Couples Therapy and Sex Therapy | Paula Kirsch, LCSW, CST
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Telehealth Couples & Sex Therapy
Couples Therapy · Telehealth

Couples Therapy for the Things You Can't Say at Home

Virtual sessions with a Certified Sex Therapist. Real depth, from the first appointment, wherever you live.

Book a Free 15-Minute Consultation
NY CT MI MA FL

Does any of this sound familiar?

If something brought you here, that's usually enough to start.

Schedule a Free Consultation
  • You and your partner used to have sex. Now you don't, and neither of you has said it out loud yet.
  • You've been in couples therapy before. It was fine. Nothing shifted.
  • You're fine on paper. In bed, or in conversation, something is missing.
  • One of you wants more, one of you wants less, and every conversation about it ends the same way.
  • Something happened between you, and you're both still trying to find your way back.
  • You love your partner. You're just not sure you want to stay.
  • Your relationship doesn't fit the standard model, and you're done explaining it to therapists.
What to Expect

Couples work that goes where it's needed

I'm a Certified Sex Therapist as well as a couples therapist, so nothing is too awkward to bring into the room. We work on communication, trust, desire, and intimacy together, and sessions are entirely talk-based on a secure video call.

A structured conversation that moves.

Sessions start with what's actually going on: not the version that's easiest to say, but the real one. From there the work is specific and goal-oriented, with new ways of talking to each other and practices to try between appointments that we process together.

My couples work is Gottman Method informed, and I bring in Brainspotting when trauma or emotional blocks are part of the picture. I work with all relationship structures, including LGBTQ+, ENM, kink-aware, and mixed-orientation couples.

Being in your own space for this kind of conversation turns out to be exactly right for most couples. No waiting room, no commute, no performance.

$250Couples session, 55 minutes
Not Sure If You Want to Stay?

Discernment counseling is a short, structured way to decide.

Sometimes the real question isn't how to fix the relationship. It's whether to try. If one of you is leaning out and the other wants to stay, or you're both genuinely unsure, regular couples therapy can feel like the wrong tool.

Discernment counseling is a brief, focused process designed for exactly this moment. The goal isn't to push you toward staying or leaving. It's to help you reach a clear decision you can stand behind, with a full understanding of what's happened and what each path would take.

$495First session, 2 hours
$395Sessions 2 to 5, 90 minutes each

Discernment counseling generally takes 1 to 5 sessions in total. The first session is 2 hours, and sessions 2 to 5 are 90 minutes each.

Ask About Discernment Counseling
Where I Practice

Serving five states

New York Connecticut Michigan Massachusetts Florida

Wherever you have privacy and a connection.

I'm a Licensed Clinical Social Worker licensed in New York, Connecticut, Massachusetts, and Michigan, and a registered telehealth therapist in Florida. I'm also a Certified Sex Therapist through both IBOSP and IAPST, and a PhD student in Sexology at MSTI, which keeps my work grounded in current research.

All sessions are virtual, so you can meet from home, your office, or wherever you have privacy. You need to be located in one of these five states at the time of your session.

If you're in one of these states and any of this sounds like you, this is where that conversation belongs.
Paula Kirsch, LCSW, CST, couples and sex therapist
Your Therapist

Paula Kirsch, LCSW, CST

I became a sex therapist because it's where the most important, and most avoided, conversations happen. Most couples never get a real place to talk about intimacy, desire, and the things that sit underneath the arguments.

Licensed in NY, CT, MA & MI
Registered Telehealth Therapist in FL
Certified Sex Therapist (CST), IBOSP & IAPST
Gottman Method Trained, Level II
Brainspotting Trained
PhD Student in Sexology, MSTI
LGBTQ+, ENM & Kink Affirming
Getting Started
1

Book a free 15-minute consultation

We'll make sure this is the right fit. Most new clients are in session within a week.

2

Meet online

I'll send you a secure link. All you need is a private space and an internet connection.

3

Do the real work

We start where you actually are, not where you think you should be.

Questions

Things couples ask before reaching out

I serve couples in New York, Connecticut, Massachusetts, Michigan, and Florida. Both partners should be located in one of these states at the time of the session.
Couples sessions are $250 for 55 minutes. Discernment counseling is $495 for the 2-hour first session and $395 for each 90-minute session in sessions 2 to 5, and generally takes 1 to 5 sessions in total. Paula Kirsch Therapy is a private-pay practice, and payment is due at the time of each session. I don't provide superbills for couples therapy or discernment counseling. Your first call is a free 15-minute consultation, so you can ask questions before you commit to anything.
No. It is entirely talk-based, conducted on a secure video call like any other therapy appointment. Sessions focus on conversation, education, and skill-building.
That's common, and it's exactly what discernment counseling is for. It's a short, structured process for couples where one or both partners are unsure about staying. It generally takes 1 to 5 sessions. The first session is 2 hours, and sessions 2 to 5 are 90 minutes each. Ask about it during your free consultation.
Communication that's shut down, trust after infidelity, emotional distance, desire discrepancy, sexual disconnection, and the question of whether to stay or go. My practice is affirming of all relationship structures, LGBTQ+, kink-affirming, and ENM partnerships included.
Start with a free 15-minute consultation. Then you'll complete intake paperwork in your own encrypted portal and receive a secure link for your first session.
When You're Ready

You've already done the hard part.

Deciding to reach out, especially about something as personal as sexuality, relationships, or intimacy, takes courage. The fact that you're here matters.

15 minutes, free. A brief call to see if we're a good fit. No commitment required.

You just need to take one small step, and I'll meet you there.

Couples therapy: $250 for a 55-minute session.

Discernment counseling: $495 for the 2-hour first session, then $395 per 90-minute session for sessions 2 to 5. Generally 1 to 5 sessions in total.

Your first call is a free 15-minute consultation. Paula Kirsch Therapy is a private-pay practice, and payment is due at the time of each session. Superbills are not provided for couples therapy or discernment counseling.

Schedule your free 15-minute consultation.

Book My Consultation

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Available to couples located in NY, CT, MI, MA, and FL.