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Sessions & Fees

Sessions & Fees

Counseling and Sex Therapy Sessions are available via Telehealth

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Individual Counseling
& Sex Therapy

$150/50 min

Individual adults may seek support for concerns related to identity, sexuality, or sexual satisfaction. Clients may also seek affirming and aware support for depression, anxiety, past trauma, or life concerns. 

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Relational Counseling
& Sex Therapy
$180/50 min

Relational counseling and sex therapy are designed for couples and polycules seeking support to find a deeper and more satisfying level of intimacy and sexual satisfaction and to reconnect with passion and desire. 

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Other Services
priced by service - contact for details

  • Longer and shorter sessions

  • Sex education sessions and workshops 

  • Letter writing

  • Coaching & consultation

Please reach out with any other specific questions or requests.

Currently Accepting New Clients

Click below to be redirected to my HIPAA-compliant booking page.

Initial 50--minute sessions are available for $30.


Sex Therapy

This specialized form of therapy is designed to support a wide variety of sexual, relational, and identity concerns in a welcoming and non-judgmental way.

Individuals seeking sex therapy can be supported in navigating a range of complex concerns, from fostering a deeper connection with pleasure and desire, to supporting recovery from the impact of stigma and shame.

I also provide support for those dealing with sexual dysfunction, painful sex, or past sexual or relational traumas, offering a safe and empathetic space to explore and heal.


For couples or polycules seeking to strengthen their bonds and improve their relationships, I offer intimate partnership counseling. Whether you're dealing with specific challenges, seeking to enhance intimacy, sex, and sexuality within your relationship, or wanting to improve closeness and commitment, I'm here to provide guidance and support.

Individuals, couples, and polycules seeking support to enhance desire, explore sex-related concerns, or process complex feelings related to sex and sexuality may be helped by receiving sex therapy treatment. Our work together progresses at a pace and with a focus that respects your comfort and level of trust and readiness. Together, we can set out on a path of self-discovery and growth, empowering you nurture more meaningful and satisfying connections with yourself and intimate partners.


I also provide general counseling services for a wide range of concerns, including depression, anxiety, trauma, and adjustment to life changes. My approach is inclusive, offering support to individuals from diverse backgrounds, including those who identify as erotically marginalized (those who are LGBTQIA+, Kinky, Polyamorous, or Sex & Body Workers). Importantly, I understand that your identity does not always have to be the focal point of counseling. If it is not relevant to your current concerns, we can explore other aspects of your needs and well-being. 

For those who do not identify as erotically marginalized but are seeking generalist support, I am here to help as well. Let's connect, discuss what brought you to my practice, and explore how we can work together effectively. If my approach does not align with your needs, I am happy to assist you in finding resources that might be a better fit for you. 

Sex Education & Consultation

Whether you are seeking a one-on-one or group educational experience, high quality, adult sex education can be a liberating and enlightening experience. It may be the first time you have had the opportunity to explore your questions with a trained educator or it may be a chance to delve deep into specific areas of curiosity. Topics might include partner communication, choice and use of toys/accessories, sexual health information, setting up a sensual space, sexual mindfulness, or another topic of your choice.


Personalized sex education is integrated into sex therapy treatment and is also available as a stand-alone service for individuals and groups. 

About Services

Who can benefit from sex therapy?

Services with Karina StarkHart, LMHCA are specifically designed for adults seeking affirming, non-judgmental support. Clients interested in a deep exploration of their needs, values, and perspectives will experience the greatest benefits from any form of counseling services. 

Sex therapy can benefit anyone who wants to improve their relationship with sex and pleasure. It can be especially helpful for those who have difficulty with:

  • Intimacy issues

  • Sexual trauma

  • Body image issues

  • Communication problems about sex within a relationship

  • Mismatched sexual desire between partners

  • Sexual orientation or gender identity issues

  • Religious or cultural conflicts related to sex

  • Sexual dysfunctions, such as erectile dysfunction, premature ejaculation, vaginal dryness, or difficulty having an orgasm

  • Pain during sex

  • Low libido

Sex therapy can also be helpful for people who want to learn more about their sexuality, identity, explore new kinks or fetishes, or improve their sexual skills.

If you are experiencing any of these issues, or if you simply want to improve your sexual satisfaction, sex therapy can be a great option. 

Here are some specific examples of how sex therapy can help:

  • A couple may seek sex therapy to improve their communication about sex and to address their mismatched sexual desires.

  • An individual who has experienced sexual trauma may seek sex therapy to learn how to cope with their triggers and to develop a healthy relationship with sex.

  • Someone who is struggling with erectile dysfunction may seek sex therapy to learn relaxation techniques and to explore other ways to achieve sexual pleasure.

  • A person who is questioning their sexual orientation or gender identity may seek sex therapy to explore their feelings and to find support.

Whether you're just beginning to explore questions related to your sexuality and desire or you consider yourself an expert in this domain, my goal is to meet you where you are.

For those who are new to discussing sexual concerns, it's completely normal to feel some apprehension or fear. Your comfort and well-being are deeply important to me and I'm here to create an environment where you can open up at your own pace. On the other hand, if you're well-versed in matters of sex and are seeking a knowledgeable and understanding person to process more complex concerns with, your expertise is valued and respected.


Wherever you are starting, we will collaborate to make a plan that works for you.

All identities are welcomed and celebrated.

Who can benefit?

Additional Information


I do not accept or bill insurance directly, which allows for a higher level of privacy and control over your therapy journey. Upon request I can provide you with a "superbill," which you can submit to your insurance company for potential reimbursement. Please note that most insurance plans do not cover relational counseling or sex therapy.


Only telehealth sessions are available at this time. Clients in Washington State seeking confidential telehealth services may enjoy the privacy and flexibility to join sessions in a comfortable and familiar place. Due to limitations of ethical telehealth practices, these services are not designed to support individuals in crisis or who are experiencing advanced mental health concerns. Please view the resources page for services best designed to support your needs. 

In some cases, you or I might determine that your needs will be better supported by another clinician or in another setting. In such situations, I will work to offer you appropriate resources and referrals.

Additional Information

Schedule a First Session

If you would like to send me a confidential message or book an appointment, click below to be redirected to my HIPAA-compliant booking page.

Initial 50--minute sessions are available for $30.

*Currently accepting new telehealth clients*

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