Alexandria Steely
If psychosis, mood swings, or a diagnosis no one else wants to sit with has made it hard to find a therapist who stays, I do. Hey, I'm Alexandria. My work is rooted in one belief: symptoms make sense in context.
Therapy for psychosis and complex mental health, for clients who've been told they're too hard to help
Newly out of graduate school, I went straight to the work I wanted most. I was hired as the Intake Coordinator of a 24/7 residential program for adults living with psychosis, mood disorders, and the diagnoses society fears most. Five months later, I was promoted to Assistant Program Director. My work there laid the foundation for how I practice now, and for where my private practice started. People are never just their diagnosis. Symptoms are not character flaws, and, "what's wrong with me?" is always the wrong question. The real questions are: "what are you struggling with?" and "how is it affecting you?" In my practice, I work with teens and adults navigating complex mental health. This includes first-episode psychosis, schizophrenia spectrum disorders, bipolar disorders, as well as personality disorders. Sessions are held via telehealth across California and Washington when virtual therapy is clinically appropriate. What therapy with me can look like: a session that feels like casual talk, or a weekly vent, can actually be CBT, DBT, and solution-focused work in one, with questions that are not the obvious textbook ones, slipped in to help you think and question. Sessions are $185, self-pay, via telehealth in California and Washington when virtual therapy is clinically appropriate. I'm honest, and I've been told I'm funny. I'm a slightly blunt millennial who's seen it up close, and I'm rooted in research. But you're the expert in your story, and only you know what you've gone through.
First session
My job is about understanding you, how your mind works, what you've been dealing with, and what's actually been going on beneath the surface. You don't have to have the perfect words or a clear story. Most people don't. We'll figure it out together. Our first session is about gathering as much information as I can about you. I'll ask questions about what's bringing you into therapy currently, if you have had any history with mental health services and what your experience was like, what symptoms or problems you've been struggling with, how long it has been going on, and how it has been affecting you. My goal is to have you leave our first session with more clarity, a better understanding of yourself, and a sense of where we're going next.
Strengths
My approach? Context matters. You’re more than what has happened to you. I believe healing should come with laughter, real talk, some tears, but ALWAYS zero shame. Whether you’re learning to un-trust that b*tch anxiety or need support managing the highs and lows of life, my goal is to help you feel capable, connected and unapologetically you. I believe in taking an evidence-based approach and am always grounded in science and research, however I recognize that each individual is unique, and that their experiences and struggles are going to be as unique as they are. Here's what that actually looks like. We look at the pattern, the context it formed in, and the survival strategy underneath it, including the version of you that had to adapt. We work from the research, and we work at the level the problem actually lives at, not just the symptom of the week.
Ideal clients
My ideal client is a teen or adult navigating psychosis, bipolar disorder, or a personality disorder, and the feelings that come with all of it. Maybe you know something's off but you don't know what to talk about, or where to start. You don't have to have it figured out, and you don't have to be ready to be honest about all of it yet. You just have to be willing to get curious, and get vulnerable eventually. You don't need therapy to be soft, you need it to be real.
Treatment methods
Cognitive Behavioral (CBT)
I use CBT to help you see the connection between how your thoughts make you feel, and then what you do because of it. With psychosis, that doesn't mean arguing with what you hear, see, or believe. It means working to find solutions for what your symptoms cost you, then finding the right therapy techniques to have in your back pocket for the moments that send you. We can't stop emotions from happening, but we can decide how long an emotion is going to control us.
Psychodynamic
Psychodynamic therapy is bound to show up at some point along the therapeutic journey. It comes into play when you explore and process the emotions and experiences that are unique to you. You can begin to understand the patterns that keep repeating and identify how and where they started. A lot of what feels like a present-day problem is an old survival strategy still running the show, so we trace it back to the context it formed in and figure out what it's still trying to protect.
Dialectical Behavior (DBT)
I use DBT to help you build real skills for the moments when emotions hit hard and fast, so you have something in your back pocket instead of just reacting. It's about learning to ride out an intense feeling without letting it run the show, and getting through the worst moments without making them worse. DBT is based on CBT and was specifically created for people with Borderline Personality Disorder.
Location
Virtual sessions