Online Therapy and Coaching Services with Ruthie

Therapy: I am a registered psychotherapist in Ontario, Canada, which may also be referred to as being licensed. This allows me to offer therapy to individuals and relationships within the province of Ontario, and in locations that do not restrict where a client's therapy is located. Psychotherapy is mental health work, and can include diving deeply into topics that fall under that category. My profession is not allowed to diagnose or prescribe medications, but we can talk about those topics. We may focus on resolving things from the past or present, as well as improving how things may go in the future. I am not available for emergency services and I cannot work with clients who are actively in crisis unless they also have another registered/licensed mental health professionals for that work.

Coaching: Coaching is an unregulated field, and therefore practitioners cannot be registered or licensed to provide it. Coaching is not covered by insurance, and may be defined in lots of different ways. My style of coaching involves more self disclosure (I may share some things about myself, if you request it, like my experiences of handling things as a non-binary person), does not dive into topics that we anticipate might be riskier, and focuses mostly on the present and future. It's best suited to folks who are generally doing well in life, but have areas that they'd like to enhance and improve. It's also a good option for people who already know me, as there are no restrictions on dual relationships. Coaching is not for people who are in crisis, unless that crisis work is being done with a difference registered/licensed professional.

Both: Whether I'm offering coaching or therapy, my style tends to involve a lot exploration into the presence and impacts of power, stigma, trauma, interpersonal dynamics, and especially strengths. Oppression is frequently explored, whether it's internalized, familial, or cultural. Because of my background as a sex educator, clients working with me on sexuality topics may also get some bonus comprehensive and very applied sex & pleasure ed along the way. I am strongly influenced by Narrative approaches, although I am trained and experienced with a variety of models and approaches. Sessions are typically 50-60 minutes in length, and most clients see me once every 2-3 weeks. Availability varies based on whether I have any openings at the time. My full fee for services is $250 x hour. Reduced rates may be available for trans and/or BIPOC clients facing financial strain.

I welcome all intimate relationship structures between consenting adults. While I regularly work with monogamous, straight, cis-gendered couples I primarily work with relationships between sex and/or gender queer, non-monogamous, and/or kinky people. Sex workers their partners are also welcome. There is no additional fee for relational therapy with two or more clients. Please let me know if you will be logging in from more than 1 computer so I can ensure that my video call service can work with everyone. See the top section for more information on coaching and therapy.

Since about 2003 I have been offering sessions focused on discovering or re-discovering greater pleasure and sexual intimacy. This work can be done with individuals as well as relationships. Many of my clients have complex trauma histories, while others are just looking to explore more deeply rooted pleasure and intimacy. My background includes working as a sexuality educator in locations from university classrooms to homeless shelters to large kink events. Clients' goals often include learning to orgasm or give orgasms, dating and hook-up skills, sexual communication, sex and dating between autistic and "neurotypic" people, gender affirming sex techniques for trans people, exploring kinks and/or open relationships, and dating and sex skills for fat bodied people and their lovers. 

Usually at least half of my clients are gender queer, trans, gender creative, agender, non-binary, questioning, and other gender identities that are not cis gender. I am also non-binary gender queer and I live within a trans household, so my knowledge in this area is grounded in lots of formal training as well as extensive personal and professional experience. I invest a great deal of time in my own on-going education in this area, including through resources like Rainbow Health Ontario. While many or most of my clients are under the trans umbrella, sometimes it is the focus of therapy/coaching and other times it an important context for life but not the focus of our sessions. Trans clients may attend with loved ones (who may or may not also be trans), or by themselves.

 

I do offer support letters that may be requested by physicians or others in order to access hormone therapy or surgical referrals. Most health professionals who request/require letters prefer that clients/patients have an on-going relationship with a psychotherapist, or at least three sessions. I agree with that recommendation but do not require multiple sessions for a letter. However, the letter will note the length and frequency of our professional relationship, among other details about you. Letters are co-written with clients, sometimes during extended sessions, in order to make it as much of a transparent and respectful process as possible. I cannot promise that my letter will be what your doctor requires to feel comfortable prescribing or referring, as that depends a great deal on the specifics of the client and their experiences. It would be extremely rare for me to have strong concerns about providing one of these letters to a client, but if that occurs I will be honest with you. Letters of support are given to clients to submit to their own healthcare providers, so it is always your decision whether or not to use the letter.

Certain coaching clients may be good candidates for experiential sex coaching in order to support their specific goals. Sex coaching sessions may include explicit work on these goals, including the use of educational, explicit videos and images as resources, or live online guidance of an explicit nature. Sex coaching may be done in collaboration with referrals to trained therapeutic sex workers who offer hands-on work, as I do not provide those services. Consent is the cornerstone of this work, and clients are expected to be transparent about their comfort level and needs while I strive to co-create the most safe, respectful, and supportive environment possible.

 

My sex coaching sessions are never intended to be an erotic experience with me, but rather for me to provide guidance to help you achieve your solo and partnered sexual goals. I remain professionally clothed (although clients may not, depending on their goals and comfort levels) and I do not offer sexual touch. This is not phone sex, cam sex, or professional domination. Experiential sex coaching sessions may be especially useful for clients with chronic health considerations, less common kinks, not dangerous trauma responses to sexual situations, or a general lack of sexual knowledge and who have not found existing educational resources to be useful enough. Sex coaching of an explicit nature is not recommended or available for all clients, and the fee structure may be different as sessions are often longer, more intense, and more spaced out. These services are not legal to provide to anyone who has seen me for therapy, or who intends to do so in the future.

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© 2020 by Ruth Neustifter, Ph.D.