TELE[mental]HEALTH serving
QUEER & Neurodivergent
clients in Tahoe & BEYOND

with Dr. Sage Rian

 

whole soul healing

MAYBE YOU'RE AT A crossroads

and realizing that you still feel empty & lost even after you did everything you were “supposed” to do

OR NEEDING A guide

to help you get through a life transition, burnout, existential crisis & other issues relating to identity, spirituality, or anxiety

TO TAKE your life BACK

so that you can live freely and authentically, after developing the skills & insight needed to heal your wounds for a fulfilling future.

hey there, I'm Dr. Sage

my pronouns are he/him & they/them

I'm an existential psychotherapist, counseling professor, holistic healer, and yogi. I take a mind-body-spirit approach to wellness that is uniquely tailored to you and integrates counseling, transformational coaching & mindfulness. Whatever we are working on, my goal is to provide a non-judgmental place for you to express, explore, and discover yourself.

As a queer and neurodivergent clinician, I am passionate about providing quality care to clients in those communities. I am also a coach, certified yoga teacher, and ecotherapist.

My practice strives to be anti-racist, anti-colonial, and anti-oppressive in all of the work I do, which also means we'll explore issues through a social justice & systems-based lens.

Get to Know Me

 

my expertise

I specialize in issues related to
identity, trauma, and existential crisis

Gender, Sexuality & Relationships

In a world where gender, sexuality, and relationship norms are often narrowly defined, it is a great honor to offer a fluid, safe space where you can explore the parts of yourself that transcend the binary. Whether you’re re-evaluating your identity, changing or opening up a relationship, or just wanting to work with someone who “gets” it, I’m here to help you navigate your personal journey. We may work together over a period of time to explore your identity or relationships, but I also provide single-session evaluations for letters in support of gender affirming procedures.

Autistic, ADHD & Highly Sensitive Adults

Living as a neurodivergent adult can often feel like you’re navigating a world that doesn’t get you, wasn’t built for you, or like you’re just deeply different from other people – maybe you’re even seeking therapy because you want to be “fixed”. Getting a diagnosis, or coming to realize you’re neurodivergent can be both liberating and dysregulating, but I’m here to help you make sense of it. I also frequently work with people who are questioning whether or not they might be autistic and/or ADHD, especially in high-achieving women or AFABs, which we can also explore.

Trauma & Complex PTSD

Trauma manifests in many forms, from single major incidents like an assault to prolonged exposure like experiencing neglect, and it can leave lasting imprints on your mind, body, and spirit. Complex PTSD, a result of repeated or chronic traumatic events, can be particularly challenging to navigate, but is common among neurodivergent people. Whether you're dealing with emotional dysregulation, disconnection, or dissociation, I’m here to help you reclaim your sense of self and safety. Our work together will be a collaborative effort towards healing your nervous system.

Grief & Loss

Experiencing loss can be one of the most isolating and overwhelming experiences in life. Whether you're mourning the death of a loved one, the end of a relationship, or a significant life change, I am here to provide a compassionate space for you. Loss is not linear, and everyone's grieving process is unique. Grief or loss can also crop up during “happy” transitions, which can be overwhelming or confusing. For many people grief or loss has spiritual implications that we can explore together; I have a sub-speciality (specific training) in spirituality & religion in counseling.

 


Offerings

Psychotherapy is available to residents of Nevada & Colorado, and I work with clients internationally as a transformational coach. Ecotherapy is available in Truckee.

 


tele-therapy

Heal on your own terms and from the comfort of your own space by connecting with me over phone or video. Experience personalized therapy or coaching sessions that fit seamlessly into your busy life, allowing you to conveniently prioritize your mental health. I offer counseling, coaching, yoga therapy, and ecotherapy services to adults and couples or partners; I see teens & families on a case-by-case basis.

Let's Talk

 


letter writing

I provide single-session psychological evaluations for those in need of a letter of support, as required by insurance, for a gender affirming surgery or procedure. Because I am committed to an informed consent model of care, I only require one session to obtain this letter. Should your insurance push back or deny it, I’ll be your advocate, offering additional support at no extra charge until the letter is approved.

Get Yours

 


consultation

I offer professional consultations on topics related to gender and sexuality, including how to write letters of support for clients seeking gender affirming surgeries or procedures. I also consult with clinicians and educational organizations on autism and ADHD, especially on alternatives to behavior therapies. I also provide career coaching and consultation for those interested in pursuing a career in mental health.

ConnecT

faq & rates

  • I am both a doctoral-level licensed therapist and coach; in order to make services more accessible, I utilize a dual therapy-coaching model - meaning you can work with me no matter where you live. My background in psychology, counseling, and holistic health informs both my therapy and coaching practices, but psychotherapy is only available to clients living in Nevada or Colorado because I am bound by the jurisdiction of my license. This also means that I do not work with clients in crisis or struggling with severe mental illness (like psychosis), active suicidality, and ongoing addictions, eating disorders, or other chronic traumas, because coaching is not appropriate for those needing a high level of care; this also helps ensure safety for all clients since we are not physically in the same place when meeting. However, I regularly work with clients who have a history of addiction, eating disorders, suicidality, or other traumas, but are now removed from the immediate harms & experience of it.

  • I am an existential psychotherapist, which means I am most interested by how people making meaning in their lives, and the ways that relates to freedom, authenticity, and the anxieties that come up due to closely examining your growth edges. I utilize the strengths & abilities you already have to pull out your inner healer because I believe you can heal yourself with a little bit of guidance. In addition to traditional talk therapy, I also incorporate holistic & alternative techniques when desired and appropriate, like mind-body connection, the therapeutic use of tarot or astrology, and/or integrating your spiritual practices. I practice depth work, meaning I usually work with clients over a longer period of time to explore the past, present, and future. If you would like a more concrete definition of my approach, click here for a thorough overview of my philosophy, as written by my training institute (I am currently enrolled in a four year long training program that leads to formal certification as an Existential Analyst).

    Some excerpts from client testimonials about their experiences:

    • “The environment Sage created made me feel like I was having a candid and heartfelt chat with a friend instead of a clinical dissection of my brain, behavior, and memories. For the first time, I felt like I was seeing someone who actually understood what I was going through and was speaking from a place of experience, sensitivity, and candor.”

    • “Sage was a lighthouse for me, a sherpa at a time when I felt lost and disoriented and unsure of what I was doing, and thanks to them my life is heading in a substantially better direction.”

    • “I was going through several big, often-overwhelming changes in my career, home, and relationship life when I started working with Dr. Sage. Working with them provided me with a calm, consistent, engaging space for reflecting upon and navigating my concerns, needs, and desires. I have never been as comfortable opening up about all of myself with any mental health practitioner as I have been with Dr. Sage, and that comfort came pretty instantly. The lack of judgment and presence of support was tangible throughout our sessions.”

    • “Dr. Sage helped me come out of a really dark place in life. There was so much going on that I "couldn't see the light" and they really guided me through that darkness and helped me shift my mindset.”

  • COACHING & THERAPY:

    Individual: $250 per 45-minute session
    Partners: $300 per 60-minute session

    I do not accept insurance directly, but can provide superbills for out-of-network reimbursement.
    *In order to make the most of the momentum we build up front, I only take on therapy clients who are ready to commit to weekly (or bi-weekly) sessions. This consistency helps build up the safety and trust needed to explore what brought you in, and helps ensure we don't waste time in session just getting caught up.


    OTHER SERVICES:

    The letter writing fee is $125, which includes the letter and the evaluation session.
    *Partial scholarships are always available to gender expansive clients in need of letter writing services

    Fees for speaking, training, or events vary based on the needs of your company or organization; Please reach out directly to request a quote.

  • I'm an out-of-network provider, so you can be reimbursed through your insurance company if you have OON benefits. The main difference between being “in” and “out” of network with an insurance company is the control and influence they have on treatment. As an out-of-network provider, you are not required to have a diagnosis to see or work with me, and insurance has no say over what kind of therapy can be practiced, or for how long. This also ensures that insurance will not have access to your records, keeping things truly confidential.

    To get insurance reimbursement through your OON benefits, you still pay for sessions upfront, but then submit or upload a special receipt I'll give you (called a superbill) to your insurance; after they process the claim, they'll reimburse you for part or all of the session (typically about 50-80% of the session, meaning therapy can be as affordable as $40/session). Please note a formal diagnosis is required for superbilling, but your insurance still would not have access to your records or be able to dictate any aspect of your treatment.

    Click Here to get an instant estimate of your coverage

  • Clients often seek me out for help or guidance navigating things like coming out or starting a gender transition; understanding or seeking an adult Autism or ADHD diagnosis; beginning a life transition- like becoming a parent, changing careers, or re-locating; unpacking religious trauma or faith exploration; shifting a relationship into non-monogamy; recovering from burnout; feeling adrift or like life has lost it's purpose/meaning; moral injury; grief and loss; personal fulfillment and growth; or other issues related to identity, meaning, spirituality, trauma, and recovery.

    I work with all types of clients, but the majority of them would fall into one or more of these categories:

    • Gender, Sexuality, or Relationship Expansive

    • Adult Autism and ADHD

    • High Achievers, Academics & Perfectionists

    • Queer Spirituality and/or Religious Trauma

    • Nature Lovers

    • Artists & Creatives

    I do NOT work with clients experiencing current/ongoing suicidality, trauma, eating disorders, addictions, psychosis, and those with acute care needs or severe psychological distress. Due to the nature of telehealth, clients I work with must be able to function in their day to day lives but know they could be doing better, are looking for deep self-exploration & understanding, and/or finally feel ready to heal and unpack past traumas.

  • Therapy helps many people, but that same system also continually harms marginalized clients through pathologizing responses to trauma or oppression, and disempowers them by positioning the therapist as an expert on someone else's life. Additionally, I do not believe you need a mental health diagnosis or illness to benefit from therapy, and many of my clients come to me because they are looking for personal growth or self-exploration, which coaching allows for. People who are concerned about their privacy and confidentiality often prefer coaching, so there is nothing linking you to mental health treatment. Coaching also tends to be more concrete, time-limited, and less formal or clinical than therapy, which may be more appropriate and desirable for clients who already doing okay but could be better. Lastly, coaching helps me improve access to care because it allows me to work with clients across the globe.

  • Short answer: absolutely!

    Long answer: All modes of therapy & coaching work, but what is going to work best for you depends on your needs and priorities. Phone therapy helps lots of clients who may be dealing with dysphoria, masking (common for neurodivergent people or anyone who may feel the need to be “on” for video), and people who work primarily on/with screens - screen breaks are needed for mental & physical health, and meeting on the computer may keep you in “work mode”, preventing you from fully engaging or focusing in therapy. Phone therapy also enables you to walk, hike, stretch, or move around during sessions, either from the comfort of your home or as a long-distance form of ecotherapy. On the other hand, connecting over video gives us the opportunity to be face-to-face, which can feel more personal and grounding for some.
    *While I am happy to meet with clients by phone as a primary method when requested, I do require at least one initial video meeting to confirm your identity.

  • I have compiled a Resources page for people who want to heal own their own or can't afford therapy right now, anyone wanting more information about my approach, and for professionals looking for more information.

 

inquire

 

let's work together

new clients
Request a Consultation


general inquiries

email: sage[@]tahoetherapy.com


research collaborations
email: srian[@]saybrook.edu