Online therapy for chronic pain and migraine across Washington

How video sessions work

You can meet with me by video from anywhere in Washington, whether you live in Seattle, Tacoma or Spokane or in a small town far from any of them. All you need is a private room and a reliable connection, and the work comes to you.

What to expect in a video session

A video session is a real conversation, face to face, with the same close attention you would get in my office. Video suits the way I work: much of the work happens in the moment, as I watch for the small changes in breathing, posture, gestures and voice that show a feeling rising, and those come through clearly on screen. We begin with a 60-minute initial consultation, in which we look at your symptoms, the treatment you've had so far and what was happening in your life and relationships as they developed, and then we build a treatment plan together. From there, ongoing sessions are 60 minutes.

Session by session, you come to understand what keeps your symptoms going and practice meeting them in new ways, at a pace that works for you. Pain that has felt fixed for years can still change, and understanding why yours persists can be where that change begins.

I lead with Emotional Awareness and Expression Therapy (EAET) and also draw on Pain Reprocessing Therapy and attachment-oriented psychodynamic therapy informed by ISTDP (intensive short-term dynamic psychotherapy), and my approach explains how the three fit together. I completed the Pain Reprocessing Therapy Center's Foundational (Level I) training.

Setting up a private space

You'll need a device with a camera and microphone, a reliable internet connection and a room where you can talk freely. Privacy matters for this work, because EAET invites you to notice feelings you may have held back, such as anger or grief, and to put them into words. A room with a door you can close is ideal, and headphones keep my side of the conversation private. If others are home, let them know you need the time to yourself, and a fan or white-noise machine outside the door adds another layer of privacy.

Who online therapy suits

Online therapy suits adults anywhere in Washington who want specialized care for chronic pain, migraine or headache without a drive to an office. It suits people who live far from specialty pain care, and people for whom a long car ride is hard on a bad pain day. It also suits busy professionals, including the high-achieving people I work with, because a video session adds no travel to the hour.

Specialized care wherever you are in Washington

By video, you can choose a psychologist for their training and approach, whether you live in King County or in a rural county east of the mountains. Our work fits alongside the in-person care you receive from your own physicians.

That reach matters most in rural Washington. Chronic pain is more common outside cities across the United States, and Washington's rural counties have fewer psychologists per resident than its urban ones. In 2025, 27.9% of US adults in nonmetropolitan counties regularly experienced chronic pain, compared with 16.4% in large central metropolitan counties, according to the National Health Interview Survey. In a 2025 data brief by Woolcock and colleagues, federal provider records from January 2025 showed 37.2 psychologists per 100,000 Washington residents, with 39.7 per 100,000 in urban counties and 16.5 in rural ones. Those counts include every kind of psychologist, whatever their specialty.

Clinicians trained in particular pain therapies are fewer still. The Pain Reprocessing Therapy Center keeps a directory in which clinicians trained in its method list themselves. On October 31, 2026, it showed 23 mental health clinicians within 30 miles of Seattle, but 3 within 30 miles of Spokane, 2 within 30 miles of Yakima and 1 within 30 miles of Kennewick. For EAET, the University of Michigan's pain guide notes that few providers are specifically trained in the method. Wherever you are, from Vancouver to Wenatchee and from Olympia to the Tri-Cities, video brings specialized care to you.

Research on video therapy for chronic pain

Video therapy for chronic pain has been tested directly against in-person care. In a 2017 randomized trial in The Journal of Pain by Herbert and colleagues, 128 veterans with chronic pain received eight weeks of acceptance and commitment therapy (ACT), either by video or in person. Video sessions worked as well as in-person sessions in reducing how much pain interfered with daily life, both after treatment and six months later, and people were just as satisfied with them.

EAET, the method I lead with, has also been tested by video. In a pilot study in Clinical Gerontologist by Yarns and colleagues, 16 older veterans with chronic musculoskeletal pain had EAET entirely by video at home, in one individual session and eight group sessions. They attended nearly every session, none dropped out, and by the end of treatment 14 of the 16 had their pain drop by at least 30%, three of them by 90% or more.

Pain Reprocessing Therapy has been delivered entirely by video as well. In a 2025 pilot study by Sturgeon and colleagues, adults with fibromyalgia had three one-on-one video sessions of the therapy, and their pain fell over the following three months. Online programs have been tested too. A 2023 Cochrane review by Rosser and colleagues found 32 randomized trials of psychological therapies delivered remotely for chronic pain other than headache, and online CBT programs reduced pain at the end of treatment compared with usual care.

One smaller 2017 trial in Iran, by Chavooshi and colleagues, used the video technology of its day and found larger pain reductions when intensive short-term dynamic psychotherapy (ISTDP) was given in person.

In person in Lynnwood on Fridays

If you'd rather meet in person, I see clients on Fridays at my Lynnwood office, 5108 196th St SW, Suite 103, Lynnwood, WA 98036.

Fees

The practice is private pay and does not bill insurance, and fees are the same by video or in person. The initial consultation is $325 for 60 minutes, each ongoing session is $265 for 60 minutes, and Services and Fees lists every option.

Questions about online therapy

Can I see you by video from anywhere in Washington?

Yes. You can join from home, from work or from anywhere else in the state where you have a private room, from Bellingham to the Tri-Cities. If you travel often, mention it on the discovery call and we'll plan our sessions around it.

Is online therapy as effective as in-person therapy for chronic pain?

Video therapy can work just as well as in-person therapy for chronic pain. In a randomized trial of 128 veterans with chronic pain, acceptance and commitment therapy by video worked as well as the same therapy in person at reducing how much pain interfered with daily life, after treatment and six months later. Video also spares you the drive, which can matter most on a bad pain day, and if you prefer to meet face to face, I see clients in Lynnwood on Fridays.

Is a video session private?

Sessions take place over secure video and are held to the same standards of confidentiality and privacy as sessions in my office. On your side, a room with a closed door and a pair of headphones keep the conversation between us.

How does online therapy fit with my medical care?

It works alongside your medical care. Your physician or neurologist diagnoses your condition and manages any medication, and our work adds to that care.

Book a free discovery call

On a free discovery call, we can talk about what you're dealing with, how video sessions work and what a first appointment would involve.

Book a free discovery call

References

Chavooshi, B., Mohammadkhani, P., & Dolatshahee, B. (2017). Telemedicine vs. in-person delivery of intensive short-term dynamic psychotherapy for patients with medically unexplained pain: A 12-month randomized, controlled trial. Journal of Telemedicine and Telecare, 23(1), 133–141. https://doi.org/10.1177/1357633X15627382

Herbert, M. S., Afari, N., Liu, L., Heppner, P., Rutledge, T., Williams, K., Eraly, S., VanBuskirk, K., Nguyen, C., Bondi, M., Atkinson, J. H., Golshan, S., & Wetherell, J. L. (2017). Telehealth versus in-person acceptance and commitment therapy for chronic pain: A randomized noninferiority trial. The Journal of Pain, 18(2), 200–211. https://doi.org/10.1016/j.jpain.2016.10.014

National Center for Health Statistics. (2026). NHIS adult summary health statistics [Data set; indicator "Regularly experienced chronic pain"]. Centers for Disease Control and Prevention. https://data.cdc.gov/d/25m4-6qqq

Pain Reprocessing Therapy Center. (2026). Directory of practitioners [Mental Health Clinician, Medical Provider and Health Coach directories]. https://www.painreprocessingtherapy.com/directory-of-practitioners-new

Rosser, B. A., Fisher, E., Janjua, S., Eccleston, C., Keogh, E., & Duggan, G. (2023). Psychological therapies delivered remotely for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, 2023(8), Article CD013863. https://doi.org/10.1002/14651858.CD013863.pub2

Sturgeon, J. A., Trost, Z., Ashar, Y. K., Lumley, M. A., Schubiner, H., Clauw, D., & Hassett, A. L. (2025). Brief pain reprocessing therapy for fibromyalgia: A feasibility, acceptability, and preliminary efficacy pilot. Regional Anesthesia & Pain Medicine. Advance online publication. https://doi.org/10.1136/rapm-2025-107076

University of Michigan. (n.d.). Emotional awareness and expression therapy (EAET). Tailored Pain Guide. Retrieved October 31, 2026, from https://tailored.painguide.med.umich.edu/professional-care/therapies/eaet

Woolcock, S. C., Andrilla, C. H. A., Garberson, L. A., & Graves, J. M. (2025, August). Washington rural behavioral health workforce [Data brief]. WWAMI Rural Health Research Center, University of Washington. https://familymedicine.uw.edu/rhrc/wp-content/uploads/sites/4/2025/08/RHRC_DBAUG2025_WA_BH_Woolcock.pdf

Yarns, B. C., Molaie, A. M., Lumley, M. A., Zhu, T. A., Najafian Jazi, A., Ganz, D. A., & Melrose, R. J. (2024). Video telehealth emotional awareness and expression therapy for older U.S. military veterans with chronic pain: A pilot study. Clinical Gerontologist, 47(1), 136–148. https://doi.org/10.1080/07317115.2022.2159909