting with others in deep conversation, I crave movement and levity on Sundays. I no longer seek out long coffee dates or dinners—I’d rather hike with a friend, stroll on the beach, or hang with their kids. Sunday is a no-work zone. I don’t check email. I don’t prepare for clients. I need that time to refuel so I can give fully to my practice the rest of the week. That’s part of what being a grounded therapist means to me—living the balance I guide others toward.

Being a therapist in LA is both a calling and a lifestyle. It means showing up in integrity, staying grounded in self-care, and holding space for the beautifully complex lives of others. And I wouldn’t trade it for anything.

If this resonates with you and you’re looking for a therapist in California, I’d love to connect.

Understanding Sliding Scale in Therapy: What It Is, Who It’s For, and Why Standard Rates Matter

by Courtney Killough | Mar 1, 2025 | Articles

Understanding Sliding Scale in Therapy: What It Is, Who It’s For, and Why Standard Rates Matter

If you’re considering starting therapy and wondering about the cost, you may have come across the term sliding scale. As a therapist in private practice, I want to offer some clear information about what a sliding scale is, why it exists, who it’s intended to support, and why therapy costs what it does.

What Is Sliding Scale?

Sliding scale is a reduced fee offered by some therapists to clients who need therapy but cannot afford the therapist’s full standard rate. It’s most often available to people who are not using insurance because they are choosing to pay privately due to not having insurance or their therapist is out of network and their insurance has a high OON deductible and low reimbursement rate.

The reduced rate is based on need, and that need can be financial and/or circumstantial. For example, someone may be eligible for a sliding scale if they are:

* Recently unemployed, underemployed or working a minimum wage or low-paying job with a high cost of living (common in California)
* Someone who has lost their home and been displaced due to a natural disaster
* A single parent with multiple dependents and childcare responsibilities
* Part of a household where a partner is unemployed or has a disability and is unable to work
* A student or recent graduate without financial support

In these cases, people are often living paycheck to paycheck, covering their basic needs (rent, groceries, transportation, childcare), and still unable to afford therapy at full price. Sliding scale is one way to help bridge that gap and make mental health care more accessible to those who need it most.

Who Is Sliding Scale Not For?

Sliding scale is not simply a discount. It’s not for someone who could afford therapy but prefers to pay less. That includes people who:

* Have access to financial support from family
* Have a steady income and have chosen to prioritize luxury spending (travel, designer items, aesthetic treatments, boutique fitness memberships, home renovations, etc.)
* Have savings or investments they prefer not to tap into

If you fall into one of these categories, I absolutely want you to get the support you need. But sliding scale isn’t meant for those with optional spending flexibility. In these cases, part of the therapeutic journey may include reevaluating priorities and choosing to invest in your mental health at this time.

How Sliding Scale Works in My Practice

In my practice, I reserve a limited number of sliding scale slots for clients with genuine need. These spots are offered in ranges such as $70–$110 and $115–$155 per session, depending on individual circumstances. I don’t require tax forms or proof of income—I work on the honor system, trusting clients to be transparent and respectful of the intention behind sliding scale.

After all, therapy is built on honesty. If the relationship starts with a misrepresentation of your ability to pay, it undermines the trust that’s essential for meaningful work.

Standard Rates and Why They Matter

For those who are financially stable or have access to resources, I offer package options as a way to honor your commitment to therapy while also offering some savings. Packages include:

6 Individual Sessions for $975 (1 free session included)
6 Couple Sessions for $1175 (1 free session included)

My standard rates are $195 for individuals and $235 for couples. These rates reflect not only the time spent in each session, but also the years of education, training, and investment that therapists bring to their work. Here’s a quick overview of what goes into becoming and remaining a licensed therapist:

* A Master’s degree (often costing over $200,000)
* 3,000 hours of supervised clinical training (typically taking 2+ years after graduation)
* Ongoing expenses including office space, insurance, continuing education, licensing fees, and administrative support
* A limited caseload (I see around 20 clients a week) to maintain the energy and attention required to offer high-quality care

All of these costs are factored into the price of sessions and into the quality of support I strive to offer every client.

In Summary

Sliding scale is a tool for increasing access to therapy for those who truly cannot afford it. It’s part of my commitment to social responsibility and to helping people through difficult seasons when they might otherwise go without support. But it’s also limited and based on need, not preference.

If you’re in a position to afford full-fee therapy, paying the standard rate allows me to continue offering reduced fees to others in need—and it’s a meaningful investment in yourself.

If you’re unsure where you fall or want to explore options, feel free to reach out. Together, we can see what’s possible and what feels fair—for both of us.

When the Smoke Clears: Reflections and Resources for Healing After the Fires

by Courtney Killough | Feb 1, 2025 | Articles

When the Smoke Clears: Reflections and Resources for Healing After the Fires

Wildfires swept through parts of Los Angeles recently—this time touching Pacific Palisades and Altadena, sending smoke and panic across the basin. As someone whose office is in Calabasas, I found myself nervously watching the hills outside my window, tracking evacuation updates, and eventually packing up quickly when one of the fires came alarmingly close. Thankfully, that fire was put out quickly and the Palisades Fire going through Topanga was contained. My office was spared. But not everyone was so lucky.

My heart aches for those who lost homes or were forced to evacuate, unsure of what they’d return to—if anything. These recent fires brought up something deeply personal for me. My maternal grandmother’s family has roots that go back five generations in the Pasadena area. I grew up hearing stories of their early life here, and I’ve always carried a reverence for this land, this light, these hills.

Over the years, my family has lived in many parts of Los Angeles—Pasadena, Pacific Palisades, and Malibu. One of the homes I lived in as a child in Malibu burned to the ground about a year after we moved out. Even though we weren’t living there anymore, the loss was painful. It was a place that had held our memories. Seeing homes reduced to rubble—places that were once so familiar, streets I drove by frequently—it’s a disorienting and devastating sight.

These fires aren’t just environmental disasters—they are deeply human ones too.

When someone loses their home, or even just the sense of safety in their community, it doesn’t get resolved the moment the flames are extinguished. In the beginning, it’s all about survival: evacuating quickly, trying to save pets or precious belongings, figuring out what’s safe to eat or drink, where to go next. These are urgent, necessary decisions made in the midst of fear.

But once the adrenaline subsides—once you’re in a temporary rental or staring at what’s left of your home—the real emotional aftermath begins. That’s when trauma, grief, and PTSD can start to set in. It’s not uncommon to feel numb, or to be overwhelmed by waves of sadness, anger, guilt, or helplessness. This is a normal and human response to an abnormal and heartbreaking situation.

As a therapist who specializes in trauma, I want to offer a few tools—gentle suggestions—for those who are navigating the emotional aftermath of the fires. These are ways to reconnect with your body, your emotions, and your sense of self during a time that feels so destabilizing:

10 Ways to Take Care of Yourself After a Wildfire:

1. Shake Your Body – Animals instinctively shake off stress after a threat passes. Try literally shaking your limbs in the air while laying on your back or doing a full-body shake standing up. It can help release stored adrenaline and signal to your body that you’re safe now.

2. Listen to Music That Matches Your Mood – Let yourself cry. Let yourself sing loudly. Let yourself *feel*. Music can help us move emotions that feel stuck.

3. Dance – Even if it’s just in your living room. Movement brings life back into the body. Let yourself move freely without judgment.

4. Exercise – Gentle movement or more vigorous workouts can help regulate your nervous system and rebuild a sense of routine and control.

5. Journal – Write about what happened. Let the words come uncensored. Your story matters, and processing it on paper can be deeply therapeutic.

6. Practice Self-Compassion – You may feel numb, grateful, angry, guilty, overwhelmed—or all of it at once. Every emotion is valid. Speak to yourself with kindness, the way you’d talk to a friend.

7. Rest – You might feel exhausted, emotionally and physically. Rest is not a luxury—it’s a need. Give yourself permission to slow down.

8. Hug Someone – Whether it’s a loved one, a friend, or a furry companion. Physical touch helps regulate our nervous systems and reminds us we’re not alone.

9. Talk to Loved Ones – Share your story, your fears, your memories. Let people support you. Healing happens in connection.

10. Talk to a Trauma-Informed Therapist – Especially if you’re feeling anxious, hypervigilant, depressed, or stuck. You don’t have to carry this alone.

This city holds so many of our stories—ours and those who came before us. The land remembers. And we remember too. Healing doesn’t mean forgetting or pushing forward at full speed. It means honoring what was lost, acknowledging the pain, and gently finding ways to move forward—one breath, one moment, one step at a time.

If you’ve been impacted by the fires and are struggling, I see you. I’m here. And you’re not alone.

With deep care,

Courtney Killough, LMFT
Therapist | Trauma Specialist
Calabasas, CA

Are You Dating an Avoidantly Attached Partner?

by Courtney Killough | Dec 1, 2024 | Articles

Are You Dating an Avoidantly Attached Partner?

10 Subtle Signs After 6 Months Together

Written from the heart of a therapist’s chair

After about six months into a relationship, patterns start to solidify. The honeymoon phase gives way to something more revealing—something more real. As a therapist, I often hear clients quietly ask, “Is it normal that I still feel like a stranger to my partner?” If you’ve been dating someone for half a year and you’re starting to question their emotional availability, you might be experiencing the effects of avoidant attachment.

Here are some signs to gently tune into—because your feelings matter, and so does your need for connection.

1. You’re still only seeing each other once a week—by their choice.

In the early days, that might have felt romantic, even refreshing. But six months in, if they’re not initiating more time together or seem resistant to it, it could signal discomfort with too much closeness.

2. Your dates are always “doing” things, rarely “being.”

Rock climbing, concerts, errands… but deep conversation over wine or a lazy Sunday morning in bed? Not so much. Avoidantly attached partners often gravitate toward activity-based dates that don’t require emotional vulnerability.

3. The idea of a weekend getaway just… doesn’t happen.

You’ve hinted, maybe even suggested. But there’s always a reason: busy at work, not feeling up to it, not the right time. Planning future closeness can be overwhelming for someone who fears intimacy.

4. They said no to being your plus-one—to a big event.

A friend’s wedding, your cousin’s birthday party. They made an excuse, or said they just don’t like “those things.” But showing up for your people is part of showing up for you.

5. They avoid meeting your family—even when it’s easy.

Your parents live a short drive away, but they’ve never shown interest in saying hello or joining you. It’s not about the distance—it’s the emotional commitment that they might be resisting.

6. You don’t exist on their social media.

No pressure to post every moment, but if they’re active online and haven’t acknowledged your relationship in any way, you might be wondering: Are they protecting their privacy or their independence?

7. When you open up, they’re… elsewhere.

You’re trying to be vulnerable, but they’re half-scrolling on their phone, multitasking, or checking out. It can feel like your emotions are an inconvenience.

8. “How are you feeling?” gets a classic “I’m fine.”

You’re trying to connect. They give you a surface-level answer and shift the conversation. It’s not that they don’t feel—it’s that they may not know how to share those feelings safely.

9. Relationship conversations are always postponed.

You bring up something that’s bothering you, and they’re too tired, not in the mood, or “don’t want to ruin the vibe.” And so your needs get put on the back burner—again.

10. Any talk about the future? Cue the jokes.

You bring up moving in, traveling together, or long-term goals—and suddenly, they’re deflecting with humor. It’s not that they’re funny (okay, maybe they are)—it’s that vulnerability feels unsafe for them.

So, what now?

If you’re nodding along, take a deep breath. You’re not imagining things. These aren’t just quirks—they’re patterns. Avoidantly attached individuals often crave connection but fear what it will cost them. That push-pull dynamic can leave you feeling confused, unseen, and emotionally lonely—even if the relationship looks “fine” on the surface.

It doesn’t mean your partner is a bad person. It means they may have learned early on that closeness equals vulnerability, and vulnerability equals risk. But here’s the thing: your emotional needs are not too much. Wanting closeness, consistency, and communication is not clingy—it’s human.

As a therapist, here’s what I often tell my clients:

If you feel like you’re constantly managing your partner’s comfort while silencing your own needs, it’s worth exploring. You don’t have to settle for emotional breadcrumbs. A secure, loving relationship isn’t about walking on eggshells—it’s about building something safe together.

And you deserve nothing less.

Ready to explore what you need in love? Therapy can help.

If this post stirred something in you—confusion, clarity, even grief—you’re not alone. Whether you’re navigating an avoidant partner, questioning the health of your relationship, or just trying to understand your attachment style, therapy offers a safe, judgment-free space to unpack it all.

You don’t have to figure it out by yourself.

Together, we can explore how you show up in relationships, what feels fulfilling (and what doesn’t), and how to create the kind of connection you truly want. Because you deserve more than guessing games—you deserve secure, soulful love.

Interested in starting? Let’s talk.

Letting Go of the “Shoulds”: Reimagining Sexual Intimacy

by Courtney Killough | Nov 1, 2024 | Articles

Letting Go of the “Shoulds”: Reimagining Sexual Intimacy

If there’s one theme I see over and over in the couples I work with, it’s this: We are haunted by what we think sex “should” be.

In Come Together, Dr. Emily Nagoski names this haunting beautifully. She breaks down the pressures many of us carry around sex—pressures that aren’t natural or necessary but learned, absorbed from culture, media, and outdated models of what it means to be in a sexual relationship. And then, she offers us a way out.

The “Sex Imperative” Isn’t Helping

Dr. Nagoski outlines several “imperatives”—internalized rules that tell us we need to be doing sex better, more often, more passionately, more correctly. These include:

* The coital imperative (sex = penetration),
* The variety imperative (keep it spicy or else),
* The performance imperative (be good at it),
* The confidence imperative (feel sexy or don’t bother),
* The pleasure imperative (orgasm or it doesn’t count),
* The relationship imperative (if we’re not having sex, something is wrong with us),
* And the desire imperative (we should always *want* sex, or at least want to want it).

These “rules” create a sense of urgency and failure. Even in loving relationships, they quietly whisper: You’re not doing enough. You’re not enough.

But what if sex didn’t need to be a task, a test, or a symbol of your worth?

What if sex could simply be an experience of shared presence, however it shows up today?

In therapy, I encourage couples to ask: What would intimacy look like if you stopped trying to “fix” our sex life and instead started creating new rules that fit you?

Dr. Nagoski calls this “playing new games.” Maybe your new game is lying in bed together touching each other’s hair. Maybe it’s taking a shower together without the goal of arousal. Maybe it’s saying “no sex tonight” and letting that be a relief, not a failure.

The goal? To release the pressure. To return to connection. To be together as you are, not as you think you “should” be.

The Magic Trick Is Aliveness

Dr. Nagoski moves us beyond sex—into something even more powerful: ecstasy.

She defines it not as orgasm or intensity, but as a state of aliveness, of feeling fully connected to your body, your breath, your self, and the moment.

The “magic trick” she offers? Savor pleasure. Move your body. Touch with consent and love.

That’s it. And yes, it can happen in sex. But it also happens in dance, in chanting, in walking together in rhythm, in yoga classes, in drumming circles, in moments when we’re “in sync” with others.

This is the kind of intimacy that goes deeper than desire—it taps into something spiritual. Something ancestral. Something deeply human.

What This Means in Practice

If you’re in a long-term relationship and struggling with sex—whether it’s desire discrepancies, performance anxiety, or just the slow fade of connection—you’re not broken. You’re human. You’ve been fed a lifetime of imperatives that don’t serve you.

So what if you let go?

What if you created new rituals of intimacy that honor your reality now?

What if your connection wasn’t measured by frequency or technique, but by presence and joy?

And what if you treated pleasure like a practice—one you tend to in all areas of life?

That’s the invitation of Come Together. Let go of the pressure. Get curious. And let your relationship evolve—not toward some perfect ideal, but toward something truer.

From the therapy room to your living room, here’s what I want you to remember: You don’t have to earn intimacy. You don’t have to perform desire. You just have to show up—with curiosity, gentleness, and a willingness to feel alive together.

That’s the real magic.

A couples therapist who believes that intimacy begins when the “shoulds” fall away, and presence takes their place.

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